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CLINICAL BACTERIOLOGY > LEC - Semifinals | Neisseria > Flashcards

LEC - Semifinals | Neisseria Flashcards

1
Q

GENERAL CHARACTERISTICS of Neisseria species & Moraxella Catarrhalis

A

Aerobic
Non-motile
Non-spore forming
Gram-negative Diplococci
Capnophilic

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2
Q

All species are cytochrome oxidase and catalase positive EXCEPT?

A

N. elongate subsp. Nitroreducens and N.
bacilliformis

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3
Q

These species are both cytochrome oxidase positive and catalase positive

A

N. gonorrhoeae and N. meningitidis

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4
Q

Require CO2 to grow

A

Capnophilic

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5
Q

Optimal growth environment

A

Humid temperature

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6
Q

Causative agent of:
- Otitis media (young children)
- Chronic upper respiratory infections (adult)

A

M. catarrhalis

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7
Q

Causative agent:
- Gonorrhea (STD)
- Localized to the
mucosal surfaces
- Pelvic inflammatory
disease (complication)
- Ophthalmia neonatorum

A

N. gonorrhoeae

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8
Q

2nd most commonly reported sexually transmitted infection

A

Gonorrhea (STD)

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9
Q

Mucosal surfaces of N. gonorrhea infection

A
  • Urethra
  • Endocervix
  • Anal Canal
  • Pharynx
  • Conjuctiva
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10
Q

May be asymptomatic or acute with a pronounced purulent response (presence of pus)

A

Localized infection

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11
Q

Symptomatic localized infection is common among?

A

Men

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12
Q

In female, it could either be asymptomatic and could further lead to complications such as?

A

Pelvic Inflammatory Disease

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13
Q

It causes infertility, Ectopic pregnancy, or perihepatitis (Fitz-Hugh-Curtis Syndrome)

A

Pelvic Inflammatory Disease

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14
Q

A gonococcal eye infection where the mother is tested positive for gonorrhea and passed through the child

A

Ophthalmia neonatorum

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15
Q

A post-prophylaxis given; anti-microbial eyedrops which prevents further infection

A

Erythromycin

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16
Q

Causative agent of :
- Meningococcemia
- Fatal bacterial meningitis
- Nasopharyngeal colonization
- Respiratory droplet secretions

A

N. meningitidis

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17
Q

It is transmitted via respiratory droplet secretion and starts with nasopharyngeal colonization which can further develop to Fatal bacterial meningitis

A

Meningococcemia

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18
Q

These species exclusively infects human

A

N. gonorrhoeae and N. meningitidis

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19
Q

Two main diseases that can occur when N. meningitidis enters the blood stream

A
  1. Fulminant meningococcemia
  2. Meningitis
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20
Q

It may occur with or without meningitis. Carrying 25% mortality rate even if treated

A

Meningococcemia

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21
Q

Minor hemorrhage into the skin and mucosal membrane which can further lead to the development of bruises

A

Purpura

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22
Q

Very common characteristic in meningococcemia along with the presence of petechial skin rash

A

Purpura

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23
Q

These can all develop during bacteremia and consequently because of purpura and petechiae, which are manifestation of thrombosis

A

Tachycardia and hypotension

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24
Q

In some cases, the disease becomes fulminant and spreads rapidly and causes:

A
  • DIC (Disseminated Intravascular Coagulation
  • Septic shock
  • Hemorrhage in the Adrenal Canals
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25
Q

Hemorrhage in the adrenal canals is also known as

A

Waterhouse-Friedrichsen Syndrome

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26
Q

Death may develop within how many hours after onset?

A

12-48 hours

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27
Q

Virulence factors of Neisseria

A
  1. Receptors for human transferrin
  2. Capsule (N. meningitidis)
  3. Pili (fimbriae)
  4. Cell membrane proteins
  5. Lipooligosaccharide (LOS) or endotoxin
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28
Q

Diseases caused by Neisseria are very fatal
and infectious especially in?

A

N. meningitidis

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29
Q

The most well-characterized virulence factor

A

Pili or Fimbriae

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30
Q
  • Fine hairlike projections for initial attachment
  • Inhibits phagocytosis
  • Aid in the exchange of genetic material between cell
A

Pili or Fimbriae

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31
Q

This Neisseria spp. produces a polysaccharide capsule

A

N. meningitidis

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32
Q

It is antiphagocytic and serves as one of the important virulence factor

A

Capsule

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33
Q

Virulence factor that plays a role in host attachment

A

Opacity Protein

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34
Q

Helps the organism’s evasion of the complement mediated cell lysis

A

Lipooligosaccharide (LOS) or endotoxin

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35
Q

These are other important Neisseria spp.

A
  1. Saprophyticus Neisseria
  2. Normal microbiota in respiratory culture
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36
Q

Specimen collection

A
  1. Swab – within 6 hours from collection
  2. Dacron or rayon-tipped swabs
  3. CO2 transport
  4. 37°C in 3% to 5% Co2 - incubation
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37
Q

In swabs, specimen must be plated within how many hours from collection?

A

6 hours

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38
Q

Ideal for optimal recovery of N. gonorrhoeae

A

Bedside plating

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39
Q

Pathogenic Neisseria are very sensitive to?

A

Drying and extreme temperature

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40
Q

Optimal specimen for N. gonorrhoeae. If not available, swabs are acceptable

A

Discharge

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41
Q

Reduced recovery of the organism may result as soon as how many minutes after collection?

A

30 minutes

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42
Q

Swabs should be plated immediately in what media?

A

Chocolate Agar

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43
Q

Most recommended swabs

A

Dacron or Rayon-tipped Swab

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44
Q

If cotton-tipped swab is used, you must use a?

A

Transport medium containing charcoal (Amie’s Charcoal medium)

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45
Q

It inhibits toxic fatty acid present in the
cotton fibers

A

Amie’s Charcoal medium

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46
Q

NEVER use because it inhibits the recovery of N. gonorrhoeae

A

Calcium alginate

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47
Q

Transport media should be

INCREASED C02 or DECREASED CO2?

A

Increased CO2

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48
Q

Atmospheric or broth requirement

A

37°C in 3% to 5% Co2 incubation

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49
Q

Special media used to make bedside plating possible

A

JEMBEC plates

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50
Q

JEMBEC plates contains

A

Modified Thayer-Martin Agar

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51
Q

CO2 generating tablet is composed of

A

Sodium bicarbonate and Citric acid

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52
Q

It activates the tablet and will generate a CO2 atmosphere in the pouch

A

Moisture in the agar

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53
Q

Both organism are sensitive to? which is found in the blood culture bottle

A

Sodium polyanethanol sulfonate

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54
Q

If blood culture broth is used, SPS content should not exceed

A

0.025%

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55
Q

Vacutainer tubes containing the SPS, the specimen must be transferred to the broth cultured system within

A

1 hour of collection

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56
Q

Body fluids (Joints & CSF) should be stored until cultured at what temperature?

A

37°C

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57
Q

In Gram staining, we will observe the

A

Gram-negative diplococci

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58
Q

“kidney bean shaped” or “coffee been shaped”

A

Gram-negative diplococci

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59
Q

In males, the specimen is

A

Urethral discharge

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60
Q

Diagnostic for males (especially if the specimen is urethral discharge)

A

Appearance of gram-negative diplococci inside the polymorphonuclear leukocyte

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61
Q

Only presumptive evidence of gonococcal infection in symptomatic females

A

Direct examination of endocervical secretion

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62
Q

Normal vaginal and rectal microbiota can be sometimes composed of? Which can resemble?

A

Gram-negative coccobacilli; Neisseria

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63
Q

Specimen that should not be gram stained

A

Pharyngeal specimen

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64
Q

Non-pathogenic commensal Neisseria may be present in this SPECIMEN and the presence of this organism is not diagnostic of infection

A

Pharyngeal specimen

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65
Q

Pharyngeal specimen should not be gram stained because this organism may be present and its presence is not diagnostic of infection

A

Non-pathogenic commensal Neisseria

66
Q

Media of Choice

A
  1. Trypticase soy agar with 55 sheep blood
  2. Chocolate Agar
  3. Selective medium
67
Q

Selective medium (5)

A
  • Thayer-martin Medium
  • Modified Thayer-Martin
  • Martin-Lewis
  • GC-Lect
  • New York City medium
68
Q

It is more fastidious in typically does not grow on blood agar but will grow on Chocolate Agar

A

N. gonorrhoeae

69
Q

Base medium

A

Chocolate Agar

70
Q

The difference between the medias is that these are added

A

Antibiotic

71
Q

Contains chocolate agar as its base enriched with IsoVitale X and antimicrobial colistin (inhibit gram negative bacilli), nystatin (inhibits yeast), and vancomycin (inhibit gram-positive bacteria)

A

Thayer-Martin Medium

72
Q

It inhibits the swarming observed with
Proteus spp.

A

Trimethoprim

73
Q

The changes in the modification of Thayer-Martin

A

Includes Trimethoprim

74
Q

Antifungal agent

A

Anisomycin

75
Q

Similar to MTM except that anisomycin, an antifungal agent, is substituted for nystatin and the concentration of vancomycin is increased

A

Martin-Lewis

76
Q

In Martin-Lewis, Anisomycin is substituted for?

A

Nystatin

77
Q

A selective medium that contains additional
antimicrobials to inhibit bacteria found in oropharyngeal specimens; it includes vancomycin and lincomycin, colistin,
amphotericin B, and trimethoprim

A

GC-LECT Agar

78
Q

Antimicrobials to Inhibit gram-positive bacteria

A

Vancomycin and Lincomycin

79
Q

Antimicrobial to inhibit gram-negative bacteria

A

Colistin

80
Q

Antimicrobial to inhibit yeast

A

Amphotericin B

81
Q

Antimicrobial to inhibit swarming Proteus spp. and Capnocytophaga spp.

A

Trimethoprim

82
Q

A transparent clear-to- yellow medium containing lysed horse blood, horse plasma, yeast dialysate, and the same antimicrobials as MTM, also has been used

A

New York City Medium

83
Q

Advantage of New York City Medium

A

It inhibits the growth of genital mycoplasmas
(Mycoplasma hominis and Ureaplasma)

84
Q

Incubation Conditions and Duration

A
  • 35°C to 37°C for 72 hours in a CO2-enriched, humid atmosphere
  • Increased CO2 at 3%-7%
85
Q

Organisms that grow best under conditions of increased CO2 at 3%-7%

A

N. gonorrhoeae, N. meningitidis, and
Moraxella catarrhalis

86
Q

How to achieve increased CO2 at 3%-7%?

A

Candle jar, a CO2 generating pouch, or CO2 incubator

87
Q

They can be toxic to Neisseria, both gonorrhoeae and meningitides

A

Scented candles

88
Q

How to provide humidity?

A

By placing a pan with water in the bottom of the CO2 incubator or by placing a sterile gauze pad soaked with sterile water in the bottom of the candle jar

89
Q

All species of Neisseria are

A

Oxidase positive

90
Q

All species EXCEPT? are catalase positive

A

N. elongata

91
Q

To differentiate Gram negative rod Kingella denitrificans and Acinetobacter spp., the organism can be streaked to a plate with?

A

10-unit Penicillin disk

92
Q

After growth, it is stained to visualize the microscopic morphology

A

Edge zone of inhibition

93
Q

After penicillin disk, the microscopic morphology of N. gonorrhoeae remains?

A

Gram-negative diplococci

94
Q

After penicillin disk, the microscopic morphology of Kingella denitrificans is?

A

Gram negative rod

95
Q

After penicillin disk, the microscopic morphology of Acinetobacter spp. is?

A

Elongated gram negative rod

96
Q

Gram negative diplococci

A

Neisseria

97
Q

Gram negative rod

A

Kingella denitrificans

98
Q

Elongated or filamentous
gram negative rod

A

Acinetobacter spp.

99
Q

Reagent of Oxidase Test

A

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

100
Q

The oxidase test must be done on all suspected isolate of

A

N. gonorrhoeae

101
Q

The oxidase reagent is placed on a filter, and a colony from the plate and rubbed onto the reagent with an applicator stick or non-nichrome loop

A

Filter paper method

102
Q

(Filter paper method)
After 10 seconds → positive result = ?

A

Purple color

103
Q

Alternatively, the oxidase reagent may be dropped directly onto a colony or plate of Neisseria

positive reaction = ?

A

Deep purple to black

104
Q

If subculture is needed, it must be done:

BEFORE or AFTER adding the reagent?

A

BEFORE

105
Q

More convenient in Oxidase Test

A

Direct plate method

106
Q

Standard Method of Identification

A
  • Acid production from glucose, maltose, lactose, sucrose, and fructose in a CTA base medium and a carbohydratefree control (historically)
  • Buffered, low peptone substrate with the appropriate carbohydrate
107
Q

The test is used to determine the ability of an organism to hydrolyze DNA

A

DNAse Test

108
Q

The medium of DNAse Test is? because of the?

A

Pale green; DNA-methyl green complex

109
Q

If the organism growing on the medium hydrolyses DNA, what will happen to the green color?

A

Green color fades

110
Q

If the organism growing on the medium hydrolyses DNA, what will happen to the colony, it is surrounded by?

A

Colorless zone

111
Q

DNAse Test is used to differentiate?

A

M. catarrhalis from Neisseria

112
Q

In DNAse Test, M. catarrhalis is?

A

DNAse positive

113
Q

In the presence of hydrochloric acid:
When there is clear zone surrounding the inoculum, streak with the rest of the plate remaining opaque

RESULT: DNAse-positve or DNAse-negative?

A

DNAse-positive

114
Q

In the presence of hydrochloric acid:
Absence of a clear halo around the inoculum streak

RESULT: DNAse-positve or DNAse-negative?

A

DNAse-negative

115
Q

DNAse-positive RESULT in the presence of toluidine blue

A

Appearance of pink halo surrounding the inoculum streak. The rest of the plate remains blue

116
Q

DNAse-negative RESULT in the presence of toluidine blue

A

Absence of the pink halo surrounding the inoculum

117
Q

There is opacity in the presence of?

A

Hydrochloric acid

118
Q

There is a pink halo in the presence of?

A

Toluidine blue

119
Q

Historical or traditional method used to identify Neisseria spp.

A

Carbohydrate Utilization Method - CTA

120
Q

Carbohydrates that can be added in each tube of CTA

A

Glucose
Lactose
Maltose
Sucrose

121
Q

Positive result in Carbohydrate Utilization Method - CTA, and due to?

A

Yellow color; acid production

122
Q

After incubation in Carbohydrate Utilization Method - CTA, examine the tube within how many hours for a yellow color?

A

24 to 72 hours

123
Q

The pH indicator will turn to what color if the carbohydrate is utilized?

A

Yellow

124
Q

Precaution in Carbohydrate Utilization Method - CTA:

Avoid incubation in CO2 because it may alter the pH of the media which may cause

FALSE POSITIVE REACTION or FALSE NEAGTIVE REACTION?

A

False positive reaction

125
Q

Precaution in Carbohydrate Utilization Method - CTA:

A yellow color can also change throughout the tube that may also indicate presence of

A

Contaminating organisms

126
Q

It is positive for glucose only in Carbohydrate Utilization Method - CTA

A

N. gonorrhoeae

127
Q

It is positive for Glucose and Maltose in Carbohydrate Utilization Method - CTA

A

N. meningitidis

128
Q

It is positive for glucose, maltose, and lactose in Carbohydrate Utilization Method - CTA

A

N. lactamica

129
Q

This organism is only negative for Lactose in Carbohydrate Utilization Method - CTA

A

Non-pathogenic Neisseria

130
Q

Negative for all carbohydrates in Carbohydrate Utilization Method - CTA

A

Maroxella catarrhalis

131
Q

Preferred assays for the detection of N. gonorrhoeae in clinical specimens because it has increased sensitivity, specificity, and ability to test with the non-invasive urine specimens

A

Nucleic Acid Amplification Tests (NAAT)

132
Q

This test will provide faster detection of Neisseria

A

Nucleic Acid Amplification Tests (NAAT)

133
Q

In NAAT, this specimen is used

A

Urine

134
Q

Its advantage is being less sensitive to transport and storage conditions compared with culture

A

Nucleic Acid Amplification Tests (NAAT)

135
Q

One of the advantages of NAAT is that it can detect both of these organisms in the same specimen

A

N. gonorrhoeae and Chlamydia trachomatis

136
Q

It exists as a co-infection of Chlamydia trachomatis

A

N. gonorrhoeae

137
Q

Conditions that NAAT is NOT recommended

A
  • Cases of child sexual assault involving boys
  • Extragenital infections (rectal or oropharyngeal) in prepubescent girls
  • Urethral specimen from boys and extragenital from both boys and girls
  • Culture for N. gonorrhoeae is necessary to monitor antimicrobial resistance
138
Q

In cases of child sexual assault involving
boys and extragenital infections (rectal or oropharyngeal) in prepubescent girls, this is RECOMMENDED

A

Culture

139
Q

What is preferred when the condition presents diagnosis of sexual abuse

A

Culture

140
Q

Only method to monitor the effectiveness of treatment because NAATs are not approved for use as a test of cure

A

Culture

141
Q

Culture for this organism is necessary to monitor antimicrobial resistance

A

N. gonorrhoeae

142
Q

Conditions that NAAT CAN be used

A

Vaginal or urine specimens from young girls

143
Q

Chromogenic substrate enzyme tests:

Prolyl-hydroxylprolyl aminopeptidase is for?

A

N. gonorrhoeae

144
Q

Chromogenic substrate enzyme tests:

Beta-galactosidase and gammaglutamyl aminopeptidase is for?

A

N. meningitidis

145
Q

ONPG means

A

O-Nitrophenyl-B-Galactopyranoside

146
Q

This test is used to differentiate N. lactamica and N. meningitidis

A

ONPG Test

147
Q

In ONPG Test, it is used determine the organisms ability to produce?

A

Beta-galactosidase

148
Q
  • Enzyme present in lactose fermenters
  • Very important for enteric
A

Beta-galactosidase

149
Q

Organisms present with beta-galactosidase
enzyme indicate it as a?

A

True lactose fermenter or lactose utilization

150
Q

ONPG positive organism

A

N. lactamica

151
Q

ONPG negative organism

A

N. meningitidis

152
Q

This organisms are not routinely identified in the clinical laboratory

A

saprophyticus Neisseria

153
Q

This organism may be misidentified as N. gonorrhoeae if the isolate produces a weak positive glucose reaction in the acid production

A

Neisseria cinerea

154
Q

This organism can grow in the nutrient agar at 35°C; it is saprophytic Neisseria

A

N. cenerea

155
Q

It will not grow in nutrient agar, only on chocolate agar

A

N. gonorrhoeae

156
Q

Can N. cenerea be inhibited by Colistin?

A

YES

157
Q

Can N. gonorrhoeae be inhibited by Colistin?

A

NO

158
Q

Moraxella catarrhalis can be differentiated from the gonococci and meningococci based on its growth on?

A

Blood agar at 22°C

159
Q

This organism can grow on BAP with sheep blood agar

A

Moraxella catarrhalis

160
Q

This organism can reduce nitrate to nitrite and cannot utilize any carbohydrates

A

Moraxella catarrhalis

161
Q

It is negative to all carbohydrate utilization test but positive for DNAse

A

Moraxella catarrhalis

162
Q

The only member of this group that hydrolysis DNA

A

Moraxella catarrhalis

CLINICAL BACTERIOLOGY (1 decks)

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