Module 9- Gram Negative Cocci

human

Neisseria can only be transmitted from human to ______

meningitidis

N. ________ is the causative agent of meningitis

pneumoniae, negative

Meningitis in adults can be caused by :

-strep __________ (gram pos)

- N. Meningitidis (gram ____ )

- Hemophilus infuenzae

agalactiae, positive

Meningitis in kids is most commonly cause by strep. _________ (group B strep)(gram ____)

CSF

Meningitis is identified inside ______ (usually doctor will do spinal tap)

bacterial meningitis

inflammation of the protective membranes covering the brain and spinal cord caused by various types of bacteria

gram stain (to make an educated guess on what antibiotic to use)

What is the first test a doctor will ask for when meningitis is suspected?

gonorrhoeae

N. ________ is the causative agent of gonorrhea

nonpathogenic, upper

There are other species of neisseria, but most are ______ and part of normal flora in ______ respiratory tract

fastidious, 37, CO2

Neisseria is _________ and is optimized at _____ degrees C, dies in the cold temps, and wants MORE ______

delay

it is important to not ________ the culture of neisseria after the sample is collected (very sensitive to environmental factors-- drying, chilling, sun, pH)

Thayer- Martin , VCN agar

What are the two CHOCOLATED (boiled blood) based augar medias that isolate growth of pathogenic Neisseria?

jembec system

is a transport direct plating of N gonorrhoeae.

- Chocolate based agar is mixed w/ specimen.

- put in impermeable plastic bag with a bicarbonate-sodium citrate pellet to generate a carbon dioxide rich environment.

kidney, negative

For lab diagnosis, Pathogenic Neisseria MUST:

- grow on Thayer Martian agar or VCN

AND

- have gram stain that is _______ shaped, gram _____ diplococci

Oxidase

A Neissera will be _________ positive (looks dark purple)

CTA (cystine triptic agar)

biochemical test where sugars used to differentiate Neisseria

gonorrhoeae

N. _________ is ONLY glucose positive (yellow)

meningitidis

N. _________ is glucose and MALTOSE positive

antibiotics kill competing bacteria

What makes Thayer-Martin and VCN media selective for pathogenic Neisseria?

Kids, elderly

In what age groups is meningitidis more fatal? (b/c of lower immunity)

capsule

N. meningitidis has a _______ that inhibits phagocytosis

greater

All gram negative bacteria have endotoxin, but N. Meningitidis has 100- 1,000 times ________ than normal

heart, leakage

Endotoxin targets the _______ and is able to cause blood vessel _______ because it separates cell junctions

airborne droplets, nasopharnyx

N. Meningitidis is transmitted by ________ _______that are carried by the __________

antibodies

________ that are in the blood of infants was probably acquired by the placenta (from 6-24 months-- unable to make their own)

upper respiratory, nasopharynx

For N. meningitidis most bacteria enter via the ______ ________ tract, most infections stop in the ____________, --> so host becomes asymptomatic carrier

gonorrhoeae; 20-24

What is the most prevalent sexual disease and what age group has the highest incidence of infection?

Waterhouse-Friderichsen syndrome

- a severe meningococcal infection

- happens suddenly and intensely

- BLEEDING ADRENALS

- fatal if not treated

(hemorrhage of skin, mucous membranes, severe headache, rapid progression)

slight

_______ N. meningitidis--

- mild febrile disease- can be accompanied by pharyngitis

moderate

________ N. meningitidis--

- systemic disease characterized by fever, exhaustion

severe

________ N. meningitidis--

- abrupt onset, headache, stiff neck, fever, pinpoint hemorrhage that turns into larger hemorrhaged areas

petechial rash

Red or purple discolorations on the skin that do not blanch (lighten) on applying pressure (a sign of meningitis)

meningitis

inflammation of the meninges of the brain and spinal cord (can happen with severe N. Men.)

septicemia

bacterial infection in the blood (can happen with severe N. Men.)

arthritis

inflammation of a joint (can happen with severe N. Men.)

paricarditis

inflammation of the pericardium (can happen with severe N. Men.)

disseminated intravascular coagulation (DIC)

abnormal blood clotting in small vessels throughout the body that cuts off the supply of oxygen to distal tissues, resulting in death (always SECONDARY problem)

85%, 10

Mortality for N. Meningitidis is ______ is untreated and ______ % if treated early

deafness, CNS damage, necrosis, blindness

What are some examples of complications that can happen after having meningitis?

penicillin, azithromycin, ceftriaxone

previously treatment for N. meningitidis was ________ and now b/c of resistance it is a combo of _____________ and _____________

antimicrobial prophylaxis

The use of antimicrobial drugs (like rifampin--kids) to prevent infection (kills it in the carrier state)

polysaccharide vaccine

made from molecules in pathogen's capsule; used for prevention of N. meningitidis (type of immunization)(safe and highly immunogenic)

burning urine, yellow pus discharge

What is the common manifestation of N. gonorrhoeae ?

male, pee pee, yellow

N. gonorrhoeae in _______ -->

- 25% chance of getting it during unprotected sex

- 10% asymptomatic-- MOST= burning during _______ with _______ pus discharge

urethral stricture, sterility, sealing of vas deferens with scar tissue

Some complications of N. gonorrhoeae in males include??

females

N. gonorrhoeae in _______ -->

- 20-80% may be asymptomatic

- burning/frequency of urination

- discharge, fever, abdomen pain

pelvic inflammatory disease (PID), sterility

What is the biggest complication of N. gonorrhoeae in females?

ectopic pregnancy

implantation of the fertilized egg in any site other than the normal uterine location

scar tissue blockage-- ectopic pregnancy, scar tissue closes off lumen

What are the two pathways that N. gonorrhoeae can cause sterility in females?

gonococcal ophthalmia neonatorum

Blindness in infants from gonococcal contamination through the birth canal

1% silver nitrate/ or antibiotic ointment

What solution is applied to prevent blindness in infants that have conjunctivitis from infant gonorrhea (from mother's vajj)

neonatal gonococcal arthritis

-highly destructive form of arthritis

-acute arthritis with onset at 1-4 weeks of life

gonorrheal vulvovaginitis

-usually occurs in older children (girls 2-8 years of age)

-frequently occurs in cases of suspected sexual abuse

-may cause sterility

true

True/False: A direct gram stain of male urethral discharge positive for gram negative diplococci is diagnostic of N. gonorrhoeae

false (further testing required)

True/False: A direct gram stain of female urethral discharge positive for gram negative diplococci is diagnostic of N. gonorrhoeae

penicillin

What is the drug for N. gonorrhoeae?

Moraxella catarrhalis

can cause:

- otitis media and sinusitis in children

- lower respiratory tract infection in adults

(more common if underlying conditions are present)

pili (bacterial velcro)

What is the only pathogenic determinant for N. gonorrhoeae?