Neisseria and Moraxella

Neisseria (general)

-aerobic

-gram neg

-diplococi

-flora: upper respiratory, urogenital

elongata, bacilliformis

Neisseria are:

-catalase: neg

-rods

weaveri

-catalase: pos

-rods

iron, CO2 (5-10%)

required for Neisseria growth

human transferrin receptors

Neisseria virulence factor competes for iron binding

capsule

N. meningitidis virulence factor

-prevents phago

Neisseria virulence factors

-human transferrin receptors

-capsule (meningitidis)

-pili (fimbriae)

-MOMP: proteins I, II, III (porA/B, opa, )

-LOS (endotoxin)

-IgA protease

IgA protease

Neisseria virulence factor cleaves IgA on mucosal surfaces

LOS

Neisseria endotoxin

humans

natural Neisseria gonorrhoeae host

sexual contact

how Neisseria gonorrhoeae primarily spread (state reported)

arginine, hypoxanthine, uracil (AHU)

-Neisseria streain

-isolated with nutritional requirements

-related to disseminated infections

-nutritional req: arginine, hypoxanthine, uracil

male n gon

-2-7 days inc

-95% symptomatic

-acute urethritis, dysuria, urethral discharge

-epididymitis, urethral stricture, prostatitis

female n gon

-50% asymptomatic

-pelvic inflamm disease (perihepatitis possible, Fitz-Hugh-Curtis synd)

-commonly endocervical inf

-disseminated (arthritis)

-sterility

-ectopic preg

disseminated

-rare gonococcal disease

-blood borne

-arthritis

-commonly AHU strains

-gelatin to culture (SPS kills)

sodium polyanethol sulfonate (SPS)

-inhibits N. gonorrhoeae

-blood culture medium media

-gelatin to neutralize

arthritis

-N. gonorrhoeae inf

-purulent infection

-disseminated gonococcal bacteremia

pharyngitis, anorectal

extra-genital N. gonorrhoeae inf

opthalamis neonatorum (eyes)

-N. gonorrhoeae inf in newborns

-vaginal delivery

-prevent inf w eyedrops: erythromycin, silver nitrate

erythromycin, silver nitrate

eye drops to prevent N. gonorrhoeae inf in newborns

rayon, Dacron

swab used to collect N. gonorrhoeae

Aimes w charcoal

N. gonorrhoeae transport medium

-provides CO2 atmosphere

culture media (N. gonorrhoeae)

-Thayer-Martin media

-JEMBEC (modif TMM)

-Martin Lewis

-NYC

-GC-Lect

3-5

% CO2 for N. gonorrhoeae culture

6

collection to culture time of N. gonorrhoeae (hrs)

Aptima

swab or urine tube for PCR sample of N. gonorrhoeae

women

men/women N. gonorrhoeae inf requires confirmatory testing if direct gram stain has gram neg, kidney bean diplococci

72

hrs for full N. gonorrhoeae colony growth

penicillin disk

differentiates N. gonorrhoeae gram neg diplococci from gram neg rods (likely Kingella)

superoxol test

-30% hydrogen peroxide

-N. gonorrhoeae only pos

carbohydrate utilization test (CTA)

-cystine trypticase, semisold agar, sugar

-glucose, maltose, lactose, sucrose

-DNase

-yellow: pos

g

pos CTA for N. gonorrhoeae

phenol red

indicator for CTA

beta lactamase

enzyme responsible for N. gonorrhoeae penicillin resistance

-test: API NH, RapID NH, QuadFerm

MOMP (Por)

fluorescent monoclonal Ab recognize epitopes on N. gonorrhoeae

ceftriaxone, azithromycin

drug combo used to treat gonorrhoea and chlamydia

Neisseria meningitidis

-flora: upper resp

-capsule to inhibit phago, has serogroups

-cytospin gram stain from CSF: gram neg diplococci, intra and extracellular

-SBA and choc

-penicillin: S

-CTA: glucose, maltose

-BSC II

II

biosafety cabinet class to work with N. meningitidis

SBA, choc

media to culture N. meningitidis

CSF

pathogenic N. meningitidis location

penicillin

N. meningitidis drug treatment

3rd gen cephalosporins (ceftazidime, ceftriaxone, cefixime)

used to treat meningococcemia

rifampin, sulfonamide

treat household or medical contacts of meningitis or menigococcemia patients

N. meningitidis

disseminated infection causes Waterhouse-Friderichsen syndrome (purpura rash, DIC, death)

g, m

N. meningitidis CTA sugars

N. lactamica

-nasopharynx of infants and children <2

-CTA: glucose, maltose, lactose

g, m, l

N. lactamica CTA

Moraxella catarrhalis

-gram neg diplococci, kidney bean

-flora: nasopharynx, conjunctiva, eyelid

-SBA, choc

-butyrate enzyme: pos

-CTA: neg

-DNase: pos

-treat: fluoroquinolones, SXT/TMP (bactram), clarithromycin, beta-lactam combo (amox/clav)

butyrate enzyme, DNase

enzymes specific to M. cararrhalis

neg

M. catarrhalis CTA

SBA, choc

media for M. catarrhalis culture

IB

pos test differentiates M. catarrhalis from Neisseria (IB/BGAL/GGA/PRO)

BGAL, PRO

N. lactamica pos tests (IB/BGAL/GGA/PRO)

GGA

pos test differentiates N. meningitidis from other Neisseria (IB/BGAL/GGA/PRO)