B3.2 NEISSERIA GONORRHEAE (GONOCOCCOCI) Flashcards by 횐호 강

What are the Gram stain characteristics of Neisseria gonorrhoeae?

Gram-negative diplococci.

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Does Neisseria gonorrhoeae ferment glucose?

Yes

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Is Neisseria gonorrhoeae part of the human microbiota?

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What type of agar does Neisseria gonorrhoeae require for growth?

Enriched chocolate agar plate (CAP).

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How is Neisseria gonorrhoeae transmitted?

Sexual contact

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What body sites are primarily affected by Neisseria gonorrhoeae?

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

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List the virulence factors of Neisseria gonorrhoeae.

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

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What is the principal virulence factor of Neisseria gonorrhoeae?

Common pili

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What is the function of common pili in Neisseria gonorrhoeae?

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

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

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

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

LOS endotoxin

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

porB

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Adherence to phagocytic and epithelial cells in Neisseria gonorrhoeae

Protein II (Opa)

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

Blocks the bactericidal effect of host IgG

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What enzyme in Neisseria gonorrhoeae cleaves IgA on mucosal surfaces?

IgA protease

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How does Neisseria gonorrhoeae acquire iron for survival?

Through receptors for human transferrin

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

gonorrhea

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List down the related infections and diseases caused by Neisseria gonorrhoeae

Gonorrhea
Ophthalmia neonatorum
Gonorrheal arthritis-dermatitis syndrome

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What is the origin of the term “gonorrhea”?

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

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

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

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What are the symptoms of gonorrhea in men?

Purulent discharge and dysuria.

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What are the symptoms of gonorrhea in women?

Dysuria and vaginal bleeding

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List down complications under gonorrhea.

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

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What body sites are commonly affected by gonorrhea?

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

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What are complications of gonorrhea in men?

Prostatitis Epididymitis

What are complications of gonorrhea in women?

Pelvic inflammatory disease (PID) Cervicitis Vaginal discharge

Pelvic inflammatory disease (PID) Can cause

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

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

Fitz-Hugh-Curtis syndrome

Chief complaint in asymptomatic oropharyngeal infections

pharyngitis

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

rectal gonorrhea

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

ophthalmia neonatorum

What are the consequences of untreated ophthalmia neonatorum?

Blindness if not treated immediately

What are the methods of preventing ophthalmia neonatorum?

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

What is Crede’s prophylaxis for preventing ophthalmia neonatorum?

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

What is the most common manifestation of disseminated gonococcal disease?

Gonorrheal arthritis-dermatitis syndrome

What are the symptoms of gonorrheal arthritis-dermatitis syndrome?

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

What joints are commonly affected in gonorrheal arthritis-dermatitis syndrome

Wrist. Knee. Ankle.

List down the laboratory diagnostic methods for N. gonorrhoeae.

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

What specimens are collected for diagnosing Neisseria gonorrhoeae?

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

Which swabs are inhibitory to Neisseria gonorrhoeae?

Calcium alginate and cotton swabs.

What type of swabs are preferred for specimen collection?

Dacron or rayon swabs

What transport media can be used for Neisseria gonorrhoeae specimens?

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

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

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

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

SPS concentrations above 0.025%.

List down the selective culture media for Neisseria gonorrhoeae

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

What are the colony characteristics of Neisseria gonorrhoeae on CAP?

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

What are the advantages of NYC medium over other media?

Supports the growth of Mycoplasma hominis and Ureaplasma urealyticum.

Which selective media inhibit swarming Proteus spp.?

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

Which colony types are associated with virulent Neisseria gonorrhoeae strains?

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

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

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

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

Pharyngeal flora can complicate interpretation, leading to unreliable results

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

Use of a cytocentrifuge

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

JEMBEC system

What is the presumptive identification test for N. gonorrhoeae

Oxidase test.

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

1% dimethyl-p-phenylenediamine dihydrochloride tetramethyl-p-phenylenediamine dihydrochloride

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

Purple color within 10 seconds

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

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

What carbohydrate does Neisseria gonorrhoeae ferment?

Glucose only

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

30% hydrogen peroxide.

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

Vigorous bubbling

A rapid screening test for N. gonorrhoeae

Limulus test

What does a positive DNAse test indicate

Positive: Moraxella spp. Negative: Neisseria spp.

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

Detects gonococcal antigen or nucleic acid directly in specimens.

What specimens are used for NAAT?

Endocervical or urethral swabs; urine

What is the limitation of the chemiluminescent nucleic acid probe?

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

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

Phadebact GC OMNI Test MicroTrak Culture Confirmation Test GonoGen II Test

Coagglutination assay with S. aureus cells coated with antibodies.

Phadebact GC OMNI Test

Uses FITC-antibody.

MicroTrak Culture Confirmation Test

Colorimetric test with antibodies adsorbed to metal sol particles

GonoGen II Test

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

fluorescent antibody tests (FAT)

What does ELISA (Gonozyme) detect?

Direct detection of gonococcal antigen in specimens.

What is the advantage of NAAT?

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

What does the chemiluminescent nucleic acid probe detect

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

What is the preferred medium for AST of N. gonorrhoeae

Gonococcal (GC) agar

What are the preferred methods for AST?

Disk diffusion or agar dilution (MIC).

What is an alternative method for AST?

E-test

What antibiotics are effective against N. gonorrhoeae?

Extended-spectrum cephalosporins and quinolones.