Module 5 Bacteriology Part 6: N. gonorrhoeae

Neisseria

it is an aerobic, gram-negative, non-motile diplococcus.

kidney bean shaped

Neisseria culture

sheep blood agar, chocolate agar

selective media: modified Thayer-Martin agar, Martin-Lewis agar, GC-Lect agar, and New York City medium

kidney bean shaped

individual cocci

Pili (fimbriae)

they enhance attachment to host cells and resistance to phagocytosis

Por protein

it forms pores in the surface; prevent fusion of phagosome with lysosome

Opa (opacity) proteins

adhesion and gonococci

Rmp (protein IIII)

reduction modifiable protein; it associates with Por protein

Lipooligosaccharide (LOS)

has endotxin

Gonorrhea for men

urethritis, with yellow, creamy pus, and painful urination

Gonorrhea for women

primary infection is in the endocervix and extends to the urethra and vagina, giving rise to mucopurulent discharge

Local

gonorrhea

Ascending

Pelvic Inflammatory Disease (PID), salpingitis

Skin lesions

(especially hemorrhagic papules and pustules) on the hands, forearms, feet, and legs

Tenosynovitis and suppurative arthritis

usually of the knees, ankles, and wrists

Gonococcal ophthalmia neonatorum

an

infection of the eye in newborns.

Neonatal infections

Gonococcal ophthalmia neonatorum

Prevention: Neonatal infections

instillation of erythromycin ointment

Treatment: Uncomplicated genital or rectal infections

Ceftriaxone (250 mg) IM and azithromycin (1g) orally

Treatment: Patient with azithromycin allergy

doxycycline (10mg orally, twice daily for 7 days)

Alternative treatment

400 mg single dose of cefixime orally with azithromycin (1 g, orally, single dose)