1. The Family Neisseriaceae : Gram-negative cocci
방소연 (PPT제작, 발표)
김내현 (자료수집, 발표)
윤효정 (자료수집) 오미우귀 (PPT 제작)

2. Contents The Family Neisseiriaceae Neisseiria gonorrhea
Neisseiria Meningitidis
Other Genera of Gram-Negative
Cocci & Coccobacilli

3. The Family Neisseriaceae

4. The Family Neisseriaceae : Gram-Negative Cocci
Mucous membranes of warm-blooded animals
Bean-shaped and paired
Gram-negative, LPS, fimbriae
Aerobic
Catalase( )
Oxidase( )

5. Neisseria gonorrhoeae : The Gonococcus

6. Factors Contributing to Gonococcal Pathogenicity
and other surface molecules
Attachment
Invasion, Infection
Slow phagocytosis
Protease
Cleaving the secretory antibody (IgA)

7. Epidemiology and Pathology of Gonorrhea
A genital or extragenital portal of entry
➡ Attaching to the epithelial surface
➡ Invade the connective tissue
➡ In 2 to 6 days inflammatory reaction
The infection asymptomatic in approximately 10% of males and 50% of females

9. Genital Gonorrhea in the Male
Infection of urethra
Urethritis, Painful urination, purulent discharge
Spread from urethra
to the prostate gland and epididymis
Render the individual i e

10. Genitourinary Gonorrhea in the Female
A mucopurulent or bloody vaginal discharge
Painful urination
Infection ascends from the vagina and cervix
Salpingitis, Pelvic inflammatory disease( )
Sterility, Ectopic pregnancies

12. Extragenital Gonococcal Infections in Adult
P s
Pharyngitis
Gingvitis
Self-inoculation of the eyes

13. Gonococcal Infections in Children
Infant pass through the birth canal
Eye infections, Keratitis, O n ,
Blindness
Antibiotics

14. Clinical Diagnosis and Control of Gonococcal Infections
Gram staining
P producing N.gonorrhoeae (PPNG) Tetracycline-resistant N.gonorrhoeae (TRNG)
Fluorquinolones (ciprofloxacin)
Cephalosporin

15. Neisseria meningitidis :The meningococcus

16. Neisseria meningitidis
Neisseria meningitidis = meningococcus
Morphology
Gram-negative diplococcus
Size: μm
Bean shaped
Non-motile
Aerobe
Encapsulated (p e capsule)

17. Neisseria meningitidis
Biochemical Properties
Oxidase
Catalase positive
Nitrate negative
Ferments glucose and m e with acid production
Doesn’t ferment lactose, sucrose and fructose

18. Neisseria meningitidis
Virulence Factors
Fimbriae : adhesion to mucosa of meningeal tissue
Capsule : Anti
Lipopolysaccharide : Endotoxin
IgA proteases : cleave IgA
Serotype A,B and C : strain of capsular antigens

19. Epidemiology and Pathogenesis of Meningococcal Disease
Natural habitat and reservoir
Mucosal surfaces of the human n
Carriage state
last few days ~ several months
3~30% of the adult population
Modes of infection
Direct close contact
Respiratory droplets

20. Epidemiology and Pathogenesis of Meningococcal Disease
In many case… (normal persons)
N.meningitidis attaches on entry in the nasopharynx
resulting in simple asymptomatic colonization.
In small number of case… (Vulnerable individuals)
N.meningitidis be engulfed by epithelial cells
penetrating into b v
damaging the epithelium
causing pharyngitis

21. Epidemiology and Pathogenesis of Meningococcal Disease
Meningitis pathogenesis
Inhalation of contaminated droplets
Adherence of organism to n l mucosa
Local invasion and spread from nasopharynx to meninges through
Cross the b b b
Permeate the meninges, and g in the cerebrospinal fluid.
They replicate and migrate to subepithelial spaces
Incubation period : days

22. C f .
M s

23. Symptoms of Meningococcal Disease
Fever
Sore throat
Headache
Stiff neck
Convulsion
Vomit

24. Complication of Meningococcal Disease
Meningococcemia
Shed endotoxin into the systemic circulation
Damage to the blood vessels hemorrhage, coagulation
P e develop on the body (half of the cases)
Shock, necrosis in extremities, loss of limbs (few cases)
Suddenly onset rapidly occuring symptoms death
Central-nervous system infection cognitive impairment,
deafness(10~20%)
Brain infection

25. Clinical Diagnosis of Meningococcal Disease
Diagnosis haste & accuracy
Stain(dyeing) & Observation
C f
Blood sample
Cultivation
Specific rapid test
Finding capsular polysaccharide
Directly finding N.meningitidis without culturing
Typical Gram (-) diplococci

26. Immunity of Meningococcal Infection
Natural immunity
Most people have a natural immunity
low infection rate
Resistance
Opsonizing antibody
Against the capsular polysaccharide
Group A, C
Against m antigens Group B

27. Treatment of Meningococcal Infection
Third generation cephalosporin
Ceftriaxone
Broad spectrum
Cross the blood-brain barrier
Treatment also for shock & intravascular clotting

28. Prevention of Meningococcal Infection
Preventive Therapy
R n
Tetracycline
Minocycline
Vaccination
Recommend for…
All persons between 11~18 years old
Who exposed during outbreaks
MCV4 (Menactra) : for 2~55 years old
MPSV4 (Menomune) : for older than 55 yeas old

29. Differentiating pathogenic from Nonpathogenic Neisseria
How to mapping each Neisseria…?
Collection of specimens streak on Thayer-Martin medium or Chocolate agar incubate in high 𝐶𝑂 2
Standard of classification
O t g
Sugar oxidation
Growth pattern
Nitrate reduction
Pigment production
PCR test

30. Other Genera of Gram-Negative Cocci & Coccobacilli

31. Other genera of Gram negative Cocci & Coccobacilli
Nonpathogens VS Pathogens
In the same Family as Neisseria
Morphological, biochemical similarities VS

32. Branhamella catarrhalis
Finding in human nasopharynx
Causing purulent disease
Associating with clinical syndromes
Morphologically similar to pathogen Neisseria
Biochemical characteristic
lack of carbohydrate fermentation
positive nitrate reduction
Treatment
Erythromycin
cephalosporin

33. Moraxella Morphology Widely distributed on the mucous membranes
Short, plump rod (as well as cocci)
Twitching motility
Widely distributed on the mucous membranes
of mammals and humans
Generally weak pathogenic or nonpathogenic

34. Thank you