Neisseria

Neisseria

1. Gram -

2. DIPLOCOCCI

3. NONMOTILE

4. AEROBES

5. OXIDASE +

6. NO ENDOSPORES

7. N. gonnorhoeae (Gonococcus)

   • STD--Gonorrhea (THE CLAP)
     • SYMPTOMS
       • WOMEN (20-40%) WOMEN ARE ASYMPTOMATIC
         • (10%) OF MEN ASYMPTOMATIC
       • IN WOMEN: MILD VAGINITIS
         • IN MEN: PAINFUL INFECTION OF THE URETHRAL CANAL
           • Burning sensation when urinating
           • white, yellow, green discharge
           • painful or swollen testicles
         • painful or burning sensation when urinating
           • increased vaginal discharge
           • vaginal bleeding between periods
       • STD's PRESENT DIFFERENT SYMPTOMS DEPENDING ON GENDER
       • OTHER ORGANS CAN BECOME INFECTED; BUT NOT COMMON
   • STRICTLY HUMAN RESORVOIR
     • MUCOSAL PATHOGEN: ASSOCIATED W/ MUCOSAL SUFACES
       • RESIDES IN EPITHELIAL CELLS; SUSTAINED IN MUCUS (GLYCOPROTEINS
   • CHARACTERISTICS
     • DO NOT SURVIVE IN DRY ENVIRONMENTS
     • SENSITIVE TO SUNLIGHT
     • N. GONORRHOEAE, URGENT
       • CLOSTRIDIUM DIFFICILE (URGENT #1)
   • TRANSMISSION
     • SEX (ANAL, VAGINAL, OR ORAL
     • OR DURING DELIVERY (INFANT CAN BE INFECTED)
       • EYE INFECTIONS IN NEWBORNS (TREATED WITH ERYTHROMYCIN DROPS)
         • PROPHYLACTIC TREATMENT (Preventative treatment)
   • HISTORY
     • OLD BACTERIAL STD
       • INFECTIONS DESCRIBED IN ANCIENT CHINA, EGYPT, ROME, GREECE
   • 2nd MOST COMMON BACTERIAL STD
     • CHLAMIDIA #1
       • 3RD SYPHILLIS
       • ~2.9 MILLION
     • ~700,000 CASES/YR/US
       • ~800,000
     • INCIDENTS OF GONORRHEA REMAIN HIGH BECAUSE:
       • ACQUIRED IMMUNITY DOES NOT EXIST
         • ORAL CONTRACEPTIVES HELP COLONIZATION
           • SYMPTOMS IN FEMALES CAN BE MILD, BUT UNDETECTED AND ARE PASSED DOWN TO MEN
     • HIGHER DISTRIBUTION GONORRHEA IN EAST COAST
       • HIGHEST IN AFRICAN-AMERICAN
       • ANTIBIOTIC USAGE STARTED IN 1945
       • 1960s-1970s increased
         • DECREASED AGAIN IN 1981 (WHEN HIV WAS DISCOVERED)
   • VIRULENCE FACTORS (NO EXOTOXINS)
     • PILI
       • BINDING TO SURFACES
     • OPA
       • SURFACE PROTEINS: BINDING TO EPITHELIAL AND PHAGOCYTIC CELLS; CELL-TO-CELL SIGNALING
         • PROTECTS FROM PHAGOCYTES
         • PHASE VARIATION
           • TO CHANGE EPITOPES OF SURFACE PROTEINS
     • IgA1 PROTEASE
       • AUTOTRANSPORTER PROTEIN
         • INACTIVATES IgA1 ANTIBODIES
           • ANTIGENIC VARIATION
             • RESULTS FROM THE REASSORTMENT AND RECOMBINATION OF DUPLICATED GENE SEGMENTS
             • GONOCOCCAL CHROMOSOME contains a single copy of the complete PILIN gene
               • PILIN is a structural protein that is polymerized to form pili
                 • This gene is called Pil E, FOR "PILIN EXPRESSION LOCUS"
                   • in addition, gonococcal chromosome contains 10 to 15 copies of variant-encoding pilin genes
                     • THESE copies are truncated at their 5' ends and lack transcriptional promoter elements, as well as the sequences specifying they N-term part of pilin
                       • copies called pilS loci for "silent (nonfunctional) loci"
           • many different EPITOPES
     • LOS & PEPTIDOGLYCAN
       • ENDOTOXINS
       • LIPOOLIGOSSACHARIDE
   • DIAGNOSIS
     • SWAB OF DISCHARGE
     • EXAMINATION OF GRAM STAINING
     • BIOCHEMICAL ASSAYS ON SELECTIVE MEDIA
     • NUCLEIC-ACID AMPLIFICATION ASSAY (RAPID AVAILABLE IN 4 HOURS/SENSITIVE/SPECIFIC
     • PREVENTION/TREATMENT
       • ANTIBIOTICS
         • PENICILLIN
         • CEPHALOSPORIN/QUINOLONES/ETC.
           • BIG PROBLEM (SUPERBUGS) MULTIDRUG-RESISTANCE
       • NO VACCINE BECAUSE:
         • i. hypervariability of surface protein
         • ii. blocking antibodies
         • iii. intracellular resistance

8. N. meningitides (Meningococcus)

   • Bacterial meningitis and septicemia
     • BACTERIAL INFECTION AROUND THE BRAIN
   • RESERVOIR: HUMAN
   • TRANSMISSION
     • DIRECT CONTACT, AIRBORNE
   • SEROGROUPS OF CAPSULES
     • A/B/C/W-135/Y
   • DIFFERENCES
     • PRESENCE OF CAPSULES
     • VACCINE AVAILABLE
   • STAGES OF BACTERIAL MENINGITIS
     • 1. BACTERIA ENTER BLOODSTREAM AND COLONIZE MENINGES (MEMBRANES LINING NERVOUS SYSTEM
       • 2. INFLAMMATION OF MENINGES ALLOW PHAGOCYTES AND BLOOD PROTEINS TO ENER SPINAL FLUID AND BRAIN
     • SYMPTOMS
       • 1. FIRST SIGNS: FEVER, STIFF NECK, HEADACHE, RASH
       • 2. CAUSES DEATH TO 3% OF ALL CASES
       • 3. ASYMPTOMATIC CARRIAGE COMMON
   • VIRULENCE FACTORS
     • CAPSULE: MOST STRAINS ARE ENCAPSULATED
     • ENDOTOXINS LOS
       • LIPOOLIGOSSACHARIDE
   • DIAGNOSIS
     • CULTURING BACTERIA FROM BLOOD
     • PCR BASED ASSAY
     • PREVENTION & TREATMENT
       • ANTIBIOTICS
         • PENICILLIN
         • CEPHALOSPORINS
       • VACCINES
         • TWO CONSIST OF CAPSULAR POLYSACCHARIDES A / C / W-135 AND Y GROUPS (MENINGOCOCCAL ACWY)
         • ANOTHER CONSISTS OF POLYSACCHARIDE B GROUP (MENINGOCOCCAL B)

9. human reservoir: HUMAN MICROBIOTA

10. BOTH INVADE

    • N. GONOCOCCUS DOES NOT HAVE CAPUSLE
      • localized infection, attacked by phagocytes
    • N. MENINGITIDES DOES HAVE CAPSULE
      • enters the blood stream

11. QEUSTIONS:

    • AN EYE INFECTION IN NEWBORNS BY N. GONORRHOEAE IS PREVENTED BY BLANK DROPS?
      • ERYTHROMYCIN
    • WHICH OF THE FOLLOWING IS A VIRULENCE FACTOR OF N. GONORRHOEAE?
      • OPA SURFACE PROTEINS