Neisseriacea: Neisseria Branhamella Moraxella

NEISSERIACEA
Neisseria
Branhamella
Moraxella
General Characteristics:
 Distinguished by their ____________________
 _______________________________
 Non spore-forming, non flagellated
 Pathogens are _____________ and
possess __________________
 Strict parasites that do not survive
long ___________________
 Sensitive to drying, cold, acidity
 _______________________
 Catalase and cytochrome oxidase
positive
N. gonorrhoeae and N. meningitidis
 Pathogenic species in the group
 Require _________________________
 Grow best in the presence of ________________
N. gonorrhoeae: The Gonococcus
 Causative agent of gonorrhea
 Virulence factors include:
1) ____________ and surface molecules:
__________________, invasion and infection of
epithelial cells and
_______________________________
2) __________: cleaves IgA on mucosal surfaces and stops
its mucosal effects
N. gonorrhoeae
 Does not survive more than 1-2 hrs on ________
 Most infectious when transferred through
___________
 Acquired through introduction into
______________________
 After attachment to epithelial tissue, bacteria invades
__________________________________
 2-6 days later, inflammatory reaction occurs
 10% of males and 50% of females are
_________________
Gonorrhea
 Strict human infection that occurs worldwide and
ranks in the top 5 STDs.
 Population: young adults with multiple sex partners
 Infectious dose: 100 – 1,000 colony-forming units
Genital Gonorrhea in Males
 Manifests as
_____________________________________
 Characterized by ____________ and purulent
discharge
 May be limited to distal urogenital tract
but may spread from urethra to
______________________
 Scar tissue in spermatic ducts will
render the individual _________
Genitourinary Gonorrhea in Females
 ___________________________________increase the
likelihood of infecting _______________during sexual
intercourse
 ________________________________occurs with
painful urination if there is urethral involvement
 Major complication: when infections in vagina and
cervix ascend to higher reproductive structures
Pelvic Inflammatory Disease
(Salpingitis)
 Caused by the ________________________________in
women
 Said structures _________________and bacteria may
initiate infection that may or may not produce symptoms
 Microbe may be involved in mixed infections with
anaerobic bacteria
 Characterized by fever, nausea, abdominal pain and
tenderness and abnormal discharge
 Buildup of scar tissue can ____________________causing
sterility and ___________________
Pelvic Inflammatory Disease
 Inflammation curbed at early age, long-term sequelae
is avoided
 Causative agent: Chlamydia spp, N. gonorrhoeae
 Pre-disposing factors:
1. Intercourse
2. Tampon usage
3. Use of intrauterine contraceptive device
4. Douching
 Long-term sequelae: Tubal Infertility
Tubal Infertility
 Scar tissue is formed from inflammatory repair process thus
___________________________________________________
__________________.
 Narrowed lumen: fertilization
may occur but _____________
___________________________
 Some cases: fertilized egg

implants in fallopian tubes or
elsewhere in abdominal cavity
Ectopic Pregnancy
 ______________________; women with history of PID
have 7-10x greater chance of experiencing ectopic
pregnancy
 Embryo growing in fallopian tube will
__________________________________
 Embryo in abdominal cavity causes
__________________________________
 ______________ is needed to save woman’s life
Extragenital Gonococcal Infections in
Adults
 Proctitis
 Gingivitis and pharyngitis
 Conjunctivitis
 Chronic arthritis with papular rash on limbs (rare):
bloodstream involvement
Gonococcal Infections in Children
 Infants born to gonococcus carriers are in danger of
being infected as they pass through the birth canal
 __________________are screened for presence of
gonococcus
 Gonococcal eye infections: keratitis, ophthalmia
neonatorum, blindness
 Universal precaution: instillation of __________and
_______________into conjunctival sac
 If found in children other than babies:
_______________________________________________
Diagnosis and Control
 Specimen: _________________________________found
to have neutrophils with gram negative diplococci is
diagnostic.
 ______________________________________________
 20M cases occur every year in the US
 20-30% are caused by drug resistant strains (PPNG,
TRNG)
 Fluorquinolones no longer part of
treatment due to increasing
resistance (2007)
Treatment
 If there is concurrent STD, broad spectrum
cephalosporin (cephtriaxone) to treat N. gonorrhoeae
with tetracycline (doxycycline) for chlamydial
infection.
 Azithromycin if allergic to cephalosporin
 Antibodies produced do not produce lasting
immunity, some may experience recurrent infections
Recommendations
 Tracing sexual partners to offer prophylactic antibiotic
therapy
 Education programs that emphasize effects of all STDs
 Safer sexual practices
Neisseria meningitidis: Meningococcus
 Causes cerebrospinal meningitis, 2nd most common
 Does not survive long in environment
 Acquired through
______________________________________
 Virulence factors:
1. _________________________
2. Fimbriae
3. _________________________
4. Lipopolysaccharide (endotoxin): released when cell
wall lyses
Epidemiology and Pathogenesis
 Carriage state: 3-30% of adult population
 Humans harbor the pathogen in the nasopharynx
 Transmission:
____________________________________________
 Risk group: young children (6-36 mos)
: older children and young adults (10-20 y.o)
Pathogenesis
 After reaching portal of entry, meningococci will attach
via the ____________
 Vulnerable individuals: meningococci is engulfed by
epithelial cells of mucosa and penetrate into nearby
blood vessels, causing _________________
 After entering blood vessels, bacteria crosses blood-brain
barrier, permeate the meninges and grow in the CSF.
 Symptoms: fever, sore throat, headache, stiff neck,
convulsions and vomiting.
 Most serious complication:
__________________________________________
Pathogenesis
Meningococcemia
 Pathogen sheds endotoxin into systemic circulation
which is a potent stimulus for some WBCs
 Damage to blood vessels caused by rush of cytokines
triggers hemorrhage and coagulation
 Petechia develop in the trunk and appendages
 Small cases: progresses to shock, necrosis of tissues in
extremities and loss of limbs
 Sudden onset, fever >40◦C,chills, delirium, widespread
ecchymoses
 Generalized intravascular clotting, cardiac failure,
damage to adrenal glands and death can occur within a
few hours
Pathogenesis
Meningococcemia
 Permanent effects of CNS infections are cognitive
impairment, learning disabilities and deafness in 10-
20% of patients
Clinical Diagnosis of Meningococcal
Disease
 Suspicion of bacterial meningitis constitutes a
_______________________
 Differential diagnosis should be done with
________________________ because complications
can come rapidly with lethal consequences
 ______________________________________________
__________
 Rapid tests are available that detect capsular
polysaccharide or cells directly from specimen without
culturing.
Immunity, Treatment and Prevention
 Infection rate is low, indicator of natural immunity
of most people
 Resistance is due to antibodies against capsular
polysaccharide of groups A &C and membrane
antigens of group B.
 Infected people must begin therapy
___________________because of 15% mortality rate
 Treatment of choice: third generation cephalosporin
that is broad spectrum and
_________________________________
 Patient may need treatment for
______________________________
 Family members, medical personnel or children in day
care: _________________________
 _____________________: recommended for personnel
between 11-18 years old including students, military
recruits and people exposed during outbreak.
1. ________________: recommended for people ages 2-55
years old
2. MPSV4(Menomune): for patients older than 55 years
Other Genera of Gram Negative Cocci and
Coccobacilli
 __________________________________: included in same
family because of morphological and biochemical
similarities
 Most are __________________________and other living
mammals or saprobes living in soil and water
 _____________________: opportunist in humans with
deficient immune function
: found in the nasopharynx and can cause purulent
disease
: associated with meningitis, endocarditis, otitis media,
bronchopulmonary infections and neonatal conjunctivitis
Branhamella
 Morphologically similar to gonococcus and may be

differentiated by biochemical methods
 Treatment: erythromycin or cephalosporins due to
production of penicillinase
Moraxella
 Appear as short, plump rods as well as cocci with some
having twitching motility
 Widely distributed in mucous membranes of domestic
mammals and humans and are generally weakly or non
pathogenic
 Rarely implicated in ear infections and conjunctivitis

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NEISSERIACEA

 Some cases: fertilized egg

 Morphologically similar to gonococcus and may be

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