5. Neisseria + Moraxella Flashcards

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1
Q

Neisseria GS

A

GNDC
Kidney bean shaped
often intracellular

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2
Q

Oxidase positives

A

Neisseria and Moraxella

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3
Q

Neisseria always considered a pathogen

A

NGON

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4
Q
A

Neisseria

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5
Q

All Neisseria are capnophiles, but —- requires CO2

A

NGON

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6
Q

Neisseria endotoxin

A

LOS

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7
Q

LOS is lacking the…

A

O antigen

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8
Q

Neisseria compete with the host for —-

A

iron

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9
Q

prevent development of NGON vaxx

A

constant alterations to pili antigens

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10
Q

Swab used for NGON collection
plate within —- hours of collection

A

rayon/dacron
6

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11
Q

NGON incubation requirements

A

35°C
3-5% CO2
humidity
up to 3 days

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12
Q

medium that selects for Neisseria

A

Thayer Martin

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13
Q

System used to grow and transport NGON, no longer used much anymore

A

JEMBEC

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14
Q

—– gives a mixed culture appearance

A

NGON

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15
Q

CTA ingredients, besides the sugar

A

cystine, peptones, phenol red pH indicator and 0.25% agar

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16
Q

GS is good for diagnosing NGON in…..

A

symptomatic males

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17
Q

why is GS no good for diagnosing females with NGON?

which other NGON infections is GS not good for?

A

Females have other GU flora organisms that mimic NGON on gram stain

pharyngeal and rectal

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18
Q

non-culture method of IDing NGON, never used for children

A

Nucleic acid amplification test (NAAT)

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19
Q

nucleic acid probe signal amplification is used on NGON in which samples?

A

urogential and conjunctival specimen swabs

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20
Q

Nucleic Acid Probe Signal Amplification turnaround time

downside

A

2 hours

must verify results, false positives occur

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21
Q

NAAT can be used on which types of samples?

A

endocervix, vagina, urethra, and urine

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22
Q

Pros and Cons of NAAT

A

Very sensitive, faster than culture, more specific, does not require viable organisms, less stringent collection and transport requirements

Expensive, some false positive results in certain settings, lack of antibiotic resistance data

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23
Q

NGON incubation

A

2-7 days

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24
Q

male vs female NGON presentation

A

male: Usually acute and symptomatic; if left untreated, 90% spontaneously resolve

female: About 50% are asymptomatic; Potential for complications if left untreated

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25
Q

pustular petechiae

A

NGON

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26
Q

What is a problem of NGON blood cultures and how do we solve it?

A

sodium polyanethol sulfonate anticoagulant is inhibitory, but if we draw at least 8 mL, it is diluted enough to recover organism.

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27
Q

prophylactic for ophthalmia neonatorum

A

1% silver nitrate drops or 0.5% erythromycin ointment

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28
Q

begins when NGON ascends into the fallopian tubes

A

pelvic inflammatory disease

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29
Q

If NGON is able to grow on BAP, it will look like…

A

tiny pinpoint

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30
Q

NGON ID methods (6)

A

CHO utilization
Enzymatic procedures
DNA probe culture confirmation
NAAT
MALDI-TOF
16sRNA gene sequencing

31
Q

super NGON is resistant to…

A

ceftriaxone and azithromycin

32
Q

NMEN grows on…

A

most non-selective media with blood

33
Q

NMEN must be handled in a ——- safety hood

A

class II

34
Q

there are —- NMEN capsule serotypes and —- is the worst one

A

13
B

35
Q

Why is serotype B the worst in NMEN?

A

Homologous to brain tissue, not immunogenic.

36
Q

Why is NMEN so pathogenic?

A

LOS
release of blebs
10-1000x more endotoxin is released than other GNs

37
Q

most common NMEN serotypes

A

A, B, C, Y, W135

38
Q

direct detection method of NMEN

A

Bacterial latex agglutination (BLAT)/Direct antigen test (DAT)

39
Q

Sx of NMEN meningitis

A

Confusion, rash, headache, fever, nuchal (neck) rigidity, vomiting, confusion, photophobia

40
Q

mortality rate for meningitis w/o sepsis

A

3-10%

41
Q

meningococcemia mortality rate and onset

A

Onset 6-8 hours
Death within 12-48 hours
50% mortality even with treatment

42
Q

complicaition of meningitis that involves the body using up all the clotting factors and then uncontrollable bleeding

A

disseminated intravascular coagulation (DIC)

43
Q

Waterhouse-Friderichsen syndrome

A

Complication of NMEN DIC
Bilateral hemorrhage of the adrenal glands

44
Q

2 populations at risk for NMEN

A

3 months to 1 year
Older teenagers and young adults

45
Q

organism that can create antibodies to NMEN

A

E. coli serotype K1

46
Q

Africa has a regional belt of —– infection from Dec to March

A

NMEN

47
Q

NMEN serotypes that the vaccine covers

A

A, C, Y and W135

48
Q

saprophytic

A

nonpathogenic

49
Q

some nonpathogenic Neisseria species produce a —— pigment

A

xanthochromic
(yellow)

50
Q

—— and —— will grow on TM (not NGON or NMEN)

——- will only grow on initial isolation

A

N. lactamica and M. catarrhalis

N. cinerea

51
Q

——– can be mis-IDed as NGON with rapid enzyme tests

why?

A

N. cinerea

Carbonic acid created from the production of carbon dioxide can result in a weak acid reaction

52
Q

butyrate esterase allows MCAT to hydrolyze….

A

indoxyl-butyrate

53
Q

3 most common causes of otitis media

A

M. catarrhalis
S. pneumoniae
H. influenzae

54
Q

COPD is a risk factor for ——- infection & pneumonia

A

MCAT

55
Q

Intracellular GNDC in a lower resp sample could be ——-, while extracellulars could be ——-

A

MCAT
Neisseria normal flora

56
Q

Why do antibiotics make NMEN patients worse at first?

A

Cell lysis releases LOS endotoxin

57
Q

4 antibiotics in TM agar and what they inhibit

A

Vancomycin—GPC (and 10% of NGON)
Anisomycin—yeasts
Trimethoprim—Proteus swarming
Colistin—GNRs and normal flora Neisseria

58
Q

oxidase reagents

A

Tetra-methyl-para-phenylenediamine dihydrochloride

Dimethyl-para-phenylenediamine dihydrochloride

59
Q

wait —– for Mcat disc to change color

A

2 mins

60
Q

NGON clinical significance (7)

A

gonorrhoea
septic arthritis
ophthalmia neonatorum
pelvic inflammatory disease
proctitis
pharyngitis
tonsilitis

61
Q

NMEN clinical significance (2)

A

meningitis
meningococcemia

62
Q

nonpathogenic Neisseria are rare causes of…

A

endocarditis

63
Q

N. cinerea clinical significance

A

proctitis

64
Q

MCAT clinical significance

A

otitis media
bronchitis
pneumonia
acute maxillary sinusitis

65
Q

NGON glucose-maltose-sucrose-lactose

A

POS neg neg neg

66
Q

NMEN glucose-maltose-sucrose-lactose

A

POS POS neg neg

67
Q

NLAC glucose-maltose-sucrose-lactose

A

POS POS neg POS

68
Q

NMUC glucose-maltose-sucrose-lactose

A

POS POS POS neg

69
Q

NSIC glucose-maltose-sucrose-lactose

A

POS POS POS neg

70
Q

NCIN glucose-maltose-sucrose-lactose

A

neg neg neg neg

71
Q

MCAT glucose-maltose-sucrose-lactose

A

neg neg neg neg

72
Q

only positive DNAse

A

MCAT

73
Q

GNDC with B-lactamase

A

NGON
MCAT
screen the others

74
Q

clue that otitis media might be caused by MCAT

A

no susceptibility to B-lactams