Nisseria Flashcards
Classify nisseria
Pathogenic
Nisseria meningitis
Nisseria gonorrheae
Non pathogenic
Nisseria flavescens
Nisseria cinnera
Nisseria subflava
Nisseria mucosa
Nisseria lactemica
Difference between gonorrhea and meningitis
Port of entry - genital tract vs respiratory tract
Capsule - absent vs present
Peptidoglycan - lipo oligo saccharide (LOS) vs lipo poly saccharide (LPS)
Maltose fermentation- no vs yes
Beta lactamase production - some vs none
Vaccine - no vs yes
What is another name of nisseria gonorrhoea
Gonococcus
Characteristics of nisseria gonorrhoea
- Gram negative
- Arranged in pairs
- Kidney shaped, concave sides are adjacent in pair
- Non motile and non spore forming
- Non capsulated
- Aerobic
- Endotoxin is lipo oligo saccharide
- Oxidase positive
- Ferment glucose but not maltose
- Only Pilated bacteria are pathogenic
- Presence of 5% CO2 enhances growth
What are the virulent factors of nisseria gonorrhoea?
- Pilli - non polished bacteria are pathogenic
- LOS - endotoxin
- IgA protease - enhance colonisation of organisms on mucosal surface
- Pot protein - confer resistance to serum killing of gonococci by preventing the fusion of phagolysome in neutrophils
- Opa - acts in attachment if gonococci to host cell
- Rmp - produce antibodies that block serum bactericidal activity against gonococci
What is pathogenesis of nisseria gonorrhoea?
Transmitted via sexual intercourse
Attachment of gonococci on mucosa (transitional and coloumnar epithelium) mediated by pilli
In male
1. Gonococci attach ti transitional cells of urethra
2. Set up suppurative inflammation
3. Urethritis develops
4. May extend and produce prostitution, seminal vasculitis, orchitis
In female
1. Gonococci attached to the columnar epithelium of endocervix
2. Set up suppurative inflammation
3. May extend to produce urethritis and may also salpingitis, oophoritis (salpingitis may result in fibrosis of Fallopian tube that leads to infertility)
Why doesn’t nisseria gonorrhoea affect vagina?
Lining is stratified squamous epithelium. It only affects transitional and columnar epithelium
What are the modes of transmission of nisseria gonorrhoea?
Sexual intercourse
Oro anal sex
From infected birth canal
What are the diseases produced by Nisseria gonorrhoea in male?
- Urethritis
- Epididymitis
- Prostatitis
- Seminal vasculitis
- Orchitis
- Prociitis
- Pharyngitis
Diseases produced by nisseria gonorrhoea in female?
- Cervicitis
- Urethritis
- Salpingitis
- PID
- Oophoritis
- Proctitis
- Pharyngitis
Disseminated infections caused by nisseria gonorrhoea
Arthritis
Tenosynivitis
Pustules in the skin
Neonatal infection cause by nisseria gonorrhoea
Purulent conjunctivitis
What are the complications caused by nisseria gonorrhoea
Males - strictures of urethra
Female - stricture of Fallopian tube that lead to infertility
What is the lab diagnosis of nisseria gonorrhoea?
Sample
A. From genital lesion
a. In male,
- acute stage - urethral discharge
- chronic stage - urethral discharge by per rectal prostatic massage
b. In female, - high cervical swab (swab from endo cervix)
B. From other site of lesion - pus and discharge according to site of lesion
C. Blood for culture
Lab examination
A. Examination of gram stained smear
- Observation: red/pink cocci against red background arranged in pair both intracellular and extra cellular
- Finding : nisseria species
B. Culture - incubate in chocolate agar media or Thayer-Martin media with 5% CO2 at 37 degrees for 24-48 hours
- observation,
a. Naked eye observation: small elevated, convex, glistening mucoid colonies are seen
b. Microscopy of culture: gram negative cocci in pair
C. Biochemical test,
a. Oxidase test : positive
b. Fermentation : ferment only glucose not maltose
What are the 4 antibiotics in Thayer Martin media
- Vancomycin
- Colistin
- Trimethoprim
- Nystatin or amphotericin B
