MBIO 4823 Final Review VIII

Neisseria: Named after German physician Albert Neisser

Defenses to overcome: Urination and vaginal secretion (pathogens washed

away), urine is acidic
N. gonorrhea: -gone: seed; rhea: a flow (a flow of seeds; reference to the
disease gonorrhea

N. meningitides: meningis, the covering of the brain; itis, inflammation

Characteristics: Gram +, diplococci, non-sporeforming, oxidase positive,

fastidious growth requirements, human specific (no other known reservoir)

• Sensitive to drying, UV light, localized to a mucosal surface (male

urethra and female cervix, throat, anus), Infants can be infected at
birth (eyes)

• Asymptomatic carriers are the norm rather than the exception

Statistics:

• Highest rates in men age 20-24 followed by those 15-19 years old

• In women highest rate in those aged 15-19, it is common to have

Gonorrhea and Chlamydia infections at the same time

• 1% of infects become systemic, announced as a new superbug in 2007

(1 in 4 cases classed as multiple resistant), 2nd most reported infectious
disease in the US

Symptoms:

• Women: generally asymptomatic, but when present include: vaginitis

(unusual discharge from the vagina), lower abdominal or pelvic pain,
pain or burning when urinating, bleeding between periods

o No symptoms are actually bad news, because Pelvic

inflammatory disease (PID) can be caused, causing damage to
the fallopian tubes (ectopic pregnancy)

• Men: White or yellow discharge from the penis, pain or burning when
urinating

N. Meningitides (meningococcal meningitis)

 • Transmission by aerosols, no mucosal inflammation

• Divided into subgroups by polysaccharide capsule

• Infects meninges, inflammation causes damage to blood brain barrier

(allowing phagocytes and serum proteins to enter spinal fluid
increasing pressure on the brain)

Virulence Factors:

• Adherence and invasion

o Invasion of the columnar epithelial cells (cervix) not squamous

cells (vaginal mucosa), causing inflammatory response

o Type 4 pili: binds to CD46 receptor which is involved in

complement cascade

o PorA and PorB: work on actin and cytoskeleton causing bacteria

to be ingested via pseudopods

o Opa proteins: 11 different types each distinct, binding to heparan

sulfate proteoglycan (HSPG) receptors

• Evasion of the host defenses

o Ability to vary surface antigens (1 million antigenic variants)

• Pili expression and control:

o Expression: pilE gene controlled by PilA (transcription activator)

and pilB (sensor)

o Nonexpressed gene pilS can inject bits of DNA into ile allowing
for variation

o pilC: gene involved in assembly and maturation of pili

• Lipo-oligosaccharide (LOS)

o Nisserial equivalent of LPS, only composed of Lipid A and

oligosaccharide

o Lipid A processes an endotoxin activity (triggers most of

inflammatory response)
 o Some strains take N-acetylneuraminic acid from blood and attach
it to galactose residues on LOS (camouflage)

• Blocking antibiotics

o Rmp (reduction0modified proteins): proteins that stimulate

antibodies to themselves that block the binding of LOS and por

• Iron Acquisition

o In vagina, nisseria have iron-sequestering receptors

o In male urethra, takes Iron from transferring and lactoferrin

N. meningitides: shares many of the same virulence factors, but causes

different disease

• Polysaccharide capsule: prevents phagocytosis and contributes to

serum resistance

Treatment/Prevention

• No vaccines, surface proteins too variable

• Increased antibiotic resistance requires newer more expensive

antibiotics

• Control measures:

o Encourage high risk groups to be screened, monogamous

relationships, condom use

Meningococcal Meningitis:

• Symptoms: fever, stiff neck, headache, sensitivity to light, seizures,

sometimes rash

• Vaccine: polysaccharide type A and C is used