GRAM NEGATIVE COCCI

NEISSERIA

 They are obligate aerobic; non-motile and non-hemolytic

 They are capnophilic and have an optimal growth in a moist temperature
 They are carbohydrate fermenters- primarily glucose and maltose
 Growth is best observed on enriched medium or media containing blood, serum, cholesterol or
oleic acid
 They are sensitive to drying and extremes of temperature- direct inoculation of specimen “at
the bedside” is required for these bacteria
 Microscopy: gram- negative diplococci with coffee or kidney bean shape
 Biochemical tests: (+) oxidase; (+) catalase
 Major pathogens: N. gonorrhoeae and N. meningitides

Neisseria gonorrhoeae

 Is never considered part of the human flora

 Transmitted by sexual contact (person to person); infected mother to newborn during birth
 It requires iron for growth
 Glucose fermenter
 Principal virulence factor: common pili
 Colonial types: T1 and T2 (virulent), T3-T5 (avirulent)
 Clinical infections:
o Gonorrhea
 Symptoms: purulent discharge, lower abdominal pain and dysuria (men); dysuria
and vaginal bleeding (women)
o Purulent urethritis
o Pharyngitis
o Conjunctivitis (Ophthalmia neonatorum)
 Gonococcal eye infection, during vaginal delivery through an infected birth canal
o Purulent arthritis
 Specimen collection and handling
o Specimen: pus and secretions from urethra, cervix, prostate, rectal mucosa, throat and
joint fluid
 o Dacron or rayon swabs- for collection of specimen
 Notes to remember:
o Swabs should be placed in a transport medium and plated within 6 hours
o Cotton swabs should be avoided due to the presence of toxic fatty acids in the cotton
fibers

THAYER MARTIN VANCOMYCIN COLISTIN NYSTATIN

AGAR
MODIFIED THAYER VANCOMYCIN COLISTIN NYSTATIN TRIMETHOPRIM
MARTIN AGAR LACTATE
MARTIN LEWIS VANCOMYCIN COLISTIN ANISOMYCIN TRIMETHOPRIM
MEDIUM LACTATE
NEW YORK CITY VANCOMYCIN COLISTIN AMPHOTERICIN B TRIMETHOPRIM
MEDIUM LACTATE
Neisseria meningitidis
 Causative agent of epidemic meningococcal meningitis/ meningococcemia
 It may be found as a commensal inhabitant of the upper respiratory tract of the carriers
 Clinical infections:
o Meningococcemia
 Refers to the presence of N. meningitides in the blood and can occur as an acute
or chronic form
 It occurs with or without meningitis
 Notes to remember:
o The LOS- endotoxin complex activates the clotting cascade, depositing fibrin in small
vessels, producing hemorrhage in the adrenals (Waterhouse-Friderichsen syndrome),
altering peripheral vascular resistance, and leading to shock and death
o Individuals with a deficiency in complement C5-C8 are at risk of meningococcemia
 Specimen collection and handling
o Specimen: CSF, blood, nasopharyngeal swabs, petechial skin lesions
o Nasopharyngeal swabs should be plated immediately to the JEMBEC system, or
submitted on swabs placed in charcoal transport media
 Non- pathogenic Neisseria species
1. N. cinerea
  The colony morphology is similar to T3 colonies of N. gonorrhoeae on CAP
2. N. flavescens
 Is a yellow- pigmented Neisseria species; assacharolytic
3. N. lactamica
 Commonly found in the nasopharynx of infants and children
4. N. mucosa
 On culture, it is a large, often adherent to agar, and very mucoid colonies
5. N. sicca
 On culture, it has dry, wrinkled, adherent and breadcrumbs-like colonies
6. N. elongate
 Is a “rod-shaped” Gram-negative cocci
7. N. weaver
 Is a “rod-shaped” Gram-negative cocci

Moraxella catarrhalis (Branhamella catarrhalis)

 This species resembles Neisseria by exhibiting “gram negative coccal” morphology

 The most commonly isolated member of the genus Moraxella
 Part of the normal flora of upper respiratory tract
 Microscopy: small gram- negative cocci that tend to grow in pair end-to-end; with adjacent
sides flattened
 Culture: smooth, opaque, gray to white colonies with “hockey puck” appearance- colonies
remain intact when pushed across the plate with a loop
 CHO utilization test- does not utilize any sugar; asaccharolytic in CHO degradation test
 DNAse test positive
 Butyrate Esterase test- positive (blue color)

DIFFERENTIAL TEST FOR PATHOGENIC Neisseria and M. catarrhalis

N. gonorrhoeae N. meningitidis M. catarrhalis

Superoxol + - -
DNAse - - +
Nitrate reduction - - +
ACID PRODUCTION

SUGAR N. gonorrhoeae N. meningitidis N. lactamica M. catarrhalis N. subflava

GLUCOSE + + + - +
MALTOSE - + + - +
SUCROSE - - + - -
LACTOSE - - - - -