Aerobic Gram Negative Cocci Student Lab Division of Medical Technology Jeanne Filbey, MT(ASCP)

General Characteristics Normal flora of upper respiratory, alimentary and genitourinary tracts Gram stain: GNDC Oxidase positive Catalase positive Non-motile Aerobic GNDC

Neisseria gonorrhoeae Fastidious Temperature sensitive Culture immediately Transport media if delay Aerobic GNDC

Specimen Gram Stain Intracellular GNDC Neisseria gonorrhoeae

Colony Morphology Chocolate agar Thayer-Martin agar –Growth –Contains antibiotics Neisseria gonorrhoeae

Identification Carbohydrates –Glucose pos –Maltose neg –Lactose neg –Sucrose neg DNase neg Nitrate neg Butyrate esterase neg Neisseria gonorrhoeae

Pathogenesis Port of entry Progression of infection Human to human transfer Females asymptomatic Neisseria gonorrhoeae

Gonorrhea Male –Acute urethritis, prostatitis and epididymitis if untreated Female –May be asymptomatic –Cervicitis --> pelvic inflammatory disease -- > scarring of fallopian tubes --> sterility, ectopic pregnancies Neisseria gonorrhoeae

Other Infections Disseminated gonococcal infection Pharyngitis Gonococcal ophthalmia neonatorum Vulvovaginitis Neisseria gonorrhoeae

Treatment Antimicrobial testing Neisseria gonorrhoeae

Neisseria meningitidis Fastidious Temperature sensitive Culture immediately Occasionally grows on SBA Aerobic GNDC

Specimen Gram Stain GNDC Neisseria meningitidis

Colony Morphology Chocolate agar Thayer-Martin agar –Growth Neisseria meningitidis

Identification Carbohydrates –Glucose pos –Maltose pos –Lactose neg –Sucrose neg DNase neg Nitrate neg Butyrate esterase neg Neisseria meningitidis

Pathogenesis Meningitis Septicemia Septic arthritis Endocarditis Pneumonia Urethritis Asymptomatic nasopharyngeal carriers Neisseria meningitidis

Neisseria lactamica Normal flora Aerobic GNDC

Colony Morphology Chocolate agar Thayer-Martin agar –Growth Neisseria lactamica

Identification Carbohydrates –Glucose pos –Maltose pos –Lactose pos –Sucrose neg DNase neg Nitrate neg Butyrate esterase neg Neisseria lactamica

Moraxella (Branhamella) catarrhalis Can be normal respiratory flora Aerobic GNDC

Colony Morphology Sheep blood agar Chocolate agar Thayer-Martin agar –Growth Moraxella (Branhamella) catarrhalis

Identification Carbohydrates –Glucose neg –Maltose neg –Lactose neg –Sucrose neg DNase pos Nitrate pos Butyrate esterase pos Moraxella (Branhamella) catarrhalis

Pathogenesis Acute bronchitis Pneumonia Meningitis Seen in immunocompromised patients (elderly) Otitis media & maxillary sinusitis in kids Most produce beta lactamase Moraxella (Branhamella) catarrhalis

Summary Specimen handling and processing Growth characteristics Identification Clinical significance Antimicrobial testing Aerobic GNDC

Who am I? Urethral gram stainThayer Martin agar Neisseria gonorrhoeae

Who am I? CSF gram stainChocolate agar Neisseria meningitidis