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BACTERIOLOGY LECTURE > MIDTERMS: L3 - GRAM-NEG COCCI > Flashcards

MIDTERMS: L3 - GRAM-NEG COCCI Flashcards

1
Q

Two major pathogens (Neisseria) of the human person

A
  1. N. gonorrhoeae

2. N. meningitidis

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2
Q

MOTF

  1. Most strains of Gonococci contains plasmids
  2. Plasmids of Gonococci - develop resistance to antibiotics
  3. Gonococci - limited treatment compare to meningococci
  4. Gonococci also contains capsules making them more pathogenic and virulent
A

1,2,3 - TRUE
4 - FALSE

Gonococci don’t have capsules - only plasmids (still pathogenic and virulent)

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3
Q

MOTF

  1. N. meningitidis - do not contain plastmids
  2. N. meningitidis - encapsulated bacteria
A

BOTH TRUE

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4
Q

MOTF

  1. N. cinerea, N. lactamica, N. sicca, N. mucosa, N. polysaccharea, N. subflava, N.flavescens, N. elongate- examples normal flora of humans
  2. They are found in upper RT in the nasopharynx
A

BOTH TRUE

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5
Q

A normal flora of the
oral cavities, upper respiratory tract of
animals like cats and dogs

A

N. animaloris

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6
Q

Formerly Neisseria catarrhalis/Branhamella

A

Moraxella catarrhalis

  • not part of Neisseriaceae
  • Resembles Neisseria biochemically and
    morphologically
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7
Q

MOTF

  1. Neisseria are gram-positive diplococci
  2. Non-motile, non-spore-forming
  3. Individual cocci are like kidney-shaped or lancet-shaped or bullet-shaped
A

1 - false
2,3 -true

1 - Neisseria - gram-negative diplococci

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8
Q

T OR F

  1. Neisseria elongata are rod-shaped bacilli
  2. They are catalase negative
A

True

ALL NEISSERIA ARE CATALASE POS EXCEPT FOR N. elongata

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9
Q

MOTF

  1. Neisseria - aerobic, and cytochrome oxidase positive (+)
  2. Most oxidize carbohydrates with acid and gas
A

1 true 2 false

2 - NO GAS

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10
Q

MOTF

  1. In gram stain, neisseria can be seen intracellularly
  2. Flat sides are adjacent
A

BOTH TRUE

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11
Q

MOTF
Culture characteristics (In enriched media, 48 hours)
1. Gonococci - small grayish white convex, shiny colonies - transparent or opaque, with pigments and hemolytic
2. Meningococci - medium, smooth, round, moist, gray to white; encapsulate strains mucoid, non pigmented and non hemolytic

A

1 - false
2- true

1 - non pigmented and non hemolytic

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12
Q

MOTF
Pathogenic neisseria
1. Very fastidious - requires requires 5% SBAP/CAP
2. Meningococci are more fastidious than gonococci

A

1 - true
2 - false

Gonococci are more fastidious than meningococci

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13
Q

Enriched culture media (especially CAP) can supply fastidious components such as:

A

iron, hemin (Factor X), coenzyme 1 (NAD (Nicotinamide adenine dinucleotide)/ Factor B)

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14
Q 
MOTF
1. N. meningitidis - requirement for
cultivation is the use of 5% SBAP
(can also use CAP)
2. N. gonococci - also grow on SBAP and CAP
3. More nutritious media - SBAP (cooked)
A

1 - true
2,3 - false

2 - only grow in CAP
3 - CAP more nutritious

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15
Q

MOTF

  1. Upon collection, transport, and cultivation, they must not be subjected to low temperatures because it will kill these 2 organisms
  2. Gonococci needs cysteine
A

BOTH TRUE

NOTE: THEY ARE COLD-SENSITIVE

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16
Q

MOTF

  1. N. flavescens, N. animaloris, N. subflava, N. lactamica, N. mucosa, N. polysaccharea - colonies may be yellow/contain yellow pigmentantion
  2. N. animaloris - has a distinct smell (popcorn-like)
A

BOTH TRUE

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17
Q

MOTF

  1. N. sicca - Opaque, brittle, wrinkled colonies, non-pigmented
  2. N. cinerea - Small, grayish white, slightly granular
  3. Moraxella catarrhalis - Large, nonpigmented or pinkish gray opaque colonies; friable, hockey puck consistency
A

ALL TRUE

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18
Q

MOTF

  1. Hockey puck consistency helps distinguish Moraxella from Neisseria
  2. Hockey puck consistency - move colonies across surface without disintegrating it
A

BOTH TRUE

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19
Q 
MOTF
1. M. catarrhalis - Grows 
on BAP at 22C and on NA at 35C
2. They can reduce nitrate to nitrite - due to their enzymes
3. Can also utilize carbohyrates
A

1,2 - true
3 - false

3 - cannot utilize carbohydrates (Inert)

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20
Q

M. catarrhalis contains enzyme that Allows hydrolyse or digest substrate tributyrin, this is called:

A

Butyrate esterase

Neisseria - negative

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21
Q

Old colonies especially after 48 hours using CAP, the appearance of colonies illustrates:

A

Wagon wheels

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22
Q

Incubation condition of Neisseria:

A
  1. 35-37C for 48-72 hours

2. Humid, CO2 enriched (3%-5% min. requirement)

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23
Q

MOTF

  1. Gonococcus and meningococcus - used of enriched/selective media
  2. Selective media - CAP base plus antimicrobials
A

BOTH TRUE

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24
Q

Thayer-martin antibiotics:

A

Vancomycin, colistin, nystatin

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25
Q

Modified-Thayer Martin (MTM) antibiotics:

A

Vancomycin, colistin, nystatin and trimethoprim

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26
Q

Martin-Lewis antibiotics:

A

vancomycin, colistin, anisomycin, trimethoprim

Increased concentration of Vancomycin

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27
Q

GC-Lec and New York City antibiotics:

A

GC lec - vancomycin, colistin, amphotericin, trimethoprim, lincomycin (inhibits gram pos)

New York City (NYC) - vancomycin, colistin, amphotericin, trimethoprim

DIFFERENCE: NYC has no lincomycin

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28
Q

Incorporated to inhibit the growth of gram positive (+) organisms

A

vancomycin, 3 μg/mL

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29
Q

Inhibit the growth of gram negative (-) organism aside from Neisseria

A

colistin, 7.5 μg/mL

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30
Q

Act as antifungal

A

amphotericin B, 1 μg/mL (nystatin, anisomycin)

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31
Q

Inhibit the swarming growth of Proteus which can be an impedance to the growing Neisseria

A

trimethoprim, 3 μg/mL

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32
Q

Positive Growth on MTM, ML, NYC

A

N. gonorrhoeae, N. meningitidis, N. lactamica (NF)

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33
Q

Reagent used in oxidase test:

A

tetra-methyl-

p-phenylenediamine dihydrochloride (TMPPD)

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34
Q

Positive result in Oxidase test:

A

Purple color

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35
Q

T OR F
CHROMOGENIC ENZYME SUBSTRATE TEST - Used to differentiate between the medically significant
organisms and those that grow on the selective culture
medium

A

True

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36
Q

CHROMOGENIC ENZYME SUBSTRATE TEST - detect 3 enzymes, which are:

A

1.Beta-galactosidase 2.Gamma-glutamyl aminopeptidase 3.Hydroxyprolyl aminopeptidase

CLUE: BEGA, GAGA, HA

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37
Q

MOTF
In CHROMOGENIC ENZYME SUBSTRATE TEST:
1. N. lactamica - Beta-galactosidase
2. Gonococcus - Gamma-glutamyl aminopeptidase
3. Meningococcus - Hydroxyprolyl aminopeptidase
4. M. catarrhalis - does not have these enzymes

A

1,4 - true
2,3 - false

  1. Gonococcus - Hydroxyprolyl aminopeptidase
  2. Meningococcus - Gamma-glutamyl aminopeptidase
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38
Q

T or F
N. elongata, a NF that is also positive
(+) for Hydroxyprolyl aminopeptidase

A

FALSE

N. cinerea - also positive for Hydroxyprolyl aminopeptidase

39
Q

Indicator for CARBOHYDRATE UTILIZATION PATTERN - Cystine Trypticase Agar (CTA) Sugars:

A

PHENOL RED
YELLOW - acidic
ALKALINE - red

If there is sugar - acid release > turns into YELLOW

40
Q

Enumerate the carbohydrate utilization pattern for glucose, maltose, lactose and sucrose:

A

GC - G + , M L S -
MC - G M +, L S -
N. Lactima - G M L +, S -
M. catarrhalis - ALL neg, DNAse pos

41
Q

MOTF

  1. N. Polysaccharea will resemble N. meningitidis
  2. Both has G M + and L S F -
42
Q

To differentiate N. Polysaccharea and N. meningitidis, what are the ways:

A
  1. Meningitidis will grow on selective media

2. Allow your polysaccharea to grow on 1% - 5% sucrose agar - produce polysaccharides

43
Q

MOTF
1. N. cinerea and N. gonorrhoeae - share same characteristics: Enzyme - Hydroxyprolyl Aminopeptidase

  1. And
    Oxidation pattern - glucose +
44
Q

MOTF

  1. Culture using mha - N. cinerea can grow and N. gonorrhoeae cannot grow
  2. MTM - N. cinerea cannot grow and N. gonorrhoeae can grow
  3. Colistin sensitivity testing - kill N. cinerea and cannot inhibit N. gonorrhoeae
45
Q

MOTF
Disadvantages of CTA test
1. Not sensitive to acid production of some organisms
2. Cannot check the oxidative strains of Neisseria

46
Q

MOTF
Newer test systems
1. Use light concentration of inoculum in a small volume of buffered low-peptone substrate with the appropriate carbohydrate
2. Results available within 4 hrs

A

1 false
2 true

1 - use heavy
Examples: Rim-Neisseria test, Neisseria Kwik Test, Gonobio Test

47
Q

MOTF

  1. Neisseria - Inhibited by Fatty Acids & salts
  2. Produce autolytic enzymes (25oC, ↑ pH)
  3. Needs rapid and prompt processing
48
Q

MOTF
1. Pili - also called fimbriae
2. Provide resistance to phagocytosis
3. Main function of the gonococcal pili is it facilitates the
attachment of gonococci to host cells
4. Different strains of Neisseria gonorrhoeae produce pili
that are antigenically different from each other

49
Q

MOTF

  1. Opa (protein II) - adhesion within colonies making them intact and attachment to host cell receptors
  2. Opa protein - colonies can form opaque
  3. Opa - no antigenic variation, same all throughout
A

1,2 - true

3 - false

50
Q

MOTF

  1. Lipooligosaccharide or LOS - One of the major virulence factor of Gonococci
  2. Gonococcal LPS (lipopolysaccharide) without long O-antigen side chains - thus, only LOS
51
Q

MOTF

  1. LOS - molecular mimicry of human glycosphingolipids. It structurally resembles human glycosphingolipids thus, causing immune invasion
  2. LOS - Released in membrane blebs (Outer membrane fragments contain LOS)
A

Both true

OTHER FUNCTIONS:

  1. suppression of leukotriene B4 synthesis - inhibits PMN activation

LB4 - calls for migration of PMNS (pmns - kill organisms)

  1. activates alternative complement pathway → inflammation
  2. activates TNF → inflammation
52
Q

Protein responsible for the formation of pores in the cell walls of our bacterium

A

Por protein (Protein I)

Importance:

  1. allows passage of nutrients
  2. facilitate the excretion of waste materials
53
Q

Prevent phagosome-lysosome fusion

A

Por protein (Protein I) - no formation of phagolysosome

NOTE: the reason why N. gonorrhoeae can be seen inside your PMNS

54
Q

Reduction-modifiable protein; associates with Por in the formation of pores in the surface

A

Rmp (protein III)

55
Q

T OR F

Ferric-binding protein or Fbp allows N. gonorrhoeae to scavenge for little amounts of iron and continue to live

56
Q

Splits/inactivates the major mucosal IgA1

A

IgA1 protease

NOTE: In the secretions, the dominant antibody is IgA

57
Q

MOTF
Uncomplicated GC infection: IN MEN
1. URETHRITIS - inflammation of urethra
2. URETHRITIS - can lead to prostatis and epididymitis
3. PHARYNGITIS - point of entry is throat
4. Proctitis - entry is rectal portion

58
Q

Painful sexual intercourse - called

A

Dyspareunia

59
Q

PELVIC INFLAMMATORY DISEASE (PID)

A

Endometritis - organism enter endometrium
Salpingitis - spread further in fallopian tube
Oophoritis - organism reached ovaries

NOTE: THESE 3 ARE PRESENT IT WILL RESULT TO PID

60
Q

Infection of peritoneum (cavity where most internal organs such as intestines are located)

A

Peritonitis

61
Q

Inflammation of the capsule covering the liver

A

Peri-hepatitis

Coming as form of complication PID = called Fitz-Hugh-Curtis syndrome

62
Q

Infection of newborn baby upon passing through the infected birth canal

A

Gonococcal Ophthalmia neonatorum

63
Q

Gonococcal Ophthalmia neonatorum treatment/antibiotics used:

A

Erythromycin - 0.5%
Tetracycline - 1%

AgNO3eye drops - used before, now stopped due to eye irritation

64
Q

Gonococcal Bacteremia (Septicemia)

A

Gonococcus is present in the blood

65
Q

Inflammation of synovium covering your tendons

A

TENOSYNOVITIS

66
Q

Difference between papules and pustules

A

Pustules - contains pus

Papules - does not contains pus

67
Q

Triad of Disseminated Gonococcal Infection (DGI:

A
  1. PAPULES and PUSTULES
  2. TENOSYNOVITIS
  3. SEPTIC ARTHRITIS
68
Q

MOTF

  1. The type of specimen depends on the manifestation of the patient
  2. Male common sample - endocervical discharge
  3. Direct gram stain - diagnostic for female gonococcal infection
A

1 true
2,3 - false

2 - Male - urethral discharge
3 - DGS - diagnostic for male, not diagnostic for female

MALE - 90% sensitivity, 95% specificity
FEMALE - 50% sensitivity, 95% specificity

69
Q

MOTF

  1. DGI (joint and blood culture) - Use a special system because the SPS that we use in blood culture bottles can inhibit the growth of N. gonorrhoeae
  2. Can still use sps - concentration of SPS mus tnot exceed 0.25%
  3. Incorporate gelatin - neutralize SPS
A

1,3 - true
2- false

2- not exceed 0.025%

SPS - Sodium polyanethole sulfonate

70
Q

Specific swabs used in acquiring sample for N. gonorrhoeae

A

Dacron and Rayon swabs

71
Q

MOTF
1. Cotton contains Fatty acids and it is toxic to N.
gonorrhoaea
2. Cotton swabs can be used but with the addition of charcoal - neutralize fatty acids
3. Calcium alginate can inhibit the growth of
gonorrhoaea

72
Q

Culture Media Transport Systems:

A

JEMBEC, Gono-Pak, and Transgrow

JEMBEC - John E. Martin Biological Environmental Chamber

Incorporated in these 3 systems is the use of selective culture medium and have their CO2 generator

73
Q

MOTF

  1. Colonies (T1, T2) - piliated GC; typical small colonies on selective subculture
  2. Colonies ( T3, T4, T5) - nonpiliated GC: larger colonies on nonselective subculture
74
Q

Colonies - piliated GC and transparent

75
Q

MOTF

  1. Gonococcus - catalase and oxidase positive
  2. CTA SUGAR - GLUCOSE ONLY
76
Q

Non culture tests for N. gonorrhoeae:

A
  1. Antigen detection (Gonozyme) - GONOZYME TEST
  2. Direct specimen nucleic acid probe (Nucleic Acid Amplification Test - NAAT)
  3. Nucleic acid amplification (Ligase Chain Reaction - LCR)
77
Q

CDC Recommended Treatment for Uncomplicated Gonorrhea:

A

Ceftriaxone (most potent), Cefixime,
Ciprofloxacin, Ofloxacin, and Levofloxacin
+
1g Azithromycin (or 100 mg Doxycycline 2x / 7 days) - for chlamydia

78
Q

Concomitant infection of gonorrhea:

A

Co-infection (chlamydia)

79
Q

Uncomplicated Gonococcal infections of the Cervix, Urethra, and Rectum (treatment)

A

Recommended regimen
○ Ceftriaxone 250 mg IM (mode of delivery:
intramuscular) in a single dose PLUS
Azithromycin 1g orally in a single dos

80
Q

Treatment of Arthritis and Arthritis - Dermatitis Syndrome

A

Recommend regimen
○ Ceftriaxone 1 g IM or IV every 24 hours PLUS
Azithromycin 1 g orally in a single dose

81
Q

Treatment of Gonococcal Meningitis and Endocarditis

A

Recommended regimen
○ Ceftriaxone 1-2 g IV every 12-24 hours PLUS
Azithromycin 1 g orally in a single dose

82
Q

MOTF

  1. Neisseria meningitidis has 13 serogroups: immunologic specificity of capsular polysaccharides
  2. Common serogroups associated with infection, diseases, and outbreaks are A, B, C, X, Y, and W-135
A

Both true

Western hemisphere - B, C, W-135 and Y

Southern Finland and Sau Paulo, Brazil - B and C

New zealand - B
Africa - A
Epidemic cases - A and C

83
Q

MOTF
1. Virulence factors of meningococci share the same
function and effects as Gonococci
2. Type IV pili - interact with GIT endothelial cells
3. Pili, Opa, LOS, and to a lesser extent, Opc, undergo
antigenic variation

A

1,3 true
2 - false

2 - brain endothelial cells

84
Q

MOTF

  1. OMP Class 1,2,3 - porins for intracellular survival
  2. Class 1 - Por A and Class 2,3 - Por B
  3. Class 4 (OPA) - attachment and invasion
  4. Class 5 (RMP) - Blocks host serum bactericidal IgG action
A

1,2 true
3,4 false

Class 5 (OPA) - attachment and invasion

Class 4 (RMP) - Blocks host serum bactericidal IgG action

85
Q

MOTF

  1. Humans are the only natural host for whom meningococci are pathogenic
  2. When meningococci enters nasopharynx, it could be a full blown pathogen or transient microbiota
86
Q

What facilitates the bloodstream invasion of N. meningitidis?

A
  1. Lack of bactericidal Abs
  2. Deficient in C5-C8
  3. Chronic irritation or damage to the RT mucosa
87
Q

Hallmark of MGC infections

A

rashes on arms, legs, and trunk

88
Q
  1. Fulminant Type of Meningococcemia
  2. Symptoms due to endotoxin activity (LOS)
  3. Characterized by disseminated intravascular coagulation
    (DIC)
A

Waterhouse-Friderichsen syndrome

89
Q

MOTF Waterhouse-Friderichsen syndrome

  1. Hemorrhage of adrenal glands happens
  2. Gangrene of skin and soft tissues
  3. Abnormal formation of blood clots in blood vessels
90
Q

MOTF

  1. Meningitis - cause severe cerebral hyperemia
  2. Permanent hearing loss/mental retardation in 11-19% of recovered Pxs
91
Q

Supine position, flex leg at the hip and knee, extend further leg
NO MENINGITIS - can flex further
WITH MENINGITIS - pain in harmstring muscle

A

Kernig’s sign

92
Q

Elevate head and neck
NO MENINGITIS - no pain
WITH MENINGITIS - flex head and neck, he/she will suffer pain, reflex of knees

A

Brudzinski’s sign

93
Q

Drug of choice for treatment of N. meningiditis

A

PENICILLIN G (IV; drug of choice)

94
Q

Prophylaxis used:

A

Prophylaxis: rifampin (most commonly used),

ciprofloxacin (for adults), or ceftriaxone (for children)

BACTERIOLOGY LECTURE (4 decks)

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