NEISSERIA

DR JOHN EGBAGBA
 Gram-Negative Cocci

• The family Neisseriaceae comprises the genera

Neisseria, Moraxella, Kingella, Eikenella and Acinetobacter.

Genus Cellular morphology

Neisseria GNC and GND

Moraxella GNC, GND and GNCB

Kingella GNCB

Eikenella Pleomorphic GNCB

Acinetobacter GNCB
 Neisseria
Description
• Gram-negative, oval cocci
• Include two impo. human pathogen:
– N. gonorrhoeae (gonococcus)
– N. meningitidis
(meningococcus)
Meningococci Gonococci
Capsulated Non capsulated
Lens shape Kidney shape ( G for Gonococci
and G looks like Kidney shape)
Ferments both Glucose and Ferments only Glucose (G for
Maltose (M for Meningococci and Gonococci and G for Glucose)
M for Maltose)
Extra/ Intracellular Mostly Intracellular ( Can live
within Neutrophils)
-Gram –ve diplococci

-Strict aerobe and capnophilic

- stays as commensal in GI and respiratory tract

-Catalase +ve

-Oxidase +ve

-Pili are very important Virulent factor

-Meningococci and Gonococci doesn’t grow at 22*C whereas other species

of Neisseria grows at that temp. It is used for differentiating.
-Gram –ve diplococci

-Capsulated

-Lens shape

-Ferments both glucose and Maltose

-Non motile

- CATALASE+VE

- OXIDASE +VE

Source of infection : Nasopharyngeal carriers : Provides natural immunity

Droplet infection : pulmonary involvement –via blood- enters meninges

DOC: 3rd generation cephalosporins

Carriers : Rifampicin
 VIRULENCE
FACTORS
1) Outer membrane protein

2) Pili : Virulence

3) Lipopolysaccharide

4) Capsular polysaccharide : Not responsible for

symptoms
 COMPLICATION
S
1) Waterhouse friedrichson Sx: B/L Adrenal Hemorrhagic
Necrosis

2) If C8-C9 complement deficiency : Recurrent Neisserial

Infections
 LAB
DIAGNOSIS
CSF Sample
Divide sample in 3 sample bottles and Send
to

Microbiology Biochem Pathology

Gram staining : Pink showing diplococci: Since Gram –

colonies ve

Media : Thayer Martin

media

Muller Hilton Agar

 VACCINE
-Meningococcal conjugate vaccine

-Vaccine includes Serotype A,C,Y & W but not against B serotype since
its capsule is poorly immunogenic
-Signs of Meningococcal septicemia
meningitis seen
Fever
+
- Characteristic
Hypotension
Rash is seen
+
Headache
:
+
Tachycardia
+
Petechial
rash
-Gram-ve, non capsulated

-Kidney shape

-Ferments only glucose

-Mostly intracellular

-Most common in females

but is mostly
asymptomatic

-More severe in males

-DOC:3RD GENERATION
CEPHALOSPORINS

- Plasmid recruitance :
Day by day resistance
 VIRULENCE FACTORS
1) Outer membrane protein

2) Pili : Virulence
Same as Meningococci
3) Lipopolysaccharide

4) Capsular polysaccharide : Not responsible for symptoms

5) Lactoferin and transferrin

 DISEASES

Ophthalmia neonatorum in newborns

Urethritis in males

Cervicitis in females
NON GONOCOCCAL
URETHRITIS
-C.trachomatis

-Ureaplasma urealyticum

- Mycoplasma hominis
 LAB DIAGNOSIS

SAMPLES
- Eye swab
- Urethral swab
- Endocervical swab

Media : Thayer Martin media

Modified new York media
 COMPLICATIONS

1) Water can perineum : In males, Multiple fistulas

2) Fitz- Hugh Curtis Sx: Perihepatitis

3) Suppurative polyarthritis

4) Reiter ’s Urethritis
+
Syndrome :
PolyArthritis
+
Conjunctivitis
1)
Cefixime
2) Ceftriaxone

3) 3rd generation
Ceftazidime
4)
Ceftazoxime
5) Except Cefuroxime which is a 2nd
Ceftibuten generation
6)
Cefoperazone
7) -Ceftoperazone and ceftazidime are active against
Cefpodoxime Pseudomonas. Rest of 3rd gen. is not active.

-More active against Gram -ve

MCQ QUESTIONS

1) The source of Neisseria meningitidis is the nasopharynx of human

carriers who exhibit no symptoms. The ability of this bacterium to
colonize the respiratory mucosa is associated with its ability to
synthesize which of the following?

A Coagulase

B Collagenase

C Hyaluronidase

D Pili

E. Catalase
Ans. D Pili

a. Both Neisseria gonorrhoeae and N. meningitidis adhere to the mucous

membrane tissues by means of pili (short protein appendages from the
membrane through the cell wall).

b.Coagulase and lipase are products of Streptococci, whereas collagenase

and hyaluronidase are enzyme products of Streptococci.
2. CSF in meningococcal meningitis shows:

A Gram positive diplococci in pus cells

B Gram negative diplococci in pus cells

C Gram negative bacilli

D Gram positive bacilli

E. Pleomorphic gram

negative rods
Ans. B Gram negative diplococci in pus cells

Meningococcus appears as gram-negative intracellular diplococci.

3. All are true about N. gonorrhoeae except:

A In adult females vaginal mucosa is commonly affected

B Thayer martin medium is selective medium

C Produces watercan perineum

D Pili is an important virulence factor

E. Gram negative diplococci
Ans. A In adult females vaginal mucosa is commonly affected

In females most common site of infection is endocervix.

Vaginal infection is seen in prepubertal females.

Thayer martin medium and New York City medium are

enriched media for
N. gonorrhoeae, made selective by adding antibiotics to
it.
 DISEASES

Ophthalmia neonatorum in newborns

MC:Urethritis in males

MC: cervicitis in females

4. Waterhouse friderichsen syndrome is caused by

A Neisseria gonorrheae

B Niesseria meningitides

C Chlamydia trachomatis

D Lymphogranuloma venerum
E. Streptococci pyogenase
B) Niesseria
meningitides
COMPLICATION
S
1) Waterhouse friedrichson Sx: B/L Adrenal Hemorrhagic
Necrosis

2) If C3-C9 complement deficiency : Recurrent Neisserial

Infections
5. All are true about Neisseria gonorrheae except

A Gram positive cocci

B Causes stricture urethra

C Involves seminal vesicles and spreads to epidi-dymis

D Drug of choice is Ceftriaxone

E. Causes meningitis
Ans. A Gram positive cocci

Gonococcus is a gram negative coccus.

6. Selective media for meningococcus is:

A Blood sugar

B Deoxycholate citrate media

C Thayer-Martin media

D McLeod media
E. Crystal violet agar
Ans. C Thayer-Martin media

Modified Thayer Martin Medium (MTM) is a selective medium used for

isolation of meningococcus and gonococcus.

Macleod medium is selective for C. diphtheriae and Deoxycholate citrate

medium is selective for Shigella.
7. A 33-year-old sexually active woman, a week after her menstrual
period, develops a painful, swollen right knee. The most likely
causative organism has which of the following characteristics?

A Both hyphae and spores

B Can live within neutrophils

C Cannot make ATP

D No true cell wall

E. Mycolic acid cell wall
Ans. B Can live within neutrophils

This is the history of septic arthritis due to N. gonorrhoeae. This

organism can live within neutrophils.

Gonococcal infections can disseminate through blood and can

cause septic arthritis.

Gonococcus is a gram negative diplococcus, catalase and

oxidase positive, fermenting only glucose.
Meningococci Gonococci
Capsulated Non capsulated
Lens shape Kidney shape ( G for Gonococci
and G looks like Kidney shape)
Ferments both Glucose and Ferments only Glucose (G for
Maltose (M for Meningococci and Gonococci and G for Glucose)
M for Maltose)
Extra/ Intracellular Mostly Intracellular ( Can live
within Neutrophils)