Unit 3 - Gram Negative Cocci Flashcards by Melanie Laird

Neiseriaceae family shape

GN Diplococci
or
Short GNR

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Family Neisseriaceae Oxidase result

Positive

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Family neisseriaceae Catalase results

Positive
EXCEPT Kingella & Eikenella

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Are Neisseriaceae fastidious or non fastidious?

Fastidious
except kingella

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Are Neisseria normal flora as a whole?

Some are, others aren’t

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Neisseriaceae Virulence factors

Capsule
Pili
Cell wall proteins
Endotoxin
IgA protease

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Sometimes when you take meds while having a neisseriaceae infection, it can hurt. Why?

Endotoxins release upon death

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What is the predominant host response with a Neisseriaceae infection?

PMN

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Neisseria spp. diseases caused

Gonorrhea
Miningitis
Meningococcemia
DGI
Gonococcal arthritis
Otitis media
Sinusitis

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Pathogenic Neisseria family colonies appear how on a plate?

Non pigmented

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What are the non-pigmented Neisseria family?

N. gonorrhoeae
N. meningitides
N. weaveri

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Normal flora Neisseria appear how on a plate?

Pigmented

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What are the pigmented Neisseria

N. lactamica
N. sicca
Moraxella catarrhalis

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Is N. gonorrhoeae ever normal flora?

No, strict pathogen

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Where is N. gonorrhoeae found in?

only humans

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Where on the body can gonorrhea be isolated?

Anus
Eyes
Throat
Blood
Private parts

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What are the male complications in male gonorrhea

Epididymitis
Urethral stricture
Prostatitis

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Female gonorrheal complications

PID
Sterility

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Manifestations of Gonorrhea

DGI
Ophthalmia neonatorum
Asymptomatic genital infections

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What causes DGI?

Gonorrhea caused by AHU strains
(Arginine, hypoxanthine, uracil)

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How common is DGI in gonnorhea patients?

<3%

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What percentage of females are asymptomatic for gonorrhea?

About 50%

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How is GC a delicate organism?

Fastidious

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Specimen collection requirements for GC

Dacron or rayon swab
Enriched agar with CO2
Must be kept warm

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Transport media for GC

JEMBEC

What is JEMBEC

Chocolate agar w antibiotics Small plastic compact with CO2 tablet Streaked in W with swab then across with loop

What kind of agar does GC require

Chocolate agar

What is in Chocolate agar?

Enriched base Hemoglobin NAD (Nicotinamide adenine dinucleotide)

What mimics NAD?

IsoVitaleX

Why must selective agar be used when plating GC?

Inhibits normal flora

What selective agars are used for GC?

Thayer Martin Modified Thayer Martin Martin Lewis NYC medium

What is Thayer Martin plate

Chocolate agar Vancomycin, colistin, nystatin

What is modified Thayer martin

Thayer Martin plus trimethoprim

What is Martin lewis

Chocolate agar Vancomycin, colistin, anisomycin (yeast), trimethoprim

What is NYC medium

Horse blood yeast extract Similar antibiotics as MTM

If clinical site has no normal flora, what plate should you use?

Plain chocolate agar

If the clinical site has no normal flora, what plate do you use?

Chocolate agar

What clinical sites have no normal flora?

Synovial fluid CSF

How does GC appear on a plate?

SMall Translucent No pigment Some variation in colonies of the same strain

How do colonies of GC vary by size?

Corresponds to P antigen on surface Types T1-T5

How old should GC be for biochemical testing?

Young, organisms will autolyze as it continues growing

Expected test results for GC

Oxidase positive Catalase postiive Uses glucose only

What is the definitive ID for GC?

Carbohydrate utilization tests

Is culture required for the ID of GC?

Not anymore

Treatment for GC

Ceftriaxone and Azithromycin

Why is GC resistant to penicillin?

Beta lactamases

Is Neisseria meningitides normal flora?

Can exist in a carrier state

Who is at risk for N. menigitides?

People living in close quarters

Which organism is quickly fatal if untreated?

N. meningitides

N. meningitides can cause ___ with or without ___

meningococcemia, menigitis

N. meningitides capsule types

A, B, C, Y, W-135

What are the pathologic mechanisms of N. menigitidis

Pili Capsule Endotoxin IgA protease

Treatment for meningitis?

Penicillin

Someone with meningitis is allergic to penicillin, what are they given next?

Chloramphenicol

What is given as prophylaxis for meningitis?

Rifampin

What capsule types are people vaccinated to

A & C, W-135 & Y when young Serotype B when older

Complications of Meningitis

DIC Shock Waterhouse-Friderichsen syndrome

What is Waterhouse friderichsen syndrome

Disseminated meningococcal infection with rash and hemorrhage in adrenals

Septic Shock in meningitis symptoms

Low oxygen and BP Inc heart rate

What can cause septic shock that's a GNC?

N. meningitis

What kind of environment is needed to grow N. meningitidis?

CO2 Warm and moist

How does N. meningitides appear on a plate?

Shiny & Non-pigmented

Test results for N. meningitides

oxidase pos catalase pos Glucose and maltose usage

What are useful tests for IDing Neisseria?

Chromogenic enzyme substrate testing MALDI-TOF carb utilization

N. meningitis on gram stain

Intracellular AND extracellular diplococci Gram negative, but may resist decolorization and size variation

Which neisseria bug is isolated from dog bite wounds?

N. weaveri

Shape of N. weaveri

Short Gram Neg rod

What did N. weaveri used to be called

CDC group M5

Carb utilization for N. weaveri

None

Non-pathogenic Neisseria is normal flora of where?

URT Female genital track

Where is Moraxella normal flora of?

URT

What does Moraxella cause?

Otitis media Sinusitis

Gram stain of M. catarrhalis

Uniform size may show tetrads

Where does M. catarrhalis grow?

SBA Chocolate

A colony on a plate appears like a wagon wheel, what might this be?

M. catarrhalis

A colony slides across the plate like a hockey puck, what might this be?

M. catarrhalis

How to distinguish M. catarrhalis from Neisseria?

No sugar DNase positive Butyrate esterase positive

Butyrate esterase result in Neisseria

Neg

M. catarrhalis can produce ____ that makes it resistant to ___

Beta lactamase Ampicillin or amoxicillin

Where is Kingella normal flora of

URT

How does Kingella appear on the agar

Like non pathogenic neisseria

Gram stain of Kingella

GNC with no water GNR with water

How do you distinguish true gram stain shape of Kingella?

Incubation with penicillin disc

How does Kingella grow when around penicillin disc?

Grows as a rod

Catalase result of Kingella

Negative

Kingella is usually isolated in..?

Immunosuppressed patients

Where is Eikenella corrodes normal flora of?

Mouth and bowel

Oxidase result of Eikenella

Positive

Catalase result of Eikenella

Negative

How does Eikenella appear on stain?

More rod shaped than Neisseria

What does Eikenella need to grow?

CO2

Where is Eikenella isolated form

Human bite from punching teeth Licking needle clean and shooting it up

What does eikenella do to the agar?

Pits the agar

What org smells like bleach?

E. corrodens