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M1 Micro Quiz 2 > Neisseria > Flashcards

Neisseria Flashcards

1
Q

What is the common name for Neisseria menigitidis?
What is the common name for Neisseria gonorrhoeae?

A

Meningococcus causes meningococcal meningitis
Gonococcus causes gonorrhea

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2
Q

What is the shape and gram stain of Neisseria?

A

Gram negative, diplococci with flattenned along their touching side

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3
Q

What is the host/vector of Neisseria?

A

Humans only

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4
Q

What lab diagnostics can distinguish Neisseria from non-pathogenic strains and other organisms?

A

Thayer-Martin selective medium selects for pathogenic strains vs non-pathogenic and other bacteria. (I’ll say what Thayer-Martin is next)

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5
Q

What is the Thayer-Martin selective medium?

A

Congtains chocolate agar with
Vancomycin to inhibit gram positives
Colistin to inhibit enteric gram negatives
Nystatin to inhibit fungals
Also inhibits non-pathogenic strains of Neisseria due to the chocolate blood agar

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6
Q

What lab diagnostics can distinguish N. meningitidis from N. Gonorrhoeae and both from non-pathogenic strains?

A

N. gonorrhoeae ferments glucose only.
N. meningitidis ferments glucose and maltose only.
Non-pathogenic Neiseria ferments glucose, maltose, lactose, but NOT sucrose.

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7
Q

Are Nesseria ox positive or ox negative?

A

Ox positive

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8
Q

What are some virulence factors that allow Neisseria to colonize and evade immunity?

A

IgA1 protease
LOS (like LPS)
Pili and OMPs contribute to colonization
Meningococcus have a capsule that is antiphagocytic.

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9
Q

Do meningococcus invade cells? Where do they multiply? In what tissue are they found?

A

Meningococcus do invade cells, but they only multiply outside of cells
Lives in the nasopharynx, but may progress to the blood stream.

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10
Q

What are the most important serogroups of meningococcus?

A

Polysaccharide capsule serogroups: A, B, C, Y, W-135
Note: each serogroup might be further divided into serotypes

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11
Q

Which Neiseria is encapsulated?

A

Meningitidis is encapsulated
gonorhoeae is NOT encapsulated

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12
Q

How is meningococcus transmitted?
How long can the carrier state last?

A

person to person respiratory droplets
common in crowded areas
carrier state can last months

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13
Q

What is the incubation period for meningococcus?
What are common symptoms?
What are severe symptoms?

A

Once bacteria enter the blood stream, incubation is 1 week
Common nasopharynx infection (non-blood stream) symptoms are pharyngitis and fever.
Severe symptoms include meningitis, adrenal failure, shock, and rapid death.

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14
Q

What is Waterhouse-Friderichsen syndrome?

A

Waterhouse-Friderichsen syndrom is adrenal failure, shock, and rapid death due to meningococcus.

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15
Q

What makes the Sub-Saharan Meningitis Belt so susceptible?

A

Dry season with cold nights damage the nasopharynx and increase risk of upper respiratory infection.
Overcrowding leads to epidemics.

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16
Q

What is the clinical Dx of meningococcus?

A

Upper respiratory infection followed by fever
Patechiae
Ecchymosis (someimes follow patechiae)

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17
Q

What are patechiae?
What are ecchymosis?

A

Patechiae are small purplish-reddish spots caused by minute hemorrhages
Ecchymosis are large black and blue spots caused by leakage of small vessels

18
Q

What is lab Dx for meningococcus?

A

Blood, Spinal Fluid, or Nasopharynx secretions can be cultured
Sugar fermentation test (takes 4 hours)
Latex agglutination test (takes 10 minutes)
Spinal test is essential if menengitis is suspected.

19
Q

Why is a spinal test Dx essential if meningococcus meningitis is suspected?

A

Meningitis can be caused by…
Meningococcus
H. influenzae
S. Pneumoniae

20
Q

What is Tx for meningococcus?

A

Prompt I.V. penicillin or ceftriaxone.
If treating a household, Rifampin is used because the antibiotic is secreated into saliva.
Ciproflaxacin is also used (very potent).

21
Q

Is there a vaccine for meningococcus?
When is it used?
What serogroups is vaccination not succesful?

A

Vaccines have been tested.
Used during epidemics and by military personel.
Serogroup B defies vaccination due to its capsule. Its capsule does not bind to C3b and evades immune response.

22
Q

In what tissue does Gonococcus reside?
Is it found intracellularly or extracellularly?

A

Gonococcus resides in the genitourinary tract.
It is found both in purulent fluid as well as inside epithelial and phagocytic cells.

23
Q

Is endotoxin a major aspect of Gonococcus?

A

Endotoxin is present, but is not a major component of the illness

24
Q

How many serotypes of Gonococcus?
Does Gonococcus have a capsule?

A

100s of seroTYPES of Gonococcus.
Gonococcus does not have a capsule.
Note: Meningococcus does have a capsule, upon which seroGROUPS are established.

25
Q

What are common transmission modes of Gonococcus?

A

STD vaginal penis sex
Butt sex
Pharyngeal mucosa oral sex and kissing
Conjunctiva in newborns as they pass through the birth canal (causes ophthalmia neonatorium discussed later)

26
Q

Explain the timeline of infection and symptoms of Gonococcus.
Note the difference between females and males.

A

Infection occurs within hours of exposure.
Symptoms occur within 3 days for males and 10 days for females.
Females are sometimes assymptomatic. Males are always symptomatic.
Infects epithelial cells and then deeper into connective tissue.
Inflammation stimulates the production of pus.

27
Q

What is the main virulence factor of Gonococcus?

A

Pili stick to epithelial cells and prevent phagocytosis.
Non-piliated strains are NOT pathogenic.

28
Q

What are the two most prevalent communicable illnesses in the world?

A

Goncoccus
Chlamydia trachomatis

29
Q

What are complications of disseminated Gonococcus?

A

Arthritis-dermatitis syndrome (can occur in the absence of genito-urinary symptoms)
Chronic pelvic inflammatory disease in females

30
Q

What is Dx of Gonococcus?

A

Clinical history and exposure
Stained smears of fresh exudate: diplococci within PMNs
Ox positive, gram neg diplococci.

31
Q

When should treatment begin for Gonococcus?
How is this different from Meningococcus?

A

Dx for Gonococcus should occur before Tx is started.
Tx for Meningococcus should occur as soon as infection is suspected.

32
Q

What are the three major forms of Gonococcus resistance to antibiotics?

A

Plasmid-mediated Penicillinase N. Gon (PPNG)
Tetracycline Resistant N. Gon (TRNG)
Chromosome-mediated Resistant N Gon (CMRNG)

33
Q

How does Tetracycline Resistant N. Gon (TRNG) interact with Plasmid-mediated Penicillinase N. Gon (PPNG)?

A

Tet-R plasmid can also activate Pen-R plasmid.
Tet-R plasmid is conjugative and can transmit both plasmids.

34
Q

What drugs are resisted with Chromosome-mediated Resistant N Gon (CMRNG)?
How severe is the resistance?

A

Penicillin, Tetracycline, Cephalosporin resistance.
Resistance isn’t strong. Tx usually works anyway.

35
Q

What is the Tx for Gonococcus?
What co-infection is always assumed?

A

Intramuscular Ceftriaxone plus 10 day oral tetracycline, doxycycline, azythromycin for Chlamydia trachomatis.

36
Q

What is Ophthalmia neonatorum?
Why is it clinically significant?

A

Conjunctival infection of Gonococcus of a newborn from a mother.
Was the cause of 50% of blindness in children.

37
Q

How is Tx of Ophthalmia neotorum mandated by law?

A

Prophylactic Tx of infants born to infected mothers is required by law.

38
Q

What are prophylatic Tx for ophthalmia neotorum?

A

Tetracycline or Erythromycin ointment on eyes.
Silver nitrate.

39
Q

How strong is immunity against Gonococcus after primary exposure?
Are there vaccines for Gonococcus?

A

Acquired immunity is very weak, so reinfections are common.
No vaccine.

40
Q

See comparison chart on page O-6 of notebook.

A

See comparison chart on page O-6 of notebook.

M1 Micro Quiz 2 (12 decks)

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