Neisseria And Moraxella

Question 1

List all characteristics of Neisseria sp. (Gram_??)

Answer 1

Gram negative diplococci
Aerobic
Fastidious
Oxidase positive
Catalase positive
Non-sporeforming
Nou-motile

Question 2

How is Neisseria Gonnorheae transmitted?

Answer 2

Sexually transmitted

Question 3

How is Neisseria Meningitidis transmitted?

Answer 3

Transmission via respiratory droplets

Question 4

What are the virulence factors of Neisseria sp.? (Adhesive proteins…)

Answer 4

• Pilli: attachment , material transfer, antigenic variation, resistance to killing
by neutrophiles.
• Porin protein: allow nutrients to pass into the cell and waste products to exit;
in NG interefere with degranulation of neutrophils (protection from IR)
• Opa proteins: mediate intimate binding to epithelial and phagocytic cells and
are important for cell-to-cell signaling
• Lipooligosaccharide (LOS): has endotoxin activity

Question 5

How does N. meningitis cause meningitis and septicemia? (Step by step)

Answer 5

1)Neisseria meningitidis is acquired through the inhalation of respiratory droplets
2) The organism establishes intimate contact with non-ciliated mucosal epithelial cells of the upper respiratory tract.
—- Asymptomatic carriage in which bacteria that enter the body by crossing the epithelial barrier are eliminated is common in healthy adults.
3) N. meningitidis can cross the epithelium through phagocytes in a ‘Trojan horse’ manner.
4) In susceptible individuals, once inside the blood, N. meningitidis may survive, multiply rapidly and disseminate throughout the body and the brain.
5) Meningococcal passage across the brain vascular endothelium (or the epithelium of the choroid plexus) may then occur, resulting in infection of the meninges and the cerebrospinal fluid

Question 6

Can Neisseria infections be seen in animals?

Answer 6

No. Strictly human pathogens

Question 7

How many serotypes of N. meningitis are present? Which are the most commonly pathogenic?

Answer 7

13 serotypes
A, B, C, Y, W135 are the most common

Question 8

Who are more likely to be infected with N. meningitis?

Answer 8

Children younger than five years, teenagers, elderly and the immune compromised

Question 9

What are the general symptoms of N. meningitis infection?

Answer 9

Sudden onset of fever, nausea, vomiting, headache, decreased ability to concentrate and myalgia

Question 10

What is the most common manifestation of N. Meningitis?

Answer 10

Meningitis

Question 11

What are the symptoms of meningitis?

Answer 11

purulent inflammation of meninges associated with headache, meningeal signs, and fever high mortality rate unless promptly treated with effective antibiotics

Question 12

What is meningococcemia, and what are its characteristic features?

Answer 12

Meningococcemia is a disseminated infection caused by Neisseria meningitidis. It is characterized by thrombosis (clot formation) of small blood vessels and multiorgan involvement. It often presents with small, petechial (pinpoint) skin lesions that may coalesce into larger hemorrhagic lesions. The adrenal glands can also be affected by lesions.

Question 13

What is the pneumonia associated with Neisseria meningitidis infection?

Answer 13

Neisseria meningitidis can cause a milder form of meningococcal disease known as pneumonia. It is characterized by bronchopneumonia and typically occurs in individuals with underlying pulmonary disease.

Question 14

What is the significance of petechiae in Neisseria meningitidis infection?

Answer 14

Petechiae are small, pinpoint-sized skin lesions often seen in meningococcemia. They are caused by the thrombosis of small blood vessels and can be an important clinical sign indicating a severe and disseminated infection.

Question 15

What is the Waterhouse–Friderichsen syndrome (WFS) caused by Neisseria meningitis?

Answer 15

Waterhouse–Friderichsen syndrome (WFS) or hemorrhagic adrenalitis or Fulminant meningococcemia, is defined as adrenal gland failure due to bleeding into the adrenal glands

Question 16

Which species does Neisseria gonorrhoeae primarily infect?

Answer 16

Neisseria gonorrhoeae primarily infects humans. It is a strict human pathogen and does not naturally infect other animals.

Question 17

In which age group is the incidence of Neisseria gonorrhoeae common?

Answer 17

The incidence of Neisseria gonorrhoeae infection is particularly common in the age group of 15 to 24 years. This age range is often associated with increased sexual activity.

Question 18

What is the reservoir for Neisseria gonorrhoeae?

Answer 18

Asymptomatic infected individuals, with a higher prevalence among women.
These individuals may not exhibit any symptoms but can still transmit the infection to others through sexual contact.

Question 19

How do pili and Opa proteins contribute to the virulence of Neisseria gonorrhoeae?

Answer 19

Pili and Opa proteins are important for adherence of Neisseria gonorrhoeae to host cells. They enable the bacteria to attach specifically to the microvilli of nonciliated columnar epithelial cells.

Question 20

What is the role of Porin (Por) protein in Neisseria gonorrhoeae infection?

Answer 20

Porin protein, located in the outer membrane of Neisseria gonorrhoeae, is thought to act as an invasin. It mediates the penetration of host cells by the bacterium. Additionally, Porin protein may prevent the formation of phagolysosomes in neutrophils, which are immune cells that would normally destroy the bacteria.

Question 21

What is the clinical presentation of gonorrhea?

Answer 21

Gonorrhea is characterized by a purulent discharge from the involved site, such as the urethra, cervix, epididymis, prostate, or anus. The symptoms typically appear after a 2- to 5-day incubation period.
In males, major symptoms include urethral discharge and dysuria (painful urination), usually without urinary frequency or urgency.
Pharyngitis (from oral-anal sex) and anorectal gonorrhea (from anal-anal sex) can cause proctitis.

Question 22

What are the complications of Neisseria gonorrhoeae infection in males?

Answer 22

In males, complications of Neisseria gonorrhoeae infection can include prostatitis (inflammation of the prostate) and orchitis (inflammation of the testicles).

Question 23

What is pelvic inflammatory disease (PID), and how is it related to Neisseria gonorrhoeae infection?

Answer 23

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. Neisseria gonorrhoeae is one of the common pathogens associated with PID. It can cause endometritis (inflammation of the uterine lining), salpingitis (inflammation of the fallopian tubes), tubo-ovarian abscess (collection of pus involving the fallopian tubes and ovaries), and pelvic peritonitis (inflammation of the pelvic peritoneum).

Question 24

How does Neisseria gonorrhoeae infection during pregnancy affect the outcome?

Answer 24

Gonorrhea during pregnancy is associated with several complications, including spontaneous abortion (miscarriage), premature labor, and early rupture of fetal membranes. It is important to diagnose and treat Neisseria gonorrhoeae infection promptly in pregnant individuals to prevent these adverse outcomes.

Question 25

What is disseminated infection caused by Neisseria gonorrhoeae? What are its characteristics?

Answer 25

Disseminated infection is a rare complication of Neisseria gonorrhoeae infection. It occurs when the infection spreads from the genitourinary tract through the bloodstream to other parts of the body, such as the **skin or joints**. It is characterized by a *pustular rash with an erythematous (red) base and suppurative (pus-filled) arthritis in the affected joints.*

Question 26

What is ophthalmia neonatorum, and how is it related to Neisseria gonorrhoeae? How is its diagnosis confirmed?

Answer 26

Ophthalmia neonatorum is a purulent ocular infection acquired by a newborn during birth. It can be caused by Neisseria gonorrhoeae transmitted from an infected mother. **Acute conjunctivitis**, characterized by inflammation of the conjunctiva, develops within a few days of delivery. The diagnosis is confirmed by identifying **gonococci in the conjunctival secretions.**

Question 27

What are the appropriate specimens for the laboratory diagnosis of Neisseria gonorrhoeae?

Answer 27

For the laboratory diagnosis of Neisseria gonorrhoeae, specimens such as urethral discharge (from males) and endocervix swabs (from females) are commonly collected.

Question 28

What are the appropriate specimens for the laboratory diagnosis of Neisseria meningitidis?

Answer 28

For the laboratory diagnosis of Neisseria meningitidis, specimens such as cerebrospinal fluid (CSF), blood, and sputum are typically collected.

Question 29

What microscopic findings are indicative of Neisseria species?

Answer 29

Gram staining of clinical specimens may reveal gram-negative diplococci within polymorphonuclear leukocytes.

Question 30

Why is it important to inoculate the specimen for Neisseria gonorrhoeae diagnosis promptly?

Answer 30

Gonococci, the bacteria responsible for Neisseria gonorrhoeae, are highly sensitive and fragile. Therefore, **specimens should be kept dry and cold during transportation to the laboratory.**

Question 31

What are the types of media used for the growth of Neisseria species?

Answer 31

Neisseria species can grow on both non-selective media, such as chocolate blood agar, and selective media that suppress the growth of contaminating organisms. The selective media commonly used include *Modified Thayer-Martin medium* (chocolate agar with enriched supplements like nyastatin, colistin, and vancomycin) *GC selective agar* (GC agar base supplemented with lysed or chocolatized horse blood).

Question 32

What is the growth requirement for Neisseria species?

Answer 32

Neisseria species require the presence of 3-5% carbon dioxide (CO2) for optimal growth.

Question 33

How to differentiate between Neisseria species and Moraxella Cattarhalis?

Answer 33

Neisseria is DNase -ve while Moraxella Cattarhalis is DNase +ve.

Question 34

How to differentiate between Neisseria Meningitis and Neisseria Gonorrheae?

Answer 34

Neisseria Meningitis is not a Mannitol fermenter Neisseria Gonorrheae is a Mannitol fermenter

Question 35

Which species of Neisseria ferments glucose?

Answer 35

Both species ferment glucose

Question 36

What is the recommended treatment for Neisseria gonorrhoeae infection?

Answer 36

The recommended treatment for Neisseria gonorrhoeae infection is *ceftriaxone*, often given as empiric therapy. It is typically combined with *doxycycline* to treat possible co-infection with Chlamydia trachomatis (which frequently occurs alongside gonorrhea) or in case of beta lactamase producing cephalosporin.

Question 37

How can ophthalmia neonatorum caused by Neisseria gonorrhoeae be prevented?

Answer 37

Ophthalmia neonatorum caused by Neisseria gonorrhoeae can be effectively prevented by the **instillation of antibiotics** or a **1% aqueous solution of silver nitrate into the conjunctivae of the newborn soon after delivery.**

Question 38

Is there a vaccine available for Neisseria gonorrhoeae? If not, how is Neisseria Gonorrheae prevented?

Answer 38

Currently, there is no vaccine available for Neisseria gonorrhoeae. Prevention primarily involves sexual education, promoting responsible behavior, and practicing safe sex with the use of barrier methods like condoms.

Question 39

What is the recommended treatment for Neisseria meningitidis infection?

Answer 39

The recommended treatment for Neisseria meningitidis infection is **penicillin or a cephalosporin**

Question 40

How can passive immunity be provided against Neisseria meningitidis?

Answer 40

Passive immunity against Neisseria meningitidis can be provided through breastfeeding, as breast milk contains antibodies that can help protect against meningococcal disease.

Question 41

Is there a vaccine available for Neisseria meningitidis?

Answer 41

Yes, there is a *polyvalent* polysaccharide-protein conjugate vaccine effective **against serogroups A, C, Y, and W135** of Neisseria meningitidis. It is recommended for all *persons aged 11 to 18 years* and other individuals at increased risk for meningococcal disease.

Question 42

Can Neisseria species produce beta-lactamase?

Answer 42

Yes, Neisseria species can produce beta-lactamase, an enzyme that inactivates beta-lactam antibiotics like penicillin.

Question 43

Which Neisseria species is more likely to disseminate?

Answer 43

Neisseria meningitis. Neisseria Gonorrheae rarely disseminates

Question 44

How long do symptoms of Neisseria gonnorheae appear?

Answer 44

2-5 days IP

Question 45

What are the characteristics of Moraxella catarrhalis?

Answer 45

Moraxella catarrhalis is a **normal flora bacterium** found in the upper respiratory tract and is a low-level colonizer (1 to 5%). It is considered one of the pathogens involved in the development of otitis media, an infection of the middle ear.

Question 46

What are the diseases associated with Moraxella catarrhalis?

Answer 46

Moraxella catarrhalis is commonly associated with otitis media (ear infection) and sinusitis (inflammation of the sinuses). It can also cause pneumonia in adults, particularly in cases of Community-Acquired Pneumonia (CAP) in individuals with Chronic Obstructive Pulmonary Disease (COPD).

Question 47

How is Moraxella catarrhalis diagnosed?

Answer 47

Moraxella catarrhalis can be diagnosed by its characteristics, including being oxidase-positive and DNase-positive. Microscopic examination may reveal gram-negative diplococci. Culturing on blood or chocolate agar and incubating for 16-48 hours at 35°C-37°C in 5-10% CO2 is necessary for its growth.

Question 48

What is the treatment for Moraxella catarrhalis infections?

Answer 48

Moraxella catarrhalis is a beta-lactamase producer, meaning it produces an enzyme that can inactivate penicillin. Therefore, it is typically resistant to penicillin. Common treatment options include cephalosporins, erythromycin, and combinations of penicillins with a beta-lactamase inhibitor (e.g., clavulanic acid).