Prof. Khalifa Sifaw Ghenghesh

Genus: Neisseria
‡ G-ve, diplococci, kidney shaped ‡ Oxidase: +ve

Neisseria gonorrhoeae

1. N. gonorrhoeae
‡ Gonorrhoea
‡ Virulence Factors
-----------------------------------------------------------------------------------Factor Responsible for: -----------------------------------------------------------------------------------Pili Attachment to epithelial cell OMP II (PrII) OMP I (PrI) Invasion of epithelial cells LPS Damage to epithelial cells IgA protease Destruction of secretory Ab ------------------------------------------------------------------------------------

Clinical Significance
‡ Transmitted by direct, close, usually sexual contact between individuals. ‡ Uncomplicated gonorrhoea:
± In men: acute urethritis >purulent discharge ± in women (endocervix): vaginal discharge
‡ asymptomatic:

‡ ii. Conjunctivitis (ophthalmia neonatorum): ‡ iii. Pelvic inflamatory disease (PID): ‡ iv. Disseminated gonococcal infection (DGI):

Laboratory Diagnosis
‡ Specimens: Transport media!!!!
‡ Endocervical swab >> ‡ In DGI:

± Men: Urethral samples. ± Women: Uretheral, cervical and rectal specimens.

± Blood, swabs from skin lesions, or pus aspirated from a joint.

‡ In neonatal ophthalmia: Conjunctival material. ‡ Urine specimen:

‡ Gram stain ‡ Thayer-Martin Media:
±Oxidase test ±Carbohydrate utilization

Gram-stain of urethral discharge from an infected individual, showing Gram-negative diplococci.

Neisseria gonorrhoeae Urethral smear with gram negative intracellular diplococci

‡ N. gonorrhoeae "F-lactamase
‡ 3rd generation cephalosporins
± Ceftriaxone

‡ Ciprofloxacin:
± resistance?

2. N. meningitidis
‡ Virulence Factors: > Capsule. ‡ Serological Classification:
± Serogroups A, B, and C. ± Others: X, Y, Z, Z' (29E), and W-135

GramGram-stain of Neisseria meningitidis GramGram-negative diplococci

Clinical Significance
‡ Habitat: Oro- or naso-pharynges of asymptomatic carriers ‡ Transmission: ‡ Meningococcemia and/or meningitis > - rash - "Waterhouse-Friderchsen syndrome" ‡ Pneumonia >

Laboratory Diagnosis
Specimens: >> Transport media !!!!!
‡ CSF, blood, aspirate from skin lesions or pus from an infected joint.

‡ Carriers:
‡ Gram stain & Blood agar/ TM medium

‡ Grouping: Specific antisera. ‡ CSF: can be examined for meningococcal
polysaccharide antigen by latex agglutination, coagglutination, etc...

‡ Chemoprophylaxis. ‡ Vaccination.

± Penicillin ± Rifampicin ± Ciprofloxacin

‡ Other Neisseria species:
± Moraxella (Branhamella) catarrhalis

Moraxella catarrhalis