Neisseria, Haemophilus, AACEK Flashcards by Melissa May

Neisseria general characteristics

aerobic
GNDC like coffee beans
ox +
cat+
non motile
acid from oxidation of carbs not fermentation

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Neisserria gonorrhoeae overview

sexual transmitted
fastidious
capnophilic
GNDC like coffee beans
acid from glucose not other sugars
intracellular in PMNs
requires special media

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Neisseria gonorrhoeae clinical symptoms

2nd STD after Chlamydia
year 2000 increase in homeless/prostitute population
.5-3% dissemination: skin lesions, arthritis, joint fluid

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Neisseria meningitidis overview

capsule
small GNDC
2nd cause of comm. aquired meningitis
swift progression

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Neisseria meningitidis disease states

meningitis
septicemia
meningoencephalitis
arthritis
urethritis
young adult peak incidence (college dorms); most common in kids under 5
babies can get and develop symp later

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Is Neisseria meningitidis normal flora?

yes in the nasopharynx

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treatment of meningitis

IV penicillin (can cross blood brain barrier when meninges are acutely inflammed)
chloramphenicol or 3rd gen cephalosporin

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Neisseria lactamica

normal flora of nasopharnyx
more common in kids

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Moraxella catarrhalis overview

NF
GNDC
causes otitis media, sinusitis, bacteremia, endocarditis
looks like Neisseria but not in same group

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Moraxella catarrhalis treatment

most prod. beta lactamase
penicillin resistant; some trimethoprim also
susceptible to: fluroquinolone, trimethoprim-sulfamethoxazole, 2 and 3rd gen cephalosporins, erythromycin, amoxicillin-clavulana

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Neisseria general lab characteristics

GNDC
capnophilic- 3-7%Nacl
special media: CHOC
NURF grows on BAP & CHOC
ox+
cat+
nit=
nonmotile

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Neisseria gonorrhoeae lab characteristics

collection: urethral discharge, vaginal swab, rectal
transport media: Stuart’s or Annies, transgrow bottles: 5%CO2, Jembec plate
sm gry translucent raised opaque glistening on CHOC
Modified Thayer Martin media, Martin Lewis agar

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modified Thayer Martin media

selective enrichment
suppress vaginal/rectal flora
denatured hgb, vitamins, L-cysteine, cornstarch (ab inhib. substances)
Ab- vancomycin (inhibit GPC), colistin (inh. GNR), trimethoprim (inh. Proteus swarm.), nystatin (inh. fungi)

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Marin lewis agar

similar to MTM
[ ] vancomycin increased (gpc better supressed)
anisomycin instead of nystatin (inh. fungi and C. albicans)

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Neisseria gonorrheae key tests

ox+
superoxol+ (30%H2O2)
glu+, mal=, suc=, lac=
latex aggl., FA tech., rapid enzyme panel, DNA probe- beta lactamase test (use 2 to confirm)

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Neisseria meningitidis key tests

ox+
glu+, mal+, lac=, suc=
latex aggl.
not tested for beta lactamase

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Neisseria lactamica key tests

rare cause of meningitis
gluc+, mal+, lac+, suc=
grow on CHOC/BA

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Non pathogenic Neisseria

N. flavescens
N. polysaccharea
N. sicca
N. flava
N. subflava
N. perflava
N. mucosa
N. elongata

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Non pathogenic Neisseria lab characteristics

colonies dry wrinkled opaque yellow self-adherant

Non pathogenic Neisseria key tests

N. sicca: grow CHOC/BA, glu+, mal+, suc+, fru+, nit=
N. mucosa: grow CHOC/BA, glu+, mal+, suc+, fru+ , nit+
N. flavescens: grow CHOC/BA, no carb acid

Moraxella catarrhalis key tests

GNDC
colony buff opaque smooth slide like hockey puck
ox+
=carb
DNase+,
butyrate esterase+
catarrhalis disk+ (blue)
beta lactamase=

Haemophilus general characteristics

pleomorphic GNCB
require media w/ X,V, XV factors
needs increased CO2
non motile

Haemophilus influenzae key tests

ALA=
Requires x and V
no hem. on BA

Haemophilus aegypitius key tests

ala=
Needs xv
no hem on BA

Haemophilus parainfluenzae key tests

ala+ x=, v+, V only no hem on BA

Haemophilus ducreyi key tests

ala= x+, v=, x only no hem on BA

Haemophilus haemolyticus key tests

ala= Requires x & v factors hemolysis on BA

Haemophilus parahaemolyticus key tests

ala+ x=, v+, v only hemolysis on BA

Aggregatibacter aphrophilua key tests

ox+ w cat= indole= ferm.: glu+, lac+, mal+, suc+ GNCB endocarditis assoc. w/ tongue piercing

Aggregatibacter actinomycetemcomitans key tests

ox+ cat+ indole= ferm.: glu+, lac=, mal+, suc= GNCB slow grow 48-72 hrs

Cardibacterium hominis key tests

ox+ cat= indole+ ferm: glu+, lac=, mal+, suc+ GNR w/ rosette, teardrop, dumbbell form may pit agar

Eikinella corrodens key tests

ox+ cat= indole= ferm: glu=, lac=, mal=, suc= thin GNR or CB pits agar smells like bleach ornithine+

Kingella kingae key tests

ox+ cat= indole= ferm: glu+, lac=, mal+, suc= short rod w/ square ends

Capnocytophaga key tests

ox+ cat v indole= ferm: glu+, lac=, mal+, suc+ gliding motility colony sweats esculin= (usually+) nit+

catarrhalis disk

brom-chloro-indolyl buturate --------buturate esterase ---- > purple/indigo color change

beta-lactamase test should be tested on what organisms?

Haemophilus influenzae, Neisseria gonorrheae, Moraxella catarrhalis

beta lactamase test

disk contains the chromogenic cephalosporin known as nitrocefin which changes from yellow to red when the organism is inoculated with a penicillin resistant organism

Modified Thayer Martin (MTM)

Vancomycin – GPC Colistin – GNR Trimethoprim – Proteus Nystain – fungi including yeast

Martin Lewis (ML)

increased Vancomycin Colistin - GNR Trimethoprim - Proteus Anisomycin - yeast

Superoxol test

30% H2O2 to distinguish N. gonorrheae (+) from other Neisseria spp. (neg)

ALA-porphyrin test

The test medium contains delta aminolevulinic acid (ALA). The unknown organism is inoculated onto the medium and incubated for the appropriate amount of time. Growth is then observed under a Wood's lamp (UV light). The organism fluoresces a "brick-red" color

What does a positive ALA test tell us?

That it is able to synthesize X factor and does not require a source of exogenous X factor for growth.

Which organism shows a school of fish morphology on gram stain?

Haemophilus ducreyi

a group of heat-stable tetrapyrrole compounds that are provided by several iron-containing pigments such as hemin and hematin

x factor

nicotinamide adenine dinucleotide phosphate (NAD) is what factor?

v factor

What agar is V factor in?

Chocolate agar serves as a source of this substance in the growth of Haemophilus spp. It is normally present in 5% TSA Sheep Blood Agar as nicotinamide adenine dinucleotide phosphate (NAD) but is inactivated by NADase enzymes in the agar. Gentle heating of the blood during the production of chocolate agar inactivates the enzymes that hydrolyze this substance and makes it more readily available for use by these bacteria Isovitalex, an exogenous source of V-Factor is also added

The AACEK group is made up of:

Aggregatibacter aphrophilus Aggregatibacter actinomycetemcomitans Cardiobacterium Eikinella Kingella