Pre-Med Microbiology

Neisseria and Moraxella

We are now into gram-negative bacteria.

Neisseria is a gram-negatve cocci. That appears in pairs, so it is called a

diplococci.
Catalase pozitive
Oxidase positive
Nonmotile and non-spore forming

Two types: Neisseria meningitides and Neisseria gonorrhoeae.

Neisseria Meningitidis

Neisseria Meningitidis (also called meningococcus) has two main virulence factors:
capsule and Endotoxin (LPS)

The capsule surrounds the bacteria, protecting it from phagocytosis

The endotoxin (LPS) causes blood vessel destruction (hemorrhage). This blood vessel
hemorrhage is seen on the skin as tiny, red dots called petechiae.

Two groups of people at high risk for Neisseria Meningitidis infection are: infants aged 6
months to 2 years and Army recruits.

Both groups have weak immune systems.

Source:
only a human (healthy or sick).Commonly colonize nasopharynx of healthy
individuals; highest oral and nasopharyngeal carriage rates in school-age
children, young adults and lower socioeconomic groups.
Spreading:
transmission of meningococci is facilitated by respiratory droplets and
requires closed and prolonged contact with carriers
Site of entrance:
upper respiratory tract

Three types of disease with Neisseria Meningitidis: Meningococcemia, Waterhouse-

Friderichsen syndrome, Meningitis.

Meningococcemia is basically Neisseria Meningitidis in the blood. Can cause spiking

fevers, chills, joint pains (arthralgia) and muscle pains as well as petechial rash.
Waterhouse-Friderichsen syndrome this is hemorrhage of both adrenal glands.
Causes hypotension (low blood pressure), fast heart rate (tachycardia) and rapidly
enlarging petechial skin rash.

Meningitis fever, vomiting, bulging anterior fontanels (in infants), stiff neck,
headache, photophobia.

Diagnosis is with gram stain and culture of blood and spinal fluid.

This bug is grown on Thayer Martin media and Chocolate Agar

Treatment is with Ceftriaxone. Also give all close contacts of the patient Rifampin.

Neisseria Gonorrhoeae

Neisseria gonorrhoeae is also known as gonococcus

Neisseria gonorrhoeae has Pili. This allows the bug to adhere (stick) to certain
parts of the body and cause damage. No capsule

Gonococcal disease in men causes inflammation of the urethra (the narrow canal
that urine comes out of). Patient will have painful urination, purulent (pus) discharge.
Treatment is Ceftriaxone.

Gonococcal disease in women damage to the cervix. Causes painful burning on

urination and purulent discharge. Also pain during sexual intercourse.

Pelvic inflammatory disease (P.I.D.). This involves inflammation of the uterus,

fallopian tubes and ovaries. Patient will present with fever, lower abdominal pain,
cervical motion tenderness (pain when the cervix is moved by the doctors examining
finger).

This bug is grown on Thayer Martin media

Treatment of PID is Ceftraixone for Nesseria gonorrheae. But since most patients with
gonorrhea also have Chlamydia, they are given Doxycycline as well.

Complications of PID are:

1) Sterility woman cant get pregnant because the fallopian tubes get scarred
2) Ectopic pregnancy women gets pregnant but the embryo starts to grow in a place
other than the normal place (normal place is the uterus)
Neisseria gonorrhoeae will cause Septic arthritis this is joint infection in a patient
who is sexually active. Patient will have fever, pain and swelling in 1 or 2 joints.

Diagnosis is made by putting a needle into the joint, taking out some synovial fluid and
examining it for gram-negative diplococci.

In newborns, that pass through their mothers birth canal that has Neisseria
gonorrhoeae, they bug can infect the newborns eyes, causing ophthalmia neonatorum.
Treatment is with Erythromycin eye drops.

Moraxella catarrhalis

Present in the upper respiratory tract of 1.5-5.4% of healthy individuals, more commonly
in children and elderly adults .

Diseases:
Acute purulent exacerbation of chronic bronchitis
Causes 10-15% of episodes of otitis media and sinusitis
Rarely associated with systemic infection (endocarditis, meningitits)

Culture: Pink coloration of colonies on chocolate agar not apparent on blood agar
Glucose, maltose, sucrose, fructose or lactose negative