Gram-Negative Cocci and Neisseria Pathogens
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Questions and Answers

Which of the following is NOT a risk factor for invasive Neisseria meningitidis disease?

  • Individuals with complement deficiencies
  • Crowded living conditions
  • Older adults living in close quarters (correct)
  • Asplenic patients
  • What is the primary mode of transmission for Neisseria meningitidis?

  • Airborne droplets (correct)
  • Fecal-oral route
  • Direct contact with infected individuals
  • Contaminated water sources
  • Which of the following is a characteristic of Neisseria meningitidis bacteria?

  • They are anaerobic bacteria and cannot survive in oxygen-rich environments.
  • They require a specific type of enriched media for optimal growth. (correct)
  • They are readily destroyed by common disinfectants.
  • They are non-fastidious and grow readily on standard media.
  • What is the typical incubation period for Neisseria meningitidis infection?

    <p>1 to 10 days (C)</p> Signup and view all the answers

    What is a possible consequence of Neisseria meningitidis infection?

    <p>Meningitis (C)</p> Signup and view all the answers

    Which age group is most susceptible to invasive Neisseria meningitidis disease?

    <p>Infants (B)</p> Signup and view all the answers

    What is the name given to the invasive form of Neisseria meningitidis infection that affects the bloodstream?

    <p>Meningococcemia (D)</p> Signup and view all the answers

    How can Neisseria meningitidis spread in crowded environments?

    <p>Through airborne droplets released by coughing or sneezing (D)</p> Signup and view all the answers

    What is a distinctive characteristic of Neisseria species that helps differentiate them from other Gram-negative bacteria?

    <p>They are oxidase positive. (D)</p> Signup and view all the answers

    Which of the following is NOT a general characteristic of the clinically significant Gram-negative cocci Neisseria and Moraxella?

    <p>They are typically Gram-positive. (B)</p> Signup and view all the answers

    What is true about the growth conditions of Neisseria species?

    <p>They can grow anaerobically in the presence of alternative electron acceptors. (C)</p> Signup and view all the answers

    How are Neisseria species often identified?

    <p>Based on their sugar fermentation patterns using CTA medium. (B)</p> Signup and view all the answers

    What is the significance of pili in Neisseria species?

    <p>Pili help the bacteria adhere to surfaces and form biofilms. (B)</p> Signup and view all the answers

    Which of the following is a true statement regarding the growth of Neisseria species?

    <p>They prefer a neutral pH environment for optimal growth. (A)</p> Signup and view all the answers

    What is the relationship between the morphology of Neisseria species and their capsule production?

    <p>Capsule presence is completely independent of the diplococcal morphology. (A)</p> Signup and view all the answers

    Some Neisseria species are described as capnophilic. What does this mean?

    <p>They prefer a high carbon dioxide concentration. (B)</p> Signup and view all the answers

    Which antibiotic is a recommended treatment option for patients allergic to penicillin?

    <p>Chloramphenicol (C)</p> Signup and view all the answers

    What are the two types of quadrivalent polysaccharide-protein conjugated vaccines available for Neisseria meningitidis?

    <p>A, C, Y, and W-135 (C)</p> Signup and view all the answers

    Who are the recommended recipients for the Neisseria meningitidis vaccine?

    <p>Military recruits, asplenic patients, and young adults aged 16 to 23 years old (A)</p> Signup and view all the answers

    What is the reason for using Azithromycin as a treatment option for Neisseria meningitidis?

    <p>Azithromycin is used as an alternative to ciprofloxacin if there is resistance. (D)</p> Signup and view all the answers

    Which of the following serogroups are NOT included in the quadrivalent polysaccharide-protein conjugated vaccines?

    <p>B (B)</p> Signup and view all the answers

    What are conjugated vaccines of proteins from other bacteria bound to Neisseria meningitides group B outer membrane proteins referred to as?

    <p>Quadrivalent vaccines (C)</p> Signup and view all the answers

    What is the recommended treatment option for confirmed meningitis?

    <p>Penicillin. (B)</p> Signup and view all the answers

    What is the primary reason for recommending vaccination against Neisseria meningitidis for laboratory scientists?

    <p>To ensure they are immune if exposed to the bacteria. (D)</p> Signup and view all the answers

    How do Neisseria species aid in exchange of genetic material from cell to cell?

    <p>Through the use of sex pili (D)</p> Signup and view all the answers

    Which of the following virulence factors of Neisseria species helps them evade the host's immune system by preventing phagocytosis?

    <p>Capsule (B)</p> Signup and view all the answers

    What is the primary function of lipooligosaccharides (LOS) in Neisseria species?

    <p>Tissue damage (D)</p> Signup and view all the answers

    Which virulence factor of Neisseria species plays a role in evading the host's immune response by preventing the binding of effective antibodies?

    <p>Antigenic variation (B)</p> Signup and view all the answers

    How does Protein II (Opa) contribute to the virulence of Neisseria species?

    <p>By facilitating adherence to phagocytic and epithelial cells (B)</p> Signup and view all the answers

    Which of the following Neisseria species is always pathogenic when present?

    <p>Neisseria gonorrhoeae (D)</p> Signup and view all the answers

    Which of the following is a known reservoir for Neisseria meningitidis?

    <p>Humans (A)</p> Signup and view all the answers

    What is the role of Protein I (Por) in Neisseria species?

    <p>Effective against inflammatory response and complement killing (B)</p> Signup and view all the answers

    What is the primary function of receptors for human transferrin in Neisseria species?

    <p>To compete for iron with the host (D)</p> Signup and view all the answers

    Which of the following is NOT a known virulence factor of Neisseria species?

    <p>Flagella (B)</p> Signup and view all the answers

    What is the primary human pathogen caused by Neisseria species?

    <p>Meningitis (B)</p> Signup and view all the answers

    Which of the following Neisseria species is also known as gonococci?

    <p>Neisseria gonorrhoeae (B)</p> Signup and view all the answers

    What is the primary role of IgA protease in Neisseria species?

    <p>Cleavage of IgA at mucosal surfaces (D)</p> Signup and view all the answers

    Neisseria species can be found as a commensal inhabitant of which of the following biological locations in humans?

    <p>The upper respiratory tract (B)</p> Signup and view all the answers

    What is the primary factor that determines whether a person infected with Neisseria meningitidis will develop meningococcal disease?

    <p>The amount of bacteria that colonize the nasopharynx (D)</p> Signup and view all the answers

    Which population is at greater risk for developing serious meningococcal disease?

    <p>Military recruits (D)</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with meningitis?

    <p>Shortness of breath (D)</p> Signup and view all the answers

    Which condition can increase the risk of developing meningococcal disease?

    <p>Being a smoker (C)</p> Signup and view all the answers

    What is a characteristic symptom of purulent meningitis?

    <p>Nausea and vomiting (B)</p> Signup and view all the answers

    Which of the following statements about meningococcus disease is true?

    <p>It can lead to septicemia. (D)</p> Signup and view all the answers

    What is the primary route of transmission for Neisseria gonorrhoeae infections?

    <p>Direct contact with infectious bodily fluids (D)</p> Signup and view all the answers

    Which of the following is a common site of infection in women infected with Neisseria gonorrhoeae?

    <p>Endocervix (A)</p> Signup and view all the answers

    What percentage of meningococcal B strains does chemoprophylaxis provide short-term protection against?

    <p>91% (C)</p> Signup and view all the answers

    Which group is not recommended for chemoprophylaxis during outbreaks?

    <p>Asymptomatic carriers (C)</p> Signup and view all the answers

    Which symptom is commonly associated with infections in women caused by Neisseria gonorrhoeae?

    <p>Lower abdominal pain (D)</p> Signup and view all the answers

    What is the primary reservoir for Neisseria gonorrhoeae?

    <p>Asymptomatic carriers (D)</p> Signup and view all the answers

    What form of delivery is used for administering chemoprophylaxis against meningococcal B strains?

    <p>2 or 3 dose series (A)</p> Signup and view all the answers

    What is the common type of discharge in women with Neisseria gonorrhoeae infections?

    <p>Cervical/vaginal discharge (D)</p> Signup and view all the answers

    Which of the following is a possible symptom of Neisseria gonorrhoeae infection in women?

    <p>Dysuria (D)</p> Signup and view all the answers

    What percentage of United States meningococcal B strains does chemoprophylaxis NOT provide protection against?

    <p>9% (D)</p> Signup and view all the answers

    Flashcards

    Neisseria

    A genus of Gram-negative cocci known for causing infections.

    Moraxella

    A genus of Gram-negative cocci associated with respiratory infections.

    Gram-negative cocci

    Bacteria that are spherical and do not retain the crystal violet stain used in Gram staining.

    Catalase positive

    Organisms that produce the enzyme catalase, breaking down hydrogen peroxide.

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    Oxidase positive

    Bacteria that can produce cytochrome c oxidase, indicating aerobic metabolism.

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    Capnophilic

    Organisms that thrive in the presence of carbon dioxide.

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    Pili

    Hair-like structures on bacterial surfaces that aid in adhesion and colonization.

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    Colony types T1-T5

    Different virulent colony types of Neisseria based on their pili presence.

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    Populations at risk for meningitis

    Military recruits, college students, smokers, and those exposed to smoke are at higher risk.

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    Symptoms of meningitis

    Key symptoms include frontal headache, stiff neck, confusion, photophobia, nausea, vomiting, and sometimes fever.

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    Septicemia

    A severe bloodstream infection that can follow meningitis.

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    Meningococcus disease rarity

    Meningococcus disease is uncommon in developed nations but poses risks to certain groups.

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    Conditions increasing meningitis risk

    Concurrent upper respiratory viral infections can escalate the risk of meningitis.

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    Fastidious organism

    An organism that requires specific nutrients for growth.

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    Epidemic meningitis

    A sudden outbreak of meningitis, often affecting specific populations.

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    Meningococcemia

    A serious bloodstream infection caused by Neisseria meningitidis.

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    At-risk populations

    Groups more likely to suffer from invasive Neisseria meningitidis diseases.

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    Asplenic patients

    Individuals who have had their spleen removed, making them vulnerable.

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    Complement deficiencies

    Genetic conditions affecting the immune system's ability to fight infections.

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    Incubation period

    Time from exposure to onset of symptoms, with meningitis ranging from 1-10 days.

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    Crowded living conditions

    Environments where many people live closely together, facilitating disease spread.

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    Neisseria meningitidis treatment

    Penicillin is used for confirmed meningitis cases.

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    Chloramphenicol

    Used for treating meningococcemia in penicillin-allergic patients.

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    Third-generation cephalosporins

    Recommended for asplenic patients with meningococcemia.

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    Chemoprophylaxis

    Preventive antibiotic treatment using rifampin, ciprofloxacin, or sulfonamide.

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    Quadrivalent meningococcal vaccines

    Vaccines available for subtypes A, C, Y, and W-135.

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    Serogroup B vaccines

    Two vaccines approved for targeting serogroup B of N. meningitidis.

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    Vaccine recommendations

    Vaccinations are advised for military recruits and certain young adults.

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    Close contacts prophylaxis

    Vaccination is essential for those close to infected individuals.

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    Virulence Factors

    Characteristics that enhance the ability of a pathogen to cause disease.

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    Capsule

    A protective layer that prevents phagocytosis by immune cells.

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    Phagocytosis

    The process where immune cells engulf and digest pathogens.

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    Mucous Membranes

    Moist tissues lining various body openings, providing a barrier against pathogens.

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    Neisseria meningitidis

    A bacterium that can cause meningitis, usually found in humans.

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    Neisseria gonorrhea

    A bacterium that always causes disease when present, known for gonorrhea.

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    Antigenic Variation

    The ability of pathogens to change their surface proteins to evade immune detection.

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    Outer Membrane Proteins

    Proteins on the surface of bacteria that aid in immune evasion and adherence.

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    Sex Pili

    Hair-like structures used for transfer of genetic material between bacterial cells.

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    IgA Protease

    An enzyme produced by some bacteria that cleaves IgA antibodies, allowing evasion of immune response.

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    Commensal Inhabitant

    Bacteria that normally live in a host without causing disease.

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    Transmission

    The process of spreading a disease from one host to another.

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    Tissue Damage

    Harm caused to body tissues by pathogens during an infection.

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    Iron Competition

    The competition between bacteria and the host for iron, which is essential for growth.

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    Meningococcal B strains

    Strains of Neisseria meningitidis responsible for meningitis outbreaks.

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    Dose series

    A sequence of doses given for vaccination or treatment.

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    Primary reservoir for gonorrhea

    Asymptomatic carriers who spread the infection without symptoms.

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    Transmission of gonorrhea

    Most commonly occurs through sexual contact.

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    Infection site in women

    The endocervix is the most common site of gonorrhea infection in women.

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    Symptoms of gonorrhea in women

    Include cervical/vaginal discharge, dysuria, and lower abdominal pain.

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    Cervical/vaginal discharge

    Fluid that can indicate a sexually transmitted infection in women.

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    Dysuria

    Painful urination often associated with infections.

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    Study Notes

    Gram-Negative Cocci

    • Gram-negative cocci are usually diplococci
    • Catalase positive
    • Oxidase positive
    • Most grow on sheep and chocolate agar
    • Identified by CTA sugar fermentation patterns
    • Aerobic
    • Nonmotile
    • Non-spore-forming

    Pathogenicity and Host Range

    • Table 17-1 shows pathogenicity and host range for Neisseria and Moraxella species.
    • Table 17-5 details characteristics of significant species
    • N. gonorrhoeae: primary pathogen, humans only
    • N. meningitidis: primary pathogen, humans only
    • N. lactamica, N. cinerea, N. sicca, N. flavescens: opportunistic pathogens, warm-blooded animals; N. subflava, N. mucosa: opportunistic pathogens, warm-blooded animals
    • Moraxella catarrhalis: opportunistic pathogen, humans only

    Cellular Structure of Pathogenic Neisseria

    • The cell wall of pathogenic Neisseria has components like LOS and pili

    Virulence Factors of Neisseria

    • Pili aid in attachment and prevent phagocytosis; exchange of genetic material
    • Capsule prevents phagocytosis
    • Cell-outer membrane proteins cause antigenic variation and prevent effective antibody binding
    • Major outer membrane porin proteins (Por, Opa, Rmp) block host serum bactericidal action and facilitate adherence
    • Lipooligosaccharides (LOS) lead to tissue damage
    • IgA protease cleaves IgA at mucosal surfaces
    • Receptors for human transferrin allow for iron competition

    Neisseria meningitidis

    • Found only in humans
    • Normal flora of the upper respiratory tract and urogenital tracts
    • May be a commensal or an invasive pathogen
    • Infections include endemic and epidemic meningitis and meningococcemia

    Neisseria meningitidis: Epidemiology

    • Spread through crowded living conditions (military recruits, college students)
    • Transmission via respiratory droplets from carriers to new hosts
    • Highest incidence in infants and adolescents
    • Populations at risk of invasive disease include asplenic patients and those with complement deficiencies
    • Factors contributing to spread include crowded living conditions and military/college settings

    Neisseria meningitidis: Clinical Infections

    • Symptoms include abrupt onset of headaches, stiff neck, fever, etc.
    • Death may occur within 12-48 hours after symptoms appear
    • Meningococcemia is characterized by purpuric skin lesions and may or may not accompany meningitis.
    • Complications may include arthritis, pericarditis, pneumonia, conjuntivitis, and urethritis
    • Can lead to Waterhouse-Friderichsen syndrome (adrenal hemorrhage)

    Laboratory Diagnosis of Neisseria meningitidis

    • Specimens like CSF, blood, or nasopharyngeal swabs are used
    • Need to grow on SBA and chocolate agar requiring CO2
    • Identification is based on colony morphology, microscopic morphology, and oxidase test

    Neisseria gonorrhoeae

    • Humans are the only natural hosts for gonorrhea
    • Urogenital tract, pharynx, and conjunctiva of the eye are common infection sites
    • Infections in men: Acute urethritis, Prostatitis, epididymitis
    • Infections in women: Endocervix (common), cervical or vaginal discharge, dysuria, lower abdominal pain, vaginal bleeding; untreated infections can lead to PID and sterility; complications may also include ectopic pregnancy and/or perihepatitis (Fitz-Hugh-Curtis syndrome)
    • Disseminated infections can lead to purulent arthritis and septicemia
    • Blood-borne disseminated infections can cause fever and rash on extremities.

    Neisseria gonorrhoeae: Identification

    • Direct microscopic examinations use Gram stains to look for gram-negative intracellular/extracellular diplococci
    • Cultures are crucial for confirmation using enriched media (like Modified Thayer-Martin (MTM) agar), with 35-37°C incubation and 3-10% CO2

    Neisseria gonorrhoeae: Treatment and Resistance

    • Penicillin for confirmed meningitis use
    • Chloramphenicol, third-generation cephalosporins, azithromycin, ciprofloxacin, or sulfonamides for penicillin-allergic patients.
    • Chemoprophylaxis with rifampin, ciprofloxacin, or sulfonamides may be used for people in close contact.
    • Antimicrobial-resistant strains exist (PPNG, CMRNG, TRNG)
    • Fluoroquinolones are no longer recommended due to resistance.
    • Ceftriaxone is currently the recommended treatment.

    Nonpathogenic Neisseria Species

    • Gram-negative cocci
    • Normal parts of upper respiratory microbiota.
    • Include N. bacilliformis, N. canis, N. cinerea, N. flavescens, N. elongata, N. mucosa, N. ovis, N. shayeganii, N. sicca, N. subflava, N. wadsworthii, N. zoodegmatis
    • Clinical diagnosis often involves growth in culture

    Moraxella Species

    • Family Moraxellaceae
    • 22 species (constantly revised), identified by being catalase-positive and oxidase-positive
    • Found in the upper respiratory tract as normal microbiota
    • One commercially important species is Moraxella catarrhalis, found in children and older adults and generally identified by being catalase positive and oxidase positive

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    Description

    This quiz covers the characteristics, pathogenicity, and virulence factors of Gram-negative cocci, specifically focusing on Neisseria species. It discusses their cellular structure, growth conditions, and host range. Test your knowledge on these important microorganisms and their roles in human health and disease.

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