), Harrison’s Principles of Internal Medicine (20th ed. ... Pathogenesis of Neisseria gonorrhoeae. Infection usually occurs following sexual contact, with the incubation period averaging 2-7 days. & Tan, M.J. (2010). 3. The classic meningitis triad may not always be present: Elevated ICP that can lead to cerebral herniation and death, Generalized hemorrhagic state that leads to a diffuse erythematous maculopapular rash that becomes petechiae and/or purpura, Progresses rapidly and is highly fatal without treatment, Bilateral hemorrhagic adrenal infarctions. Lipooligosaccharide (LOS, endotoxin) envelope protein: LOS is an oligosaccharide with a lipid A component. Neisseria is a genus of bacteria commonly present on mucosal surfaces. Neisseria is classified in the family Neisseriaceae within the phylum Proteobacteria (β subgroup) of the Eubacteria (Janda and Gaydos, 2007). Secondhand smoke linked to childhood meningitis. It requires an aerobic environment with added CO2 and enriched media such as chocolate agar for growth. DOI: 10.1097%2FOLQ.0b013e3181a4d147. Neisseria gonorrhoeae. NAME: Neisseria gonorrhoeae SYNONYM OR CROSS REFERENCE: Gonococci, Gonorrhea Footnote 1. Blood and joint fluid for culture (only 30% sensitivity) needs a special transport medium. Resistance in these strains should be confirmed by a dilution test (MIC ≥ 16 mcg/mL). None of the trademark holders are endorsed by nor affiliated with Lecturio. Gonorrhea, which is caused by Neisseria gonorrhoeae, is a sexually transmitted disease that is second only to chlamydia in reported cases to the CDC; 361,705 cases were reported in 2001. Capsules are usually polymers of simple sugars (polysaccharides), although the capsule of Bacillus anthracis is made of polyglutamic acid. Treatment and prevention of meningococcal infection. Neisseria gonorrhoeae and Neisseria meningitides are Gram negative diplococci (kidney bean-shaped) with flattened sides. MCAT is a registered trademark of the Association of American Medical Colleges (AAMC). C. called the gonococcus. Retrieved November, 1, 2020, from. The incubation period ranges from 1–14 days (usually < 7). In Jameson, J.L., et al. Capsular polysaccharides are antigenic and form 6 important serogroups, responsible for most invasive meningococcal disease (IMD): Serogroup A causes most meningitis in sub-Saharan Africa. Bacteria may also reach the meninges from nearby infected structures or through a congenital or acquired defect in the skull or spine. N. The bacteria begins infection through colonizing mucosal surfaces; humans are the only host of this bacteria and it is transmitted through sexual contact. Table 1. The capsules are imprinted “G&W 0554” with white ink on the cap and “75 mg” with brown ink on the body, filled with yellow to beige powder. Full text. N. gonorrhoeae and K. denitrificans may, however, be confused because isolates of both species produce acid from glucose in acid production tests and hydroxylprolylaminopeptidase in enzyme substrate tests. LOS mimics human cell membrane glycosphingolipids and can be sialylated, which renders them resistant to serum killing. Describe growth and colonization of the pathogenic neisseria species: Inflammatory cytokines and chemokines → intense acute inflammatory response, vasogenic edema, and purulent exudate (visible on the brain surface), Interstitial and cytotoxic edema, vasculitis, and thrombosis → ischemia, infarction, and cerebral herniation. It is a Gram-negative, non-spore forming, non-motile, encapsulated, and non acid-fast bacteria, which appear in kidney bean shape under the microscope Footnote 1. Now, unlike its sister Neisseria meningitidis, Neisseria gonorrhoeae is not an encapsulated bacteria, so it doesn’t have a polysaccharide capsule. N. gonorrhoeae – causes gonorrhoea Greek word gonos (reed) and rhoia (flow) 2. The structure of lipooligosaccharide produced by Neisseria gonorrhoeae, strain 15253 isolated from a patient with disseminated infection: Evidence for a new glycosylation pathway of the gonococcal lipooligosaccharide. Neisseria bacteria are responsible for the diseases meningitis and gonorrhoeae. Spores – Neisseria gonorrhoeae is a Non-sporing Bacterium Capsule – N. gonorrhoeae is a capsulated bacterium and is present in such a way that a capsule encloses each pair of cocci. The bacterium adheres to the mucosal epithelium (1) where it competes with microbiota and colonizes to invade the epithelium (2). 50% sensitivity for endocervical exudates, Gram stain is not helpful for throat or rectum samples because non-pathogenic. But this bacteria has a ton of other virulence factors, which it uses to attack and destroy host cells, and also to evade the immune system. It is nutritionally demanding, requiring enriched media such as chocolate agar or modified Thayer-Martin agar for growth. Nhs. These pathogens have many virulence factors, including fimbriae, lipooligosaccharide envelope … Sexually active women younger than 25 and men who have sex with men are at increased risk of getting gonorrhea. Textor, S. (2018). Serogroup B causes most sporadic meningitis. It is usually seen in pairs with adjacent sides flattened. Neisseria gonorrhoeae (often called gonococcus) causes gonorrhoea, the second most common sexually transmitted disease (STDs) of worldwide importance (Chlamydial infections are more common). That's let alone the fact that the capsule vs no-capsule I had thought was one of the biggest differences between Meningo- and Gonococcus. Virulence factors N. gonorrhoeae produces several virulence factors as mentionedbelow (Table 26-2):. Capsule: N. gonorrhoeae does not form a true carbohydratecapsule unlike N. meningitidis.Instead, it forms a polyphos-phate capsule, … Gonococcal infections are sexually or perinatally transmitted and include gonorrhea, pelvic inflammatory disease, septic arthritis, and neonatal conjunctivitis. The capsule can easily be demonstrated using India ink preparation, … N. gonorrhoeae typically appears as an aerobic gram-negative diplococcus that lacks a polysaccharide capsule (Fig. Neisseria gonorrhoeae: Neisseria meningitidis: 1: Referred as: Referred to as gonococcus. UWorld QID# 6732 on UWSA2 says N. Gonorrhoeae has a capsule, and although it's not a virulence factor as is that of Meningococcus, it helps prevent phagocytosis. Much of the neurologic injury is caused by the immune response to the endotoxin and other bacterial components rather than direct bacteria-induced tissue injury. Students: Educators’ Pro Tips for Tough Topics, Institutions: Ensure Medical Teaching Continuity, https://www.nhs.uk/news/pregnancy-and-child/secondhand-smoke-linked-to-childhood-meningitis/, https://www.uptodate.com/contents/treatment-and-prevention-of-meningococcal-infection?search=Meningococcal%20meningitis&source=search_result&selectedTitle=1~45&usage_type=default&display_rank=1#H2603449448. All the medically significant species of Neisseria are positive for both catalase and oxidase. Genetic-phase variation of pilus structure between types T1 through T5 allows the organ… Thirteen capsular polysaccharides have been described, and nuclear magnetic resonance spectroscopy has enabled determination of the structure of capsular polysaccharides responsible for serogroup specificity. Two types: types T1-T2 virulent and T3-T5 avirulent 4. Neisseria gonorrhoeae (the gonococcus), causes gonorrhea. LOS mimics human cell membrane glycosphingolipids. D. virulent due to fimbriae and a protease that inactivates IgA. Organisms reach the bloodstream → IMD, which has a rapid course and manifests as sepsis (meningococcemia) and meningitis. Risk factors. The organism is frequently found intracellularly in polymorphonuclear leukocytes (neutrophils) of the gonorrhea pustular exudate (Figure 1 Right). Referred to as meningococcus. The organism is usually found interacellulary in polymorphonuclear leukocytes, or a specific category of white blood cells with varying shapes of nuclei, of the gonorrhea pustular exudates with humans as its only natural host. Neisseria is a genus of bacteria commonly present on mucosal surfaces. Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. for Neisseria gonorrhoeae Ann E. Jerse, Ph.D. Neisseria gonorrhoeae is a Gram-negative coccus, 0.6 to 1.0 µm in diameter, usually seen in pairs with adjacent flattened sides (Figure 1 Left and Fig 2 below). Rare, usually as a result of meningococcal meningitis or septicemia that disseminates: Blood: culture (50%–60% sensitive) and real-time polymerase chain reaction (RT-PCR) if available (96% sensitivity and 100% specificity), Petechiae: smear or biopsy for culture and RT-PCR, Nasopharyngeal swab: for culture and RT-PCR: for carrier surveys but not for stand-alone diagnosis as many healthy carriers are in population, Lumbar puncture: if no contraindications (elevated ICP, coagulation disorders, thrombocytopenia, uncorrected shock), Recommended for individuals 11–18 years, with a booster dose 3 years later, Vaccination at 2 months and older for at-risk groups of people, Efficacy: 82% first year after vaccination, waning to 59% at 3–6 years. NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc (NCSBN®). B. the cause of gonorrhea. The bacteria enter the respiratory system to invade mucous membranes, then enter the bloodstream. Higher risk of spreading the infection and developing long-term complications. Rapid Review Microbiology and Immunology (Goljan, E.F.) (3rd ed.). Neisseria gonorrhoeae is: A. the cause of ophthalmia neonatorum. Mosby/Elsevier. N. meningitidis pathogenesis. (Ed. In the blood, proliferation occurs and the pathogen releases endotoxin, which causes fever, increased vascular permeability, shock, and petechiae. ‡ Gonococci with 30 mcg tetracycline disk zone diameters of less than 19 mm usually indicate a plasmid-mediated tetracycline resistant Neisseria gonorrhoeae isolate. 2: Agents: N. gonorrhoeae is the agent of gonorrhoea. UpToDate. Riedel, S., Hobden, J.A. Description and significance. Can rapidly switch from 1 antigenic form of LOS, pilin, and Opa to another, Resistance to tetracycline (from the conjugative streptococcal plasmid). By continuing use of our service you agree upon our Data Privacy Statement. Several species exist, but only 2 are pathogenic to humans: N. gonorrhoeae and N. meningitidis. Neisseria gonorrhoeae can be induced to form a large capsule that can be visualized with India ink. Smears: Sensitivity and specificity vary among sites. Each capsule contains doxycycline monohydrate equivalent to 75 mg doxycycline. They are non-sporing, non-motile and oxidase positive. Now, unlike its sister Neisseria meningitidis, Neisseria gonorrhoeae is not an encapsulated bacteria, so it doesn’t have a polysaccharide capsule. describe the capsule in the two pathogenic neisseria strains. Most capsules are hydrophilic (“water-loving”) and may help the bacterium avoid desiccation (dehydration) by preventing water loss. Acid production patterns of quality control reference strains of N. gonorrhoeae, N. lactamica, N. mucosa, and M. catarrhalis 1) meningitidis: capsule is important virulence factor 2) gonorrhoeae: have loosely associated capsule or slime layer but not important. However, at the ultrastructural level, N. meningitidis has a prominent antiphagocytic polysaccharide capsule. Note: Because several Neisseria species may give the same acid detection patterns , it may be necessary to perform additional tests to confirm the identity of the test strain. Some patients can present asymptomatically. They are characteristically found inside polymorphonuclear leucocytes. Neisseria is Gram-negative coccus arranged in pairs with long axes parallel and is strictly a human parasite. For example, N. gonorrhoeae makes acid from only glucose, but N. meningitidis produces acid from both glucose and maltose. Pathogenesis of N. gonorrhoeae. Uk. Neisseria gonorrhoeae is a gram-negative coccus, or bacteria whose overall shape is spherical. Encapsulated gonococci appeared to be resistant to non-antibody-mediated phagocytosis compared with unencapsulated gonococci of the same strain and colony type. Other virulence factors are similar to those of, Lipooligosaccharide (LOS, endotoxin) envelope protein. The genus Neisseria contains the two gram-negative cocci which are established human pathogens The genus also contains many commensal species, most of which are harmless inhabitants of the upper respiratory and alimentary tracts. Pili are the hair like appendages that extend up to several micrometers from the gonococcal surface. Lip (H8) is a surface exposed protein that is heat modifiable like Opa. The nasopharynx is the portal of entry, attaching to mucosal cells with the aid of pili. CHARACTERISTICS:Neisseria gonorrhoeae belongs to the genusNeisseria within the family Neisseriaceae Footnote 2. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. Neisseria meningitidis is a leading cause of septicemia and meningitis worldwide. Neisseria gonorrhoeae rarely causes conjunctivitis but is important to consider because infection can lead to corneal ulceration and blindness. Meningococcal meningitis occurs in 2 settings: Sub-Saharan Africa (the “meningitis belt,” from Senegal to Ethiopia). Neisseria Meningitidis (Meningococcus): Signs & Symptoms. Classification of Neisseria: 1. In the United States, the annual incidence is approximately 1/100,000. They most commonly cause meningococcemia with petechial hemorrhages and meningitis. E. All of the choices are correct. Rosenthal, K.S. Early repeat Chlamydia trachomatis and Neisseria gonorrhoeae infections among heterosexual men. It causes disease only in humans. Selected abbreviation key:LOS: lipooligosaccharide OMV: outer membrane vesicles TLR: toll-like receptor NOD: nucleotide-binding oligomerization domain-containing protein. F. Other proteins . Prevention is done by quadrivalent meningococcal polysaccharide conjugate vaccine: USMLE™ is a joint program of the Federation of State Medical Boards (FSMB®) and National Board of Medical Examiners (NBME®). Lí½x~j¹[:ZÝt¹îĄpI)Míã8F…u.ț—W»Ö%à v#©Ÿ%Ί”ë/ûRÂԌ¹I6‚"êºÕ Ý2¥_ãEœ9=ԅƒ‚pªT"¼Ö½¶sŋH£Ì‰%܃ª0^ÁÁ÷›ðÚ0͕¡cÿÏðèC](THáÒL͜výv’¹A5Bv ´=²9e^vï”, ñ¹Yn¼“ê ³Ëi `‡dúy. Apicella, M. (2020). Viability of Neisseria: They die at 55°C in 5 minutes, are fragile and cannot resist an adverse … Neisseria gonorrhoeae (gonococcus) and N. meningitidis (meningococcus) are the two principal human pathogens. Capsule, lipooligosaccharide (endotoxin), and outer cell membrane proteins I-III are important in antigenic variation and for eliciting an inflammatory response. Neisser described the causative agent of gonorrhea, N. gonorrhoeae, in 1879. Capsules and lipopolysaccharides. In men, the probability of acquiring the disease from a single exposure is about 25%; in … Professor Department of Microbiology and Immunology F. Edward Hébert School of Medicine Uniformed Services University Bethesda, Maryland, USA WHO PD-VAC Meeting June 21st-22nd, 2017 2. The bacteria do not produce any toxins. In females, gonorrhea can also infect the cervix.Gonorrhea is most commonly spread during sex. In Riedel, S, Morse, S.A., Mietzner, T., Miller, S. They have exacting growth requirements and do not grow on ordinary media. They are both Gram negative diplococci, non-sporing, oxidase positive and difficult to differentiate on morphological and cultural characteristics. Meningococcal infections are transmitted via respiratory and oral secretions. Of the 10+ species that infect humans, only 2 are strictly human pathogens: Contain lipooligosaccharides (LOS) with strong endotoxin activity, Incidence of 583,405 cases in the United States in 2018, with a 5% increase from the year before and a higher rate in males than females (212.8:145.8 per 100,000 people), Sexual contact with the penis, vagina, mouth, or anus of an infected individual, Perinatal transmission (during vaginal delivery), Provide antigenic variation among different strains, Components of the proteins of the outer membrane vesicles (OMVs), May prevent intracellular killing by neutrophils by interfering with phagosome-lysosome fusion, Opacity-associated (Opa) proteins (outer membrane proteins): aid in attachment to host cell receptors.

neisseria gonorrhoeae capsule

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