Neisseria

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1

Neisseria

gram negative obligate aerobic diplococci and rods; coffee or kidney beans with flattened ends

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N. gonorrhoeae

sexually transmitted disease

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N. meningitis

normal flora in the throat but can be pathogenic

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capnophilic

prefer CO2

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fastidious

requires special nutrients to grow

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meningitis and catarrhalis

require blood agar as a minimum for growth

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gonorrhea

requires chocolate agar, MTM, ML, or NYC (amino acid cysteine)

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temperature (35-37 C)

very specific requirement for Neisseria growth

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PG 173

Box 9-2 MTM ML NYC

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catalase positive

testing result of all Neisseria except 1

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cytochrome oxidase positive

oxidase enzymes oxidize dye from blue to purple

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capnophilic

increased CO2 3-10%, candle jar or CO2 incubator

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cystine trypticase agar (CTA)

contains glucose maltose lactose and sucrose to see how organism feeds on sugars

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phenol redis

pH indicator

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glucose

sugar gonorrhea requires turning red indicator into yellow for a positive test result

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pili

hairlike structures on the cell that enable the bacterium to attach to the host

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gonorrhea

an acute pyogenic infection (works quickly) attaching to mucous membranes of endocervix and urethra

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ophthalmia neonatorum

conjunctivitis acquired by newborn if mother passes during delivery that may result in blindness; all NB treated prophylactically with antibiotic drops or cream

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disseminated gonococcal infection

gets into bloodstream and causes a septicemia with hemorrhagic skin lesions, arthritis, and or endocarditis

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blood or synovial fluid

disseminated infection sources of gonorrhea

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avoid cotton swabs and disinfectants

important specimen collection requirements

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TM, ML, or NYC along with chocolate

media for inoculating N. gonorrhoeae immediately and incubating in CO2

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gram stain

essential for immediate presumptive identification

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PMNs and gram negative diplococci

factors to report on gram stain; important to report few, moderate, many and intra or extracellular bacteria

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males

patients gonorrhea gram stain is most reliable for presumptive identification

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females

patients gonorrhea gram stain is less reliable for due to look alike bacteria including Acinetobacter or Moraxella

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pili

bases the five colonial types of gonorrhea

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1 and 2

the most virulent gonorrhea species that possess pili

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types 3, 4 and 5

fail to cause gonorrhea species infection in human urethra that lack pili

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oxidase

automatically performed on all possible isolates; all positives placed in Neisseria genus

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glucose

present when acid is produced in Neisseria gonorrhea

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coagglutination and DFA

immunologic methods for culture confirmation of N. gonorrhoeae

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nucleic acid testing molecular methods

DNA probes for culture confirmation; direct detection in urogenital specimens

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beta lactase

activity indicates resistance to penicillin; gonorrhea penicillin resistance

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PPNG

penicillinase producing Neisseria gonorrhoeae resistance to penicillin

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auxotypes

nutritionally variant strains of gonorrhea that require different nutritional requirements

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respiratory droplets or salivary secretions

transmission of bacterial meningitis by Neisseria meningitidis in those who are infection or who carry the organism

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capsular antigen

the main virulence factor made of polysaccharide and prevents organism from phagocytosis and prevents bacteriolysis; bases the thirteen serogroups of Neisseria meningitidis

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A, B, C, and Y

the most serious N. meningitis infections

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meningitis, meningococcemia, and pneumonia

invasive meningococcal disease that may occur

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meningitis

the most common type of invasive disease; abrupt rapid progressive disease; attaches by pili

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meningococcemia

acute form of meningitis, endotoxin released, petechia into skin lungs and joints, DIC, waterhouse-friderichsen syndrome (hemorrhage, shock and death); chronic recurrent episodes and patient is mildly ill

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cytokines

increase permeability of blood brain barrier inter CNS and present with classic symptoms: headaches, stiff neck, nausea, vomiting, delirium, rigid spine

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20%

percentage of bacterial meningitis that were caused by N. meningitidis

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nasopharynx, blood, CSF, skin lesion, and synovial fluid

specimen collection sites for N. meningitidis based on carrier state, sepsis suspected, rash, or septic arthritis

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CSF

may appear slightly cloudy or turbid; cytocentrifuged to concentrate specimen and gram stain sediment which shows gram negative diplococci with flattened adjacent ends

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blood, chocolate and thioglycollate broth

media to inoculate suspected N. meningitidis

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N. meningitidis

Neisseria that will grow on blood agar

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N. gonorrhoeae

Neisseria that will not usually grow on blood agar

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N. meningitidis

colonial appearance: round, smooth, shiny grey on chocolate; encapsulated stains may be mucoid

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cytochrome oxidase positive

N. meningitidis cytochrome oxidase result

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glucose and maltose

carbohydrate reaction of N. meningitidis

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Moraxella catarrhalis

resembles Neisseria morphologically and serologically; normal flora of upper respiratory tract; increasingly opportunistic; otitis media, sinusitis, pneumonia, endocarditis, conjunctivitis, bacteremia, wound infections, and meningitis

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nutrient agar TSA at 35-37 C

Moraxella catarrhalis plate growth and temperature

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M. catarrhalis

gray smooth opaque nonhemolytic colonies

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positive

oxidase result on M. catarrhalis

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positive

DNAse test result on M. catarrhalis

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fails to produce acid

M. catarrhalis carbohydrate reaction

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slides like a hockey puck

Moraxella catarrhalis colony characteristic on agar