NEISSERIA
Aerobe, gram negative,non motile, non sporulating,
oxidase positive,
Pairs- diplococci
Human pathogen commensal
Neisseria meningitidis Neisseria lactamia
Neisseria gonorrhoeae Neisseria subflava
Neisseria sicca
Neisseria flavescens
Neisseria meningitidis – meningo coccus
Aerobe, gram negative,non motile, non sporulating,
Pairs- diplococci, capsulated
Cultural characteristics :
Growth only in enriched media
Temp 35-36 C, PH 7.4-7.6
5-10% CO2 and humidity
Blood agar- weak haemolysis
Liquid media - poor
Blood agar,
Chocolate agar,
MUELLER- HINTON starch casein hydrolysate agar
Modified Thayer martin –selective media
MUELLER- HINTON starch casein hydrolysate agar
composition :
Beef extract
Acid hydrolysate of casein
Provides- nitrogen, carbon, sulphur, amino acid, vitamins
Starch –to absorb toxic metabolite
Agar
Uses: antibiotic susceptibility
Modified Thayer martin –selective media
Haemoglobin, vitamin, amino acid,dextrose
Vancomycin, colistin, nystatin
Bio chemical reaction :
Oxidase positive
Tetra methyl para phenylene diamine hydrochloride – deep
purple
Kovac’s method –paper strip method
Nitrates are not reduced
Glucose and maltose – acid, no gas
Antigenic properties :capsular polysaccharides antigen
-13 serotypes
Six groups are important A,B,C,X,Y W
Group A- epidemics
Group B – local out break
Group C – both
Serotypes : based on outer membrane protein – serotype
&subtype
Virulent factors :
• Capsular polysaccharide- inhibits phagocytosis
• Opacity protein – adhesion, invasion
• Endotoxin
• IgA protease binding to endothelial, epithelial cells-
URT
• Factor H binding protein –impairs complement
activation
Resistance :
• Susceptible to heat, desiccation, ph variation,
disinfectants
• Sensitive to penicillin,
Pathogenicity :
• Cerebrospinal meningitis
• Meningococcal septicaemia
Inhabitat – nasopharynx
Asymptomatic,
Pharyngitis, rhinitis
Dissemination –very few
High risk group:
Lab technicians, medical care worker
Droplet transmission
PATHOGENESIS
• Blood stream
• Perineural sheath of olfactory nerve
• Cribriform plate to subarachnoid space
Suppurative lesion- brain, spinal cord
MENINGOCOCCAL SEPSIS OR MENINGOCOCCAEMIA
Endotoxin –blood
Cytokine release
Endothelial damage
Capillary leakage
Tissue necrosis
Organ failure
Menigococcal septicaemia or meningococcaemia :
• non specific symptoms,
• petechial rash
• Joints, ears, eyes, lungs adrenals,
Fulminant form – waterhouse friderichsen syndrome
Fever, shock, DIC, multi organ failure,
Deficiency of C5-C9
LAB DIAGNOSIS :
Specimen :
CSF,
Blood, throat swab, skin lesion
Culture:
Bio chemical test:
Molecular diagnosis : PCR
Prophylaxis :
Poly saccharide vaccines :
Bivalent, trivalent, tetravalent
Conjugate vaccine :
Monovalent A,C,
tetravalent
NEISSERIA GONORRHOEAE:
Kidney shaped , within polymorphs
Pili,- adhesion to mucosal surface, inhibiting phagocytosis
Cultural characteristics :
• Chocolate agar,
• Mueller Hinton agar
• Thayer martin medium
Four types based on colony morphology :
T1 –T4
T1, T2: pili, virulent, small, brown – P+, P++
T3,T4 : no pili, non virulent,granular, larger non
pigmented, P-
T1, T2 – sub culture – T3, T4
Antigenic properties :
Antigenically heterogenous , able to change the surface
structures
• Pili
• Outer membrane protein I,II,III
• Endotoxin
• Protease
PILI
Compose of pilin-
peptide subunit,
hair like structure Function – adhesion,
phagocytosis
Outer membrane
protein :
Protein 1
Protein 1A
and 1B
using Monoclonal
antibodies in protein 1
epitope
A1-24, B1-32
Opacity
Attachment
associated
Opaque to host cells,
Protein II – outer
colonies. clumping of
membrane
cocci
protein
Protein I,III – attach to host cells, forms porin
Toxin : endo toxin – lipo oligosacharride
IgA1 protease – split and inactivate IgA
Resistance :
Killed by heat antiseptics, dessication
Resistance to penicillin, due to beta lactamase
PATHOGENESIS :
Pili –initiate adhesion
Adhesion of gonococci to epithelial cells
Invasion
Pathogenicity :
Transmission –sexual contact
Incubation period : 2-10 days
Acute urethritis- mucopurulent discharge, spreads
prostate, seminal vesicle,
Chronic urethritis : stricture, spreads to periurethral
tissue – abscess with multiple dischargin sinus –
watercan perineum
Female :
• Urethra and cervix not vagina
• Cervicitis – white discharge, dysuria,
• Barhtolin’s gland infection – abscess
• Salphingitis – infertility
Vulvovaginitis – prepubertal girls
Proctitis
• Conjunctivitis
• Opthalmia neonatorum
• Credes method : instilling 1% silver nitrate solution
into eyes of all new born babies
• Blood invasion – metastasis – arthritis , endocarditis
• Bacteremia : papule, pustule,
Lab diagnosis :
• Swab- urethra, cervix,
• Microscopy :
• Culture:
• Bio chemical test : ferments glucose not maltose –
forms acid , no gas
• Molecular test : PCR
Non specific urethritis :
In chronic urethritis,gonococci can’t be demonstrated L
form
Reiter’s syndrome :
Arthritis, urethritis, conjunctivitis
Moraxella catarrhalis - genus morraxella
Gram negative diplococci,
Opportunistic pathogen in human
Colonises in upper respiratory tract
Catalase and oxidase positive
Asaccharolytic
Growth in ordinary media