ALL MATERIALS HERE ARE INTELLECTUAL PROPERTY OF THE FACULTY & OF CEU, UPLOADING OF ALL LECTURE NOTES

RECORDINGS/HANDOUTS IN OTHER PLATFORMS WITHOUT CONSENT IS PROHIBITED & IS PUNISHABLE BY LAW

GRAM NEGATIVE AEROBIC COCCI

GENUS: Neisseria
reagent (NO DMSOL
:

Tetramethyl-p-phenylenediamide-dihydrochloride
General Characteristics: *
STA Medium

yellow
:

positive
o Taxo N (Cytochrome Oxidase) ·

screening test

o CHO UTILIZATION TEST what

organisms ferment
can
test
;

:
confirmatory

o Aerobic, gram (-) diplococci

o Coffee/kidney-bean shaped with adjacent sides flattened capnophilic

o NM, non-hemolytic, non-pigmented except N. flava, N. subflava, N. flavescens

o All are Catalase (+) except N. elongata
Transpar Media :
o All are Cytochrome oxidase (+) except N. elongata * Amie's with charcoal

X
transgrow
* direct inoculation at the badside * JEMBEC

Glu Mal Lac Suc Fru DNase

N. gonorrhoeae + - - - - -

N. meningitidis + + - - - -

N. lactamica + + + - - -

N. sicca + + - + + -

N. subflava + + - V - -

N. cinerea - - - - - -

N. flavescens - - - - - -

N. elongata - - - - - -

M. catarrhalis - - - - - +
 ALL MATERIALS HERE ARE INTELLECTUAL PROPERTY OF THE FACULTY & OF CEU, UPLOADING OF ALL LECTURE NOTES
RECORDINGS/HANDOUTS IN OTHER PLATFORMS WITHOUT CONSENT IS PROHIBITED & IS PUNISHABLE BY LAW

Bacterial meningitis

Neisseria meningitidis Epidemic meningococcal meningitis

bean shaped diplococci

NS, NM, ferments glucose, maltose
Natural habitat: oropharynx and nasopharynx
Primary isolation site:
Spinal fluid: meningitis
Blood: meningococcemia
Lower R T: meningococcal pneumonia
o Neufeld Quellung reaction

o
Virulence factor:

Disease:
Meningococcemia
Waterhouse Friderichsen syndrome
Bacterial meningitis
MOT

Incubation period -

Specimen - Blood, CSF, NPS, petechial lesions

Laboratory Diagnosis
o Gram stain
Culture BAP, CAP, Thayer Martin, NEW YORK CITY AGAR
Immunologic test Latex Agglutination/ CIE
CHO Utilization test
Butyrate Disk Test
 ALL MATERIALS HERE ARE INTELLECTUAL PROPERTY OF THE FACULTY & OF CEU, UPLOADING OF ALL LECTURE NOTES
RECORDINGS/HANDOUTS IN OTHER PLATFORMS WITHOUT CONSENT IS PROHIBITED & IS PUNISHABLE BY LAW

Oxidase CHO DNase Thayer Martin

N. gonorrhoeae + Glu +

N. meningitidis + - +

M. catarrhalis None + (+) Nutrient agar

Neisseria gonorrhoea
Kidney or coffee-bean shaped diplococci
NM, NS,NE
Requires immediate incubation in CO2 for growth
Not inhibited by vancomycin or lincomycin, colistin and nystatin or anisomycin
Ferments only GLUCOSE; DNase (-); ONPG (-)
Principal virulence factor:
Incubation period

Clinical Infections
Gonorrhea purulent discharge, dysuria difficulty in urinating(men), lower abdominal pain, vaginal
bleeding
Pharyngitis
Anorectal infections
Conjunctivitis (ophthalmia neonatorum) newborns
1% AgNO3
PID may cause sterility, perihepatitis
 ALL MATERIALS HERE ARE INTELLECTUAL PROPERTY OF THE FACULTY & OF CEU, UPLOADING OF ALL LECTURE NOTES
RECORDINGS/HANDOUTS IN OTHER PLATFORMS WITHOUT CONSENT IS PROHIBITED & IS PUNISHABLE BY LAW
Specimen Collection and Handling
Collect pus and secretions from urethra, cervix, prostate, rectal mucosa, eyes, vagina and oral cavity
Swabs are acceptable if specimen will be plated within
If cotton swabs are used, transport medium should contain charcoal to inhibit toxic fatty acids present
in the cotton swabs
N. gonorrheae is sensitive to SPS so the content in blood culture broths should not exceed 0.025%.
Body fluids (CSF or joint fluids) should be kept at room temperature or placed at 37C before culturing

Laboratory Diagnosis

o Gram stain
o Culture - BAP, CAP, Thayer Martin, MTM, Martin Lewis, New York City Medium
o Oxidase test tetramethyl-p-phenylenediamine dihydrochloride
o Superoxol test rapid test for N. gonorrhoeae (urogenital sites)
Reagent: 30% hydrogen peroxide
(+) result:
o Dnase test M. catarrhalis / N. gonorrheae

Media used to cultivate N. gonorrhoea

Thayer Martin agar contains VCN

Modified Thayer Martin media same components with Thayer martin but with trimetophrim lactate. VCN-T

Martin Lewis media- all modified Thayer martin components except nystatin ; anisomycin is used instead of
nystatin (VCAT)

New York City media same antibiotics as Modified TM (VCAT) but amphotericin B was used as substitute for
Nystatin

Transport Medium Transgrow and Cary Blair medium

Transgrow media TM with glucose, .2% agar, trimetophrim lactate and CO2 incorporated in a bottle

Neisseria lactamica

weak nasopharyngeal pathogen

Gram negative cocci
utilizes glucose, lactose, maltose because of enzyme
ONPG (+)
 ALL MATERIALS HERE ARE INTELLECTUAL PROPERTY OF THE FACULTY & OF CEU, UPLOADING OF ALL LECTURE NOTES
RECORDINGS/HANDOUTS IN OTHER PLATFORMS WITHOUT CONSENT IS PROHIBITED & IS PUNISHABLE BY LAW
Neisseria flavescens

Yellow pigmented organism

Primary isolation site:

Neisseria cinerea
Was first described in 1906
The colony morphology is also similar to N. gonorrhoeae on CAP
Also grows on Sheep Blood agar
Colistin susceptibility

Neisseria mucosa
Large colonies
Isolated from the airways of
Isolated from the nasopharynx of children or young adults

Neisseria polysaccharea
Described in 1974
Isolated the organism from throats of healthy children
Tests to separate N. polysaccharea from N. meningitidis are the ability to grow on Nutrient agar at 35C
and production of polysaccharide.

Neisseria sicca
Colonies of this organism is usually dry, wrinkled, adherent
Glucose, Maltose, Sucrose (+)
Primary isolation site: Nasopharynx, saliva, sputum

Neisseria subflava
Normal flora of upper respiratory tract
 ALL MATERIALS HERE ARE INTELLECTUAL PROPERTY OF THE FACULTY & OF CEU, UPLOADING OF ALL LECTURE NOTES
RECORDINGS/HANDOUTS IN OTHER PLATFORMS WITHOUT CONSENT IS PROHIBITED & IS PUNISHABLE BY LAW
Neisseria elongata
3 subspecies:
elongata, glycolytica, nitroreducens
Tests used are catalase, acid production from glucose, and reduction of nitrate.

Neisseria weaveri
Normal oral microbiota in dogs and can be found in humans.
Catalase positive
Gram negative rod that does not reduce nitrate but does reduce nitirite to gas
Primary isolation site:

Moraxella catarrhalis
Gram (-) diplococci; NM, non-hemolytic; non-pigmented
Oxidase and Catalase (+); Dnase
Non-encapsulated
Opportunistic pathogens pneumonia, sinusitis, otitis media
Lacks:
beta-galactosidase
gamma-glutamyl aminopeptidase
prolyl-hydroxylprolyl aminopeptidase
Normal flora of oropharynx & nasopharynx

Morphologically & biochemically resembles

Butyrate Disk Test
Rapid test for ID
Substrate: bromo- chloro-indolyl-butyrate
(+) result:
DNASE Test

Veillonellaceae
Genus: Veillonella, Acidaminococcus, Megasphaera
forms pairs or short chains but smaller than Neisseria
Veillonella are found in considerable numbers within the oral cavity