WEEK 8: GRAM NEGATIVE COCCI Flashcards by ZACHARIE JAEDIEL GONZAGA

I. General Characteristics

i. Obligate Aerobes
ii. Nonmotile
iii. Oxidase Positive
iv. Catalase positive
v. Gram Negative Diplococci
vi. Capnophilic
vii. Glucose Fermenter
(Except for M. catarrhalis)

Gram Negative Diplococci

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acute pyogenic infection, primarily in urethra, endocervix, anal canal, pharynx and conjunctiva.

Neisseria gonorrhoeae

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“flow of seed”- urethral discharge was mistaken for semen

Gonorrhea

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Venereal disease

Sexually transmitted infection

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iron-binding blood plasma glycoproteins that control the level of free iron in biological fluids

Receptors for human transferrin

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protective against inflammation

Protein I (porB)

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adherence to phagocytic cells and EC

Protein II (Opa)

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blocks host serum IgG

Protein III (Rmp) reduction modified protein

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attachment to host tissues present in types T1-T2

Pili

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T3,T4,T5

avirulent - no pili

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protect against phagocytosis

Capsule

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 Mediate damage to body tissues
 Released as outer mebrane fragments “blebs” w/c contain LOS responsible for its virulence

LOS or Endotoxins

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cleaves IgA on mucosal surfaces

IgA protease

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 Most commonly acquired by sexual contact from asymptomatic carrier (primary reservoir)
 HPV, C. trachomatis, N. gonorrhoeae

Epidemiology of Neisseria gonorrhoeae

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purulent discharge and dysuria

Urethritis in male and Cervicitis in female

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AHU strains

arginine, hypoxanthine, uracil

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Ophthalmia neonatorum

Conjunctivitis

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 Urethritis (males ) and cervicitis (female)
 PID, sterility, ectopic pregnancy and Fitz-Hugh-Curtis syndrome
 Conjunctivitis (Ophthalmia neonatorum)

Clinical Infections of Neisseria gonorrhoeae

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Polysaccharide capsule A

pandemics

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Polysaccharide capsule B,C

community acquired

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Polysaccharide capsule W-135

invasive disease

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Polysaccharide capsule Y

pneumonia

enzyme that aids in invasiveness

IgA1 protease

primary sources are oral secretion/ respiratory droplets (close contact)
Abrupt onset of frontal headache, stiff neck, fever

Neisseria meningitidis

release of toxins in the blood that breakdown the walls of the blood vessels

Meningococcemia

hemorrhaging of blood into skin & mucous membranes

Purpura (bruises) and Petechial rash (red spot)

(normal coagulation is disrupted and abnormal bleeding occurs), septic shock, hemorrhage of adrenal glands (Waterhouse-Friderichsen syndrome)

Disseminated intravascular coagulation (DIC)

i. Epidemic meningitis ii. Meningococcemia  Purpura and Petechial rash  Disseminated intravascular coagulation (DIC)  Waterhouse-Friderichsen syndrome

Clinical Infections of Neisseria meningitidis

1. Virulence factor  Attachment to respiratory epithelial cell 2. Epidemiology  Commensal of the upper respiratory tract 3. Clinical Infections i. Localized infections (otitis media and sinusitis) ii. Lower respiratory tract infections iii. Systemic infections (endocarditis, meningitis, etc.)

Moraxella catarrhalis

SELECTIVE MEDIUM: Thayer-Martin INHIBITORY AGENTS: Vancomycin SUPPRESSED ORG: ?

Gram-positive

CSF, blood, nasopharyngeal swabs and aspirates

N. meningitidis

 Genitalia: Urethra (male) and Endocervix (female)  Rectum and Pharynx

N. gonorrhoeae

SELECTIVE MEDIUM: Thayer-Martin INHIBITORY AGENTS: ? SUPPRESSED ORG: Gram-negative

Colistin

SELECTIVE MEDIUM: Modified TM INHIBITORY AGENTS: ? SUPPRESSED ORG: Swarming of Proteus

Trimethoprim

SELECTIVE MEDIUM: Martin Lewis INHIBITORY AGENTS: Anisomycin SUPPRESSED ORG: ?

Yeast

Presumptive identification: Positive – Neisseria and Moraxella

Oxidase test

SELECTIVE MEDIUM: ? INHIBITORY AGENTS: Nystatin SUPPRESSED ORG: Yeast

Thayer-Martin

iv. Incubation  35°C in a 3% to 5% CO2 atmosphere up to __ hrs

SELECTIVE MEDIUM: GC-Lect Agar INHIBITORY AGENTS: Lincomycin SUPPRESSED ORG: ?

Gram-positive

SELECTIVE MEDIUM: ? INHIBITORY AGENTS: Amphothericin B SUPPRESSED ORG: Yeast

New York City

Small, tan, may be mucoid and convex

N. meningitidis

Small, tan, transluscent and raised

N. gonorrhoeae

Cystine Trypticase Agar Sugar: glucose positive (yellow); all other are negative (red)

Neisseria gonorrhoeae

Smooth, opaque, gray to white colony may be swept intact (hockey puck), 48-hr colony - Wagon wheel

M. catarrhalis

What organism is positive in Superoxol test- 30% H2O2?

N. gonorrhoeae

Differentiation of Neisseria species through acid production from oxidation of carbohydrates

Cystine Trypticase Agar Sugar

what is the indicator of CTA sugars

Phenol red

Cystine Trypticase Agar Sugar: all tubes negative (red)

Moraxella catarrhalis

Cystine Trypticase Agar Sugar: glucose and maltose positive (yellow); all other are negative (red)

Neisseria meningitidis

What organism is positive in Superoxol 30% H2O2, MTM, ML, NYC and Glucose

Neisseria gonorrhoeae

For rapid detection of carbohydrate utilization and production of DNase and beta lactamase

QuadFERM+

What organism is positive in MTM, ML, NYC, Blood agar, Glucose and Maltose

Neisseria meningitidis

this organism is negative in Glucose

Moraxella catarrhalis