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

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

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

4. Specimen Gram Stain Intracellular GNDC Neisseria gonorrhoeae

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

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

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

8. 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

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

10. Treatment Antimicrobial testing Neisseria gonorrhoeae

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

12. Specimen Gram Stain GNDC Neisseria meningitidis

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

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

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

16. Neisseria lactamica Normal flora Aerobic GNDC

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

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

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

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

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

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

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

24. Who am I? Urethral gram stainThayer Martin agar Neisseria gonorrhoeae

25. Who am I? CSF gram stainChocolate agar Neisseria meningitidis