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Neisseria
Neisseria species
N. meningitidis
N. gonorrhoeae
N. lactimica..commensals in throat
N. sicca. //
N. subflava //
N. mucosa //
N. flavescens.. //
N. cinerea //
General characteristics
Kidney or bean shaped 0.8 1 m
Growth: Strict aerobe, 37oC, pH 7.2 -7.4,
moisture, enriched medium (Chocolate,
Thayer martin, MNYC ), 48 hrs incubation
Colonies
Pathogenic species: round convex, gray
white glistening 1-2 mm
Non pathogenic: opaque, brittle, wrinkled
General characteristics
Oxidase positive
Intracellular
Pili
genetic heterogeneity
Endotoxin
Sensitive to drying. Transmission requires
close contact
Pathogenesis
Transmission:
air droplets, flora naso-pharynx, transient flora
upper respiratory tract
5% people chronic asymptomatic carriers
Virulence factors
polysaccharide Capsule : antiphagocytic, antigenic
13 serotypes, A, B type causes meningitis
Endotoxins LPS: fever, shock
IgA protease: cleave IgA. adherence to upper
respiratory mucosa
Pathogenesis
N. meningitidis enters nasopharynx colonize
URT Enter blood bacteraemia spread to
distant sites e.g. meninges, joints, throughout
body (meningococemia)
antibodies to capsular antigens develop in 2 wks
& are protective group specific immunity in
carriers
Lab diagnosis
Specimen blood, CSF, naso-pharyngeal swab
Microscopy: diplococci in PMNLs or extra-cellular
Culture: 5% CO2, chocolate agar, modified thayer
martin ( Vancomycin, Colistin, Trimethoprim, Nystatin)
Biochemical tests:
Oxidase +ve, Catalase +ve, ferments maltose and
glucose
Serological:
latex agglutination for capsular polysaccharides in
CSF
Immunofluorescence for species
Neisseria gonorrhoeae
Pathogenesis
Virulence factors:
Pathogenesis
Transmission: sensitive to dehydration and cooling.
sexual contact, newborn during delivery. Ano-rectal
and pharyngeal infections in homos.
Local Infection: genitourinary tract, of mucosal
surfaces inflammation tissue invasion
suppuration fibrosis.
Pathogenesis
Dissemination depends on host resistance.
Asymptomatic dissemination
Host defence IgA & IgG antibodies and
complement. Resistance to antibodies and
complement, cause is uncertain, may be Porin
A.
C6-9 deficiency risk for dissemination esp.
during menses and pregnancy.
Diagnosis
Specimen: urethral discharge, vaginal swab
Microscopy: Intracellular diplococci in PMNL
differentiate from flora. cervical smear
Culture: Thayer martin medium - gray or translucent
colonies, chocolate agar- colorless
Biochemical tests: oxidase+, glucose+, maltose ve
Flourescent antibody staining
Rapid tests for gonococcal nucleic acids
Serological tests not useful
Treatment