Neisseria/Moraxella

Gram-negative diplococci (GNDC)

Cells typically occur in pairs; kidney beans, coffee beans
Grow on mucous membranes
Growth
Obigate respirers (some are capnophiles)
Fastidious (to varying degrees)
"fragile" (to varying degrees)
Typical characteristics
Catalase positive
Oxidase positive
Cytochrome c oxidase - enzyme of SOME electron transport chains
Neisseria gonorrhoeae - Gonococcus, GC
Causes gonorrhea, a sexually-transmitted infection
Genital tract, mouth/throat, rectum, eyes (through birth canal)
Women - can progress to PID possible infertility
Always considered a pathogen
Symptoms of gonorrhea
Males - purulent urethral discharge (usually)
Females - endocervical specimen; may have discharge, but many (50%) are asymptomatic
Specimen processing
Remember - "fragile", fastidious pathogen
Inoculate at collection/incubate immediately or use non-nutritive transport medium
Identification
Direct Gram stain
Specimens from males - GNDC inside PMNs diagnostic (?)
Specimens from females - GNDC inside PMNs NOT diagnostic (normal microbiota
can mimic); diagnosis must be confirmed with culture
Cultivating
Chocolate agar (lysed RBC + extra nutrients); high humidity; increased CO2
Selective media - various options that contain antimicrobials
VCN - vancomycin, colistin, nystatin
Colony morphology
Small to medium
Grayish white, convex (raised), colony type varies, even in one strain, due to
antigenic variation

Biochemical tests
Acid production from glucose not maltose, sucrose, lactose
Traditional - CTA (cystine trypicase agar)
Sugar option + pH indicator
Rapid options
Others
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Antibiotic susceptibility
MUST test; was penS, but most strains now penR..now R to various other
antibiotics as well
Neisseria meningitidis - Meningococcus, MC
Found in upper respiratory tract of 3-15% of people
Causes life-threatening meningococcemia and meningitis (travels from bloodstream brain)
New vaccine (against capsular polysaccharide serotypes A, C, Y and W-135); no vaccine for B
Identification
Direct Gram stain
Intra and extracellular GNDC in PMNs; may be present in low numbers
Cultivating
Blood agar, high humidity, increased CO2
Fragile
Colony morphology
Medium, gray, smooth, glistening, convex
Biochemicals
Same as for GC, but different results (acid from glu and mal)
Serotyping available
Moraxella (Branhamella) catarrhalis
Found in upper respiratory tract of healthy humans, but status as normal microbiota is questionable
Can cause disease in ears, sinus, lungs
Grows on CA, BA AND nutrient, TSY
Med-large, whitish gray to pinkish brown, hockey puck consistency
Identification - Same as GC/MC but different results (no acid detected)