Neisseria gonorrhoeae Overview

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Questions and Answers

What is the primary shape of Neisseria gonorrhoeae?

  • Chain-shaped
  • Rod-shaped
  • Spiral-shaped
  • Cocci arranged in pairs (correct)

Neisseria gonorrhoeae can be found as a commensal organism in healthy individuals.

False (B)

What type of media do Neisseria gonorrhoeae require for growth in laboratory conditions?

Enriched media, such as chocolate agar or Modified Thayer-Martin medium.

Neisseria gonorrhoeae is classified as a _____ organism requiring carbon dioxide for optimal growth.

<p>facultative anaerobe</p> Signup and view all the answers

Match the following terms with their descriptions:

<p>Aerobes = Organisms that require oxygen for growth Diplococci = Bacteria shaped as pairs Oxidase positive = Organisms that possess cytochrome C enzyme Enriched media = Nutrient-rich media for specific bacteria growth</p> Signup and view all the answers

Which of the following is NOT a characteristic of Neisseria gonorrhoeae?

<p>Gram-positive (C)</p> Signup and view all the answers

Only Neisseria gonorrhoeae causes disease in humans within the genus Neisseria.

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

What is one of the diseases caused by Neisseria gonorrhoeae?

<p>Gonorrhea</p> Signup and view all the answers

The bacterial infection gonorrhea is most commonly transmitted through _____ contact.

<p>sexual</p> Signup and view all the answers

Which virulence factor is associated with Neisseria gonorrhoeae?

<p>Pili for attachment (D)</p> Signup and view all the answers

Which of the following is NOT a treatment for uncomplicated gonococcal infection?

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

Nisseria is oxidase negative.

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

What is the common manifestation of gonorrhea in prepubescent girls?

<p>Vulvovaginitis</p> Signup and view all the answers

Nisseria grows at _____ degrees Celsius in a CO2 enriched environment.

<p>35-37</p> Signup and view all the answers

Match the following treatments with their specific use cases:

<p>Ceftriaxone = Uncomplicated gonococcal infection Azithromycin = Mixed infection with C. trachomatis Spectinomycin = Uncomplicated gonococcal infection Tetracycline = Mixed infection with C. trachomatis</p> Signup and view all the answers

What percentage of infertility is associated with ectopic pregnancy due to infections?

<p>20% (B)</p> Signup and view all the answers

Conjunctivitis in newborns is preventable with ocular prophylaxis.

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

Name a method used to identify gonococcal colonies in a laboratory setting.

<p>Culture on chocolate agar or MTM</p> Signup and view all the answers

Secretory IgA1 is destroyed by _____ protease.

<p>IgA1</p> Signup and view all the answers

Which of the following is an infection that can occur in children during childbirth?

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

What is the primary method used for detecting N. meningitidis in a laboratory setting?

<p>Smearing on oxidase reagent impregnated filter paper (B)</p> Signup and view all the answers

All strains of Neisseria gonorrhoeae are virulent.

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

What is the role of IgA1 protease in the virulence of Neisseria gonorrhoeae?

<p>It hydrolyzes secretory IgA1 and aids attachment to mucous membranes.</p> Signup and view all the answers

Neisseria gonorrhoeae can cause _____ infections in both men and women.

<p>urethral</p> Signup and view all the answers

Match the Neisseria species with their respective acid production from sugar:

<p>N. meningitidis = Glucose: +, Maltose: +, Sucrose: _ N. gonorrhoeae = Glucose: +, Maltose: _, Sucrose: _ N. flavescens = Glucose: _, Maltose: _, Sucrose: _ N. sicca = Glucose: +, Maltose: +, Sucrose: +</p> Signup and view all the answers

Which of the following is NOT a disease caused by N. gonorrhoeae?

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

Gonococci can cause asymptomatic infections in approximately 50% of females.

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

What type of organism is Neisseria gonorrhoeae?

<p>Bacteria</p> Signup and view all the answers

The presence of _____ in Neisseria gonorrhoeae facilitates its attachment to mucosal cells.

<p>pili</p> Signup and view all the answers

Which of the following components is responsible for endotoxic effects in N. gonorrhoeae?

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

Flashcards

What is the definition of microbiota?

Organisms that reside on or within human tissues and biofluids, including the skin, mammary glands, placenta, seminal fluid, uterus, ovarian follicles, lung, saliva, oral mucosa, conjunctiva, biliary and gastrointestinal tracts.

What is the primary microbiota found in the female genital system?

Lactobacilli

What are some examples of microbiota found in the male genital system?

Pseudomonas, Lactobacillus, or Prevotella

Describe the morphology of Neisseria gonorrhoeae.

Gram-negative cocci arranged in pairs, resembling a kidney shape.

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What are the cultural characters of Neisseria gonorrhoeae?

They are aerobes, needing oxygen to survive, and require enriched media containing heated blood (chocolate agar) or a selective media like MTM (Modified Thayer-Martin medium) to grow.

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What is the oxidase test result for Neisseria gonorrhoeae?

All species are oxidase positive, meaning they possess the enzyme cytochrome C

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What diseases can Neisseria gonorrhoeae cause?

Gonorrhea, a sexually transmitted infection (STI), and other complications like pelvic inflammatory disease (PID), disseminated gonococcal infection, and ophthalmia neonatorum.

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Briefly explain the pathogenesis of gonorrhea.

The bacteria adhere to the mucous membranes of the urethra, cervix, or rectum. They then invade the epithelial cells and multiply.

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How is gonorrhea transmitted?

They are highly contagious and spread through sexual contact. Transmission can also occur during childbirth from an infected mother to her baby.

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How is gonorrhea diagnosed?

Gonorrhea is diagnosed through laboratory tests, such as a Gram stain or a culture. Molecular tests (PCR) can also be used to detect the DNA of the bacteria.

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Gonorrhea

A sexually transmitted bacterial infection caused by Neisseria gonorrhoeae which can affect the cervix, urethra, rectum, conjunctiva, and throat.

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Cervicitis

Inflammation of the cervix, the lower part of the uterus.

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Urethritis

Inflammation of the urethra, the tube that carries urine from the bladder.

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Salpingitis

Inflammation of the fallopian tubes, the tubes that carry eggs from the ovaries to the uterus.

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Pelvic Inflammatory Disease (PID)

An infection of the reproductive organs in women, typically involving the fallopian tubes, uterus, and ovaries. It can be caused by various bacteria, including Neisseria gonorrhoeae.

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Ectopic Pregnancy

A pregnancy where the fertilized egg implants outside of the uterus, usually in the fallopian tube.

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Infertility

A condition where the body is unable to conceive naturally.

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Antigenic Variation

The ability of Neisseria gonorrhoeae to change its surface proteins, making it less recognizable by the immune system.

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IgA1 protease

An enzyme produced by Neisseria gonorrhoeae that breaks down IgA1 antibodies, reducing the immune system's ability to fight the infection.

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Chocolate agar

A type of agar used for culturing Neisseria gonorrhoeae, containing factors that support its growth. It's also called modified Thayer-Martin agar.

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Oxidase Test

A laboratory test used to identify Neisseria species. It involves smearing a bacterial colony on filter paper impregnated with an oxidase reagent. A deep purple color indicates a positive result, suggesting the presence of oxidase-positive bacteria like Neisseria.

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Acid Production from Sugar

A metabolic test to determine if a bacterial species can utilize a specific sugar for energy production. It involves inoculating a culture with different sugars (glucose, maltose, sucrose) and observing acid production.

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Neisseria

A genus of bacteria that includes the causative agents of gonorrhea (Neisseria gonorrhoeae) and meningitis (Neisseria meningitidis). These bacteria are typically gram-negative diplococci.

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Pili

Hair-like appendages on the surface of Neisseria gonorrhoeae that mediate its attachment to mucosal cells. They also exhibit anti-phagocytic properties, making it harder for the immune system to engulf the bacteria.

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Lipopolysaccharides (LOS)

A component of the outer membrane of Neisseria gonorrhoeae that is responsible for its endotoxic effects, triggering inflammation and other harmful responses in the host.

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Outer Membrane Proteins (I, II, III)

Proteins found on the outer membrane of Neisseria gonorrhoeae that play a role in attachment to host cells. They can also contribute to immune evasion.

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Porin A

A specific porin protein found in some strains of Neisseria gonorrhoeae. It inactivates a crucial immune component (C3b) and allows the bacteria to resist antibody-mediated killing, potentially leading to widespread infections.

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Study Notes

Neisseria gonorrhoeae

  •  Neisseria gonorrhoeae (gonococci) cause gonorrhea (STD)
  •  Morphology: Gram-negative diplococci (kidney bean shape). Occur intracellularly and extracellularly in infected tissues
  •  Cultural characteristics: Aerobes, requiring enriched media (e.g., chocolate agar or Modified Thayer-Martin medium) containing heated blood, antibiotics to inhibit other organisms present in the specimen; incubated at 35-37°C and 5-10% CO2
  •  Biochemical activities: Oxidase-positive (due to cytochrome C)
  • Acid production from sugar: Glucose is positive for N. meningitidis and N. gonorrhoeae; maltose is positive for N. meningitidis; sucrose is negative for all species tested.
  •  Antigenic composition and virulence factors:
    • Pili: mediate attachment to mucosal cells and are antiphagocytic. Non-piliated strains are less virulent. There are 100 serotypes and antigenic variation due to chromosomal rearrangement.
    • Lipooligosaccharides (LOS): responsible for endotoxic effects
    • Outer membrane proteins (I, II, III): play a role in attachment
    • Porin A: present in some strains, inactivates C3b, making strains resistant to killing by antibodies and complement; leads to disseminated infections.
    • IgA1 protease: hydrolyzes secretory IgA1, aiding attachment to mucous membranes (colonization)
  •  Diseases caused by Neisseria gonorrhoeae:
    • Urogenital, pharyngeal, and rectal infections in males and females.
    • Conjunctivitis in adults and neonates. Untreated gonorrhea can lead to pelvic inflammatory disease (PID), tubal infertility, ectopic pregnancy, and chronic pelvic pain.
  •  Genital infection in men: urethritis, epididymitis. Infection can progress to chronic infections with scanty discharge.
  •  Genital infection in women: approximately 50% asymptomatic. Common symptoms include cervicitis, urethritis, salpingitis, pelvic inflammatory disease (PID), ectopic pregnancy, and infertility (20%). No infection of the adult vagina, due to normal vaginal acidity and flora.
  •  Anorectal and throat infections in heterosexual men and women.
  •  Infections in children: - Perinatal infections during childbirth can affect the neonatal conjunctiva, pharynx, respiratory tract, and anal canal. Preventable by newborn ocular prophylaxis. - In older children, gonorrhea should raise suspicion of sexual abuse. Vulvovaginitis (non cervicitis) is common in prepubescent girls.
  •  Repeated gonococcal infection: - Antigenic variation of pili and outer membrane proteins - Superficial nature of infection, limiting IgG protective action - Secretory IgA1 is destroyed by IgA1 protease

Diagnosis

  •  Specimen: discharge from urethra, cervix, rectum, conjunctiva, throat, or synovial fluid
  •  Identification of colonies by: - Morphology: gram-negative diplococci - Biochemical reaction: oxidase-positive, acid production from glucose - Detection of gonococcal antigen using ELISA
  •  Culture: On chocolate agar or Modified Thayer-Martin (MTM) medium. Incubation at 35-37°C in 5-10% CO2
  •  Blood culture

Treatment

  •  Penicillin G: Drug resistance reported in 1950.
  •  Ceftriaxone: uncomplicated gonococcal infections
  •  Spectinomycin or ciprofloxacin: Used if mixed infection with Chlamydia trachomatis
  •  Tetracycline or azithromycin: Used if mixed infection with Chlamydia trachomatis

Prevention

  •  Condoms
  •  Treatment of patients
  •  Treatment of neonatal ophthalmia after birth with erythromycin or tetracycline eye drops and ointments

Quiz Time

  •  Question 1: Is Nisseria oxidase negative? (Answer: False)
  •  Question 2: Does Nisseria grow at 35-37°C in 5-10% CO2? (Answer: True)

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