Glossary of Micro: Neisseria and Branhamella
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- Pathogenic Neisseria: common metaboilic Characteristics?
- - N. meningitidis, N.gonorrhoeae
- Gram Negative diplococci
- oxidase (+), glucose (+)
- optimal growth on inc. CO2 and chocalate agar
- differentiation by sugar test and slide agglutination
*Martin Lewis: chocalate agar containing antibiotics active against gram(+)bacteria
- Pathogenic Neisseria: common pathogenic characteristics?
- both species contain pili and outer membrane proteins(OMP), may change antigenically from gen to gen
lipid A and core oligosacchride function as endotoxin
- N. Meningitidis: disease states?
- upper respiratory meningococcal disease ranging from mild febrile to severe pharyngitis
may progress to systemic meningococcemia presenting w/ fever, weakness, petechial rash
20-40 % progress to meningitis, then arthritis, endocarditis and Waterhouse- Friderichsen syndrome (adrenal coritcal necrosis)
- N. Meningitidis: describe the epidemiology?
- 2-3000 cases of meningococcal disease in US/year with fatality rate 10%
4-10% nasopharyngeal carriers
carrier state is 30-90% as a result of and during epidemics
- What makes N. Meningitidis pathogenic?
- pili - for ATTACHMENT
IgA protease - colonization, deactivation of IgA
LOS(polysacchride capsule) with sialic acid - interferes with complement
Endotoxin; sheds blebs of toxin
Outer Membrane Protein OMP binds IgG
- What are methods used to id/diagnose N. meningitidis?
- Gram stain spinal fluid, even buffy coat of blood
Ag detection in spinal fluid
culture spinal fluid, blood and petechiae (*remember CSF, glucose down, protein up)
nasopharyngeal swabs and throat
* there are 12 polysacchride serogroups
- N. Meningitidis: Immunity?
- most adults have immunity to cidal Abs
newborns have passive immunity
*children 6 mos to 2 yrs are most susceptible
asplenic persons and those with C5, C6, C7 deficiencies are esp susceptible
- N. Meningitidis: Rx and Vaccines?
- Penicillin in massive doses (is of very little risk to hospital personnel)
vaccine recommended for pts w/ asplenia or complement deficiencies
for families, soldiers use rifampin, ciproflaxin or ceftriazone for prophylaxis
vaccine contains polysacchride capsular antigens, used extensively by military and international travelers
- N. gonorrhoeae: What are the disease manifestations common to men and women?
- Short incubation 2-7 days
infection of the columnar and transitional epithelia of the urogenital tract
infection makes patients more susceptible to other STDs and HIV
pharyngitis occurs from oral genital sex
- N. gonorrhoeae: What are the clinical manisfestations in MALES?
- urethral infections subside in several weeks
repeated infections can lead to sequelae
most males present with pain on urination and a purulent pus
- N. gonorrhoeae: What are the disease manifestations in FEMALES?
- asymptomatic in about 30% of cases but may present with pain on urination , abdominal pain, and vaginal discharge
sequelae inc. fallopian tube inflammation w/ scarring pelvic pain, ectopic pregnacy and recurring PID
Disseminated Gonococcal (DGI) infections can result in septic arthritis and tenosynovitis
Gonococcal perihepatitis (Fitz Hugh Curtis Syndrome) and meningitis are rare complications
- N. gonorrhoeae: What are disease manisfestations in children?
- opthalmia neonatorum (eye infection) during passage thru birth canal as a reuslt of mom being infected with this bacterium
infection from sexual abuse leads to vulvovaginitis
- N. gonorrhoeae: Epidemiologic characteristics?
- The risk of getting this infection from an infected partner is 30% for females and 10% for males
- N. gonorrhoeae: Describe its pathogenicity?
- this bacteria has a pili and OMPs for attachment
Parasite directed endocytosis allows this org to enter cells which are not phagocytic
it forms a LOS/sailic complex
it upregulates catalase inside phagocytes to defend agst killing
Genetic variation in pili and surface Opa proteins help delay Ab reponse
- N. gonorrhoeae: Rx and immunity?
- 30% are resistant to penicillin and tetracycline
Fluoroquinolones are used w/ other antibiotics to cover possibility of multiple infection
repeated infections can occur
lack of immunity is due to genetic variation of gonococci
there is NO vaccine
- N. gonorrhoeae: What is the criteria for diagnosis?
- this org requires an enriched choclate agar for growth (if taken fron anorectal area)
for women take and endocervix specimen and anal canal culture
Men urine may be used as a specimen but it must be cultured immediately;
for men gram negative intra cellular diplococci on direct smear from urethral exudate is diagnostic
- What is the difference btwn Presumptive and Definitive diagnoses of N. gonorrheae?
- garam(-) diplococci colonies on chocolate agar w/ antibiotics(thayer-Martin) that are oxidase positive, are adequate in uncomplicated cases
complicated cases where suspect colonies must be subjected to sugar utilization tests or slide agglutination; recommended for sites other than anal or genital region
- N. gonorrheae: What are tequniques used for daignosis?
- non culture tests which allow gc to be transported or stored over a pd of days
ELISA detect gc antigens
genetic transformation test to detect gc DNA
Nucleic Acid amplification tests, expensive
- N. Sicca
- these are other sp. of Neisseria that are normal in the pharynx and can occasionally cause infection
- Branhamella (Moraxell) catarrhalis
- common commensal in the throat
it causes Otitis media in children
- T/F Slide agglutination is the major way to detect cases of pirulent meningitis in the Cerebral Spinal Fluid.
- False. Gram stain of CSF can detect bacteria in about 50 % of cases and can be used to distinguish between Hemophilus influenza, Strep pneumoniae, and N. meningitis.
Slide agglutination may also be used as an adjunct but not a substitute for Gram stain.
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