ICL 2.14: Neisseria & Moraxella Flashcards
what’s the microbiology of neisseria?
gram (-) coccus
what’s the microbiology of moraxella?
gram (-) coccus
rate these bacteria from leads to most invasive:
N. meningitis (commensal)
N. gonorrhoeae/M. catarrhalis
N. meningitis (N. meningitis)
the most nontoxic, highly invasive and causes damage from immune system: N. meningitis (pathogenic)
then N. gonorrhoeae/M. catarrhalis
then lease invasive is n. meningitis (commensal)
what are the 3 genera in the Neisseriaceae family?
- Neisseria
- Eikenella
- Kingella
where in the body is Eikenella usually found?
E. corrodens is normal inhabitant of upper respiratory tract – fastidious and rarely pathogenic
it’s an opportunistic pathogen that most often causes disease after wounding during fistfights or by human bite
they’re also are sometimes associated with neck cancer and endocarditis
where in the body is Kingella usually found?
K. kingae is normal inhabitant of upper respiratory tract
although normally fastidious and non-pathogenic, can disseminate to cause arthritis or endocarditis – much less common in respiratory tract infections
which species of the Neisseria genus are in humans?
- N. gonorrhoeae
2. N. meningitidis
what kind of pathogens are N. gonorrhoeae and N. meningitidis?
opportunistic pathogens
human host
what are the disease syndromes associated with N. gonorrhoeae?
- gonorrhea
- disseminated disease = purulent arthritis, pustular rashes, fever and rigor
- conjunctivitis
what are the disease syndromes associated with N. meningitidis?
- meningitis
- meningococcemia – Waterhouse-Friderichsen syndrome
- pneumonia
- arthritis
- urethritis
what is Waterhouse-Friderichsen syndrome?
massive, usually bilateral, hemorrhage into the adrenal glands caused by fulminant miningococcemia
WFS is characterised by overwhelming bacterial infection, rapidly progressive hypotension leading to shock, disseminated intravascular coagulation (DIC) with widespread purpura, particularly of the skin, and rapidly developing adrenocortical insufficiency associated with massive bilateral adrenal hemorrhage
what is the microbiology of Neisseria?
aerobic, non-motile gram (-) cocci
oxidase and catalse positive
usually in pairs = diplococci; adjacent sides are flattened together like coffee beans (really does look like coffee beans)
how are N. gonorrhoeae and N. meningitidis related?
they’re closely related
> 80% amino acid similarity
12% of the genes showed no significant homology
in what media do N. gonorrhoeae grow in?
requires complex media and controlled conditions for growth (chocolate or Thayer-Martin agar)
what is difference in the pathogenesis of N. gonorrhoeae and N. meningitidis?
mechanisms for pathogenesis by N. gonorrhoeae and N. meningitidis are virtually the same and share many virulence factors
the major difference is that N. meningitidis has a capsule, but not N. gonorrhoeae
what role do pili play in N. gonorrhoeae and N. meningitidis?
both posses multiple types of pili that mediate different functions
type IV pilus allows initial binding to CD46 on surface of non-ciliated epithelial cells – it has multiple subunits that confer extension, adhesion and contraction
pilus then contracts to bring bacteria close to host cell
Neisseria does not initially bind to ciliated epithelial cells
pili exhibit phase variation and antigenic variation which allows for re-infection because the can evade previous antibody response!!
what is the function of Opa proteins in N. gonorrhoeae and N. meningitidis?
Opa proteins mediate tight adherence to epithelial cell
although both species possess Opa proteins, only N. gonorrhoeae become opaque
the bacteria possess multiple alleles that promote binding to different host molecules = Vitronectin, fibronectin, heparan sulfate proteoglycan, CEACAM1, 3, 5 and 6
binding also sends signals that promote invasion of host cell
what is the function of pili and opa proteins?
they’re important for attachment of bacteria to host cells
what do porin proteins of virulent Neisseria III do?
they are integral outer membrane pores that are essential to acquire nutrients
they also interfere with neutrophil function which facilitates invasion of epithelial cells
this promotes resistance to complement-mediated killing
what are the general characteristics of virulent Neisseria III?
- release peptidoglycan fragments (NAG-NAM) which slows down or kills ciliated epithelial cells and decreases mucociliary clearance
- porin proteins that interfere with neutrophil function and facilitates invasion of epithelial cells
- iron acquisition proteins that produce a number of receptors for human iron-binding molecules like transferrin, lactoferrin, hemoglobin – the bacteria can then sequester iron from these complex because iron is essential for neisseria species
do not produce siderophores! = a molecule which binds and transports iron in microorganisms
what are the general characteristics of virulent Neisseria IV?
- lipooligosaccharide (LOS)
- IgA protease
- possess several mechanisms for serum resistance (evade complement)
- virulent Neisserial strains are phagocytosed and compartmentalized by neutrophils, but often escape intracellular killing
what is the function of lipooligosaccharide in neisseria IV?
LOS is similar to LPS but lacks the O-antigen polysaccharide
it possesses endotoxin activity that elicits inflammatory response
it’s also Is responsible for the tissue damage associated with Neisserial diseases
what is the function of IgA protease in neisseria IV?
it cleaves IgA at the hinge point to produce inactive Fab and Fc fragments
which mechanisms does Neisseria IV possess for serum resistance?
neisseria IV can evade complement by:
- Sialylated LOS binds host Factor H
- Different porins bind host Factor H and/or C4bp
- Capsule (N. meningitidis) is resistant to complement deposition
- Patients with deficiencies in C5-C9 are very susceptible to Neisserial infections (especially N. meningitidis)
what do Neisseria do in the body?
Neisseria invade epithelial cells, kill them, are taken up and persist within PMNs, and eventually establish infection in subepithelium
Neisseria gonorrhoeae vingette
18 year old male has 48 hour history of painful urination with a yellowish penile discharge
he returned 2 days ago from Daytona Beach, where he had been sexually active with several female partners during Spring Break – he denied previous such episodes and said he was in good health
PE found purulent urethral discharge with no sign of genital ulcers, rash, or skin ulcers. Inguinal lymph nodes were not enlarged or tender
gram stain and culture showed gram (-) diplococci with PMN
what is the 2nd most commonly reported infectious disease in the US?
Neisseria gonorrhoeae
number of cases are probably underreported because cases are often asymptomatic especially in women and they can remain asymptomatic for months to years
what does untreated gonorrhea infection lead to?
severe reproductive complications like:
- pelvic inflammatory disease (PID)
- can lead to tubal-factor infertility and cases of ectopic pregnancy
can also have adverse outcomes for children born to infected mothers:
1. blindness
- joint infection
- septicemia