The document summarizes the characteristics, pathogenesis, laboratory diagnosis, treatment and prevention of Neisseria meningitidis and Neisseria gonorrhoeae. N. meningitidis causes meningitis and meningococcemia, while N. gonorrhoeae causes gonorrhea. Both are gram-negative diplococci that require special media for growth. Laboratory diagnosis involves gram staining, culture, and tests for oxidase and sugar fermentation. Treatment is with penicillin or other antibiotics.
The document summarizes the characteristics, pathogenesis, laboratory diagnosis, treatment and prevention of Neisseria meningitidis and Neisseria gonorrhoeae. N. meningitidis causes meningitis and meningococcemia, while N. gonorrhoeae causes gonorrhea. Both are gram-negative diplococci that require special media for growth. Laboratory diagnosis involves gram staining, culture, and tests for oxidase and sugar fermentation. Treatment is with penicillin or other antibiotics.
The document summarizes the characteristics, pathogenesis, laboratory diagnosis, treatment and prevention of Neisseria meningitidis and Neisseria gonorrhoeae. N. meningitidis causes meningitis and meningococcemia, while N. gonorrhoeae causes gonorrhea. Both are gram-negative diplococci that require special media for growth. Laboratory diagnosis involves gram staining, culture, and tests for oxidase and sugar fermentation. Treatment is with penicillin or other antibiotics.
The document summarizes the characteristics, pathogenesis, laboratory diagnosis, treatment and prevention of Neisseria meningitidis and Neisseria gonorrhoeae. N. meningitidis causes meningitis and meningococcemia, while N. gonorrhoeae causes gonorrhea. Both are gram-negative diplococci that require special media for growth. Laboratory diagnosis involves gram staining, culture, and tests for oxidase and sugar fermentation. Treatment is with penicillin or other antibiotics.
Binu Babu M.Sc. (N) MBA, M.Sc. (N) Asst. Professor Asst. Professor The Neisseriae are Gram negative diplococci
Pathogens are:- N.Meningitidis
N.Gonorrhoeae Neisseria Meningitidis General characteristics • Gram-negative, bean-shaped, diplococci • Do not possess flagella or spores • Capsulated and possess pili. • Strict parasites, do not survive long outside of the host • Aerobic • Oxidative metabolism • Produce catalase and oxidase • Pathogenic species require enriched complex media and CO2 Morphology • Gram-negative, bean-shaped, diplococci • Do not possess flagella or spores. • Capsulated and possess pili. • 0.8 x 0.6 µm in diameter. Cultural characteristics • Can grow in blood agar, Chocolate agar. • Growth is improved by addition of blood or serum. • Growth is also improved by incubation in the presence of 2- 8 % CO2 • Growth temperature is 36-39⁰C and pH ranges of 6-8. • Colonies are 1-2 mm in diameter, convex, grey and transparent. No hemolysis in blood agar. Biochemical properties • Oxidase-positive; i.e., they possess the enzyme cytochrome and produce oxidase. • N.Meningitidis is maltose fermenter. • N.Meningitidis produces no beta lactamases. It has three important virulence factors: 1. Polysaccharride capsule. It is antiphagocytic in nature. 2. The endotoxin of N. Meningitidis is a lipopolysaccharide (LPS). It induces septic shock by causing release of cytokines. 3. IgA protease. It cleaves the IgA antibodies present in respiratory mucosa. Pathogenesis • Humans are the only natural hosts • The organisms are transmitted by airborne droplets • Colonize the nasopharynx and become transient flora of the upper respiratory tract. • From the nasopharynx, the organism can enter the bloodstream and spread to meninges and grow in the cerebrospinal fluid. Diseases • N. Meningitidis is the most common cause of meningitis in persons between the ages of 2 and 18 years. • Outbreaks of meningitis are most common in winter and early spring, and favored by close contact between individuals. 1. Meningitis 2. Meningococcemia (multiplication of bacteria in the blood stream) Laboratory diagnosis • It is frequently isolated from samples such as blood, CSF. • Different methods for laboratory diagnosis are: Gram staining Culture Oxidase test Fermentation tests Latex agglutination test Gram staining The diagnosis is suggested by the finding of gram negative bacteria bean shaped capsular diplococci. Culture The organism is cultured on blood agar or chocolate agar incubated at 37°C in a 5% CO2 atmosphere. Colonies are 1-2 mm in diameter, convex, grey and transparent. No hemolysis Oxidase test: Determines the presence of cytochrome oxidase. It is Positive in N.Meningitidis. Grow the isolate(s) to be tested for 18-24 hours on a blood agar plate at 35-37°C with ~5% CO2. Dispense a few drops of Kovac's oxidase reagent. Tilt the plate and observe colonies for a color change to purple. Positive reactions will develop within 10 seconds in the form of a purple color. Manitol fermentation: N. Meningitidis ferment manitol. Maltose fermentation: N. Meningitidis ferment maltose. Latex agglutination test, which detects capsular polysaccharide in the spinal fluid. Treatment and Prevention • Penicillin G or sulphonamides are the drugs of choice. • Cholramphenicol or third generation cephalosporin such as cefotaxime or ceftriaxone are recommended for patients who are allergic to penicillin. • Meningococcal vaccine, is available which contains the capsular polysaccharide. Neisseria Gonorrhoeae • N. Gonorrhoeae causes gonorrhea, neonatal conjunctivitis (ophthalmia neonatorum) and pelvic inflammatory disease (PID). Morphology • Oval shaped • Gram negative diplococci • Size is 0.6 to 0.8 µm. • Occurs in pair • Non motile • Capsulated and have pilli Cultural characteristics • Can grow in enriched media such as chocolate agar. • Growth is also improved by incubation in the presence of 5- 10% CO2 • Growth temperature is 37⁰C and no growth if the temperature is less than 25⁰C or more than 38.5⁰C • pH ranges of 7.2-7.6. Biochemical properties The virulence factors are. 1. Pili: Most important virulence factors. Piliated gonococci are usually virulent, whereas non piliated strains are avirulent. 2. Two virulence factors in the cell wall a) Lipooligosaccharride (LOS) (a modified form of endotoxin). Endotoxin of gonococci is weaker than that of meningococci. b) Outer membrane proteins(OMP) : OMP cause attachment of bacteria to epithelial cells of the urethra, rectum, cervix, pharynx, or conjunctiva, like pilli. 3. IgA protease • The main host defenses against gonococci are antibodies (IgA and IgG), complement, and neutrophils. • IgA protease degrades one of these antibodies. Other biochemical properties are; • They ferment glucose • They are oxidase positive Pathogenesis • Humans are only reservoir, not part of normal flora. • Causes disease only in humans. • Transmitted sexually both in males and females. • N. gonorrhea causes following infections. 1. Gonorrhea 2. Neonatal conjunctivitis (ophthalmia neonatorum) 3. Pelvic inflammatory disease (PID). Laboratory diagnosis • It is frequently isolated from samples such as blood, urethral discharge in men, cervical discharge in females. • Different methods for laboratory diagnosis are: Gram staining Culture Oxidase test Fermentation tests Gram staining The diagnosis is suggested by the finding of gram negative bacteria bean shaped capsular diplococci. Culture The organism is cultured on Thayar - Martin Agar or Mueller-Hinton agar (chocolate Agar) incubated at 37°C in a 5% CO2 atmosphere. Colonies are 1-2 mm in diameter, grey and transparent. N. gonorrhea grows rapidly producing small, No hemolysis. Oxidase Test • Test on filter paper or directly on plate • Oxidase reagent =Dimethyl or tetramethyl oxidase reagent • Violet-purple color indicates a positive result. Manitol fermentation: N. Gonorrhea ferment manitol. Maltose fermentation: N. Gonorrhea do not ferment maltose. Treatment and Prevention Treatment • Penicillin • Tetracycline if beta-lactamase positive strain. Can also use cephalosporins and flouroquinolones. Prevention • The prevention of gonorrhea involves the use of safety measures and the immediate treatment of symptomatic patients and their contacts.
(Medical Radiology) Mariano Scaglione, Ulrich Linsenmaier, Gerd Schueller, Ferco Berger, Stefan Wirth (Eds.) - Emergency Radiology of The Chest and Cardiovascular System-Springer International Publish