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BACTERIOLOGY > B3.2 NEISSERIA GONORRHEAE (GONOCOCCOCI) > Flashcards

B3.2 NEISSERIA GONORRHEAE (GONOCOCCOCI) Flashcards

1
Q

What are the Gram stain characteristics of Neisseria gonorrhoeae?

A

Gram-negative diplococci.

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2
Q

Does Neisseria gonorrhoeae ferment glucose?

A

Yes

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3
Q

Is Neisseria gonorrhoeae part of the human microbiota?

A

No

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4
Q

What type of agar does Neisseria gonorrhoeae require for growth?

A

Enriched chocolate agar plate (CAP).

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5
Q

How is Neisseria gonorrhoeae transmitted?

A

Sexual contact

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6
Q

What body sites are primarily affected by Neisseria gonorrhoeae?

A

Urethra, endocervix, anal canal, pharynx, and conjunctiva.

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7
Q

List the virulence factors of Neisseria gonorrhoeae.

A

Common pili
Outer membrane proteins (I, II, III, and LOS)
Receptors for human transferrin (iron acquisition)
IgA protease

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8
Q

What is the principal virulence factor of Neisseria gonorrhoeae?

A

Common pili

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9
Q

What is the function of common pili in Neisseria gonorrhoeae?

A

Attachment to human mucosal cells
Invasion of host cells
Survival by inhibiting phagocytosis in neutrophils

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10
Q

What is the difference between T1-T2 and T3-T5 gonococcal strains?

A

T1-T2: Possess pili, virulent, small dome-shaped colonies.
T3-T5: Lack pili, avirulent, larger flatter colonies.

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11
Q

Mediates tissue damage and elicits an inflammatory response in Neisseria gonorrhoeae?

A

LOS endotoxin

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12
Q

Protects against the host’s inflammatory response and serum complement-mediated killing.

A

porB

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13
Q

Adherence to phagocytic and epithelial cells in Neisseria gonorrhoeae

A

Protein II (Opa)

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14
Q

What does Protein III (Rmp) do in Neisseria gonorrhoeae?

A

Blocks the bactericidal effect of host IgG

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15
Q

What enzyme in Neisseria gonorrhoeae cleaves IgA on mucosal surfaces?

A

IgA protease

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16
Q

How does Neisseria gonorrhoeae acquire iron for survival?

A

Through receptors for human transferrin

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17
Q

A pyogenic infection of non-ciliated columnar and transitional epithelium; incubation period is 2-7 days.

A

gonorrhea

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18
Q

List down the related infections and diseases caused by Neisseria gonorrhoeae

A

Gonorrhea
Ophthalmia neonatorum
Gonorrheal arthritis-dermatitis syndrome

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19
Q

What is the origin of the term “gonorrhea”?

A

Greek words gonos (“seed”) and rhoia (“flux”), meaning “flow of seed.

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20
Q

What is the colloquial term for gonorrhea, and where does it originate?

A

“Clap,” from the French word clapoir (“brothel”).

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21
Q

What are the symptoms of gonorrhea in men?

A

Purulent discharge and dysuria.

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22
Q

What are the symptoms of gonorrhea in women?

A

Dysuria and vaginal bleeding

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23
Q

List down complications under gonorrhea.

A

Joints: Arthritis
Heart: Endocarditis
Meninges: Meningitis
Eyes: Ophthalmia
Other parts: Pharynx, rectum

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24
Q

What body sites are commonly affected by gonorrhea?

A

Endocervix, conjunctiva, pharyngeal surfaces, anorectal area, and urethra.

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25
Q

What are complications of gonorrhea in men?

A

Prostatitis
Epididymitis

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26
Q

What are complications of gonorrhea in women?

A

Pelvic inflammatory disease (PID)

Cervicitis
Vaginal discharge

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27
Q

Pelvic inflammatory disease (PID)
Can cause

A

sterility, ectopic pregnancy, or Fitz-Hugh-Curtis syndrome (perihepatitis).

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28
Q

A type of perihepatitis caused by pelvic inflammatory disease (PID)

A

Fitz-Hugh-Curtis syndrome

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29
Q

Chief complaint in asymptomatic oropharyngeal infections

A

pharyngitis

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30
Q

Infection in the anorectal area.
Symptoms: Discharge, rectal pain, or bloody stools.

A

rectal gonorrhea

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31
Q

Gonococcal eye infection acquired during vaginal delivery through an infected birth canal

A

ophthalmia neonatorum

32
Q

What are the consequences of untreated ophthalmia neonatorum?

A

Blindness if not treated immediately

33
Q

What are the methods of preventing ophthalmia neonatorum?

A

Tetracycline
Erythromycin
Povidone-iodine
Silver nitrate (dilute solution or 1% Crede’s prophylaxis)

34
Q

What is Crede’s prophylaxis for preventing ophthalmia neonatorum?

A

1-2 drops of 1% silver nitrate solution in the eyes of newborns

35
Q

What is the most common manifestation of disseminated gonococcal disease?

A

Gonorrheal arthritis-dermatitis syndrome

36
Q

What are the symptoms of gonorrheal arthritis-dermatitis syndrome?

A

Fever.
Chills.
Malaise.
Intermittent bacteremia.
Polyarticular arthritis or tenosynovitis.
Skin lesions.

37
Q

What joints are commonly affected in gonorrheal arthritis-dermatitis syndrome

A

Wrist.
Knee.
Ankle.

38
Q

List down the laboratory diagnostic methods for N. gonorrhoeae.

A

Direct gram staining.
Culture.
Biochemical tests.
Immunoserologic identification.
Molecular assays.
Antimicrobial susceptibility testing.

39
Q

What specimens are collected for diagnosing Neisseria gonorrhoeae?

A

Urethral, cervical, anal canal, oropharyngeal, and skin lesion swabs.
Inflamed joint fluid and blood samples.
Eye discharge swabs

40
Q

Which swabs are inhibitory to Neisseria gonorrhoeae?

A

Calcium alginate and cotton swabs.

41
Q

What type of swabs are preferred for specimen collection?

A

Dacron or rayon swabs

42
Q

What transport media can be used for Neisseria gonorrhoeae specimens?

A

Amies medium with charcoal
JEMBEC plates
Transgrow
Gono-Pak
Bio-Bag

43
Q

What is the special feature of the JEMBEC system for transporting Neisseria gonorrhoeae?

A

Contains MTM medium and a CO₂-generating tablet (sodium bicarbonate + citric acid).

44
Q

What substance inhibits Neisseria gonorrhoeae in sodium polyanethol sulfonate (SPS)?

A

SPS concentrations above 0.025%.

45
Q

List down the selective culture media for Neisseria gonorrhoeae

A

CAP (Chocolate Agar Plate).
TMA (Thayer-Martin Agar).
MTM (Modified Thayer-Martin).
ML (Martin-Lewis).
NYC (New York City).
GC-Lect.

46
Q

What are the colony characteristics of Neisseria gonorrhoeae on CAP?

A

Small, grayish to tan, convex, translucent, shiny colonies with smooth or irregular margins

47
Q

What are the advantages of NYC medium over other media?

A

Supports the growth of Mycoplasma hominis and Ureaplasma urealyticum.

48
Q

Which selective media inhibit swarming Proteus spp.?

A

Modified Thayer-Martin medium (MTM) (contains trimethoprim lactate).
GC-Lect medium (contains trimethoprim).

49
Q

Which colony types are associated with virulent Neisseria gonorrhoeae strains?

A

T1 and T2: Smaller, raised, and bright colonies.

50
Q

What does a Gram stain showing >5 PMNs/field but no bacteria indicate?

A

Nongonococcal urethritis (e.g., caused by Chlamydia trachomatis or Ureaplasma urealyticum)

51
Q

Why should pharyngeal specimens not be Gram-stained for N. gonorrhoeae

A

Pharyngeal flora can complicate interpretation, leading to unreliable results

52
Q

What is the best method for direct Gram staining of body fluids

A

Use of a cytocentrifuge

53
Q

A transport and culture system for N. gonorrhoeae.
Contains:
MTM medium.
CO2-generating tablet (sodium bicarbonate + citric acid).

A

JEMBEC system

54
Q

What is the presumptive identification test for N. gonorrhoeae

A

Oxidase test.

55
Q

What is the reagent used in the oxidase test for Neisseria gonorrhoeae

A

1% dimethyl-p-phenylenediamine dihydrochloride

tetramethyl-p-phenylenediamine dihydrochloride

56
Q

What is the positive result of the oxidase test for Neisseria gonorrhoeae?

A

Purple color within 10 seconds

57
Q

What is the traditional method for carbohydrate utilization in N. gonorrhoeae

A

Use of cysteine trypticase soy agar (CTA) with 1% specific carbohydrate and phenol red as a pH indicator.

58
Q

What carbohydrate does Neisseria gonorrhoeae ferment?

A

Glucose only

59
Q

What reagent is used in the superoxol test for Neisseria gonorrhoeae?

A

30% hydrogen peroxide.

60
Q

What is the result of the superoxol test for Neisseria gonorrhoeae?

A

Vigorous bubbling

61
Q

A rapid screening test for N. gonorrhoeae

A

Limulus test

62
Q

What does a positive DNAse test indicate

A

Positive: Moraxella spp.
Negative: Neisseria spp.

63
Q

What is the nucleic acid amplification test (NAAT) used for in Neisseria gonorrhoeae diagnosis?

A

Detects gonococcal antigen or nucleic acid directly in specimens.

64
Q

What specimens are used for NAAT?

A

Endocervical or urethral swabs; urine

65
Q

What is the limitation of the chemiluminescent nucleic acid probe?

A

Not approved for pharyngeal or rectal specimens; cannot identify beta-lactamase-producing strains.

66
Q

What are particle agglutination methods used for identifying N. gonorrhoeae?

A

Phadebact GC OMNI Test
MicroTrak Culture Confirmation Test
GonoGen II Test

67
Q

Coagglutination assay with S. aureus cells coated with antibodies.

A

Phadebact GC OMNI Test

68
Q

Uses FITC-antibody.

A

MicroTrak Culture Confirmation Test

69
Q

Colorimetric test with antibodies adsorbed to metal sol particles

A

GonoGen II Test

70
Q

Highly specific and sensitive, using monoclonal antibodies to recognize epitopes on the outer membrane protein (Por) of N. gonorrhoeae.

A

fluorescent antibody tests (FAT)

71
Q

What does ELISA (Gonozyme) detect?

A

Direct detection of gonococcal antigen in specimens.

72
Q

What is the advantage of NAAT?

A

Simultaneously detects Chlamydia trachomatis.
Less sensitive to transport and storage conditions.

73
Q

What does the chemiluminescent nucleic acid probe detect

A

Gonococcal rRNA in genital and conjunctival specimens (1–2 hours).

74
Q

What is the preferred medium for AST of N. gonorrhoeae

A

Gonococcal (GC) agar

75
Q

What are the preferred methods for AST?

A

Disk diffusion or agar dilution (MIC).

76
Q

What is an alternative method for AST?

A

E-test

77
Q

What antibiotics are effective against N. gonorrhoeae?

A

Extended-spectrum cephalosporins and quinolones.

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