GRAM NEGATIVE COCCI

Neisseria, Branhamella/Moraxella (aerobic), Veilonella

FAMILY NEISSERIACEAE
GENERAL CHARACTERISTICS:
Gram (-) diplococcic
Aerobic, not motile, oxidase (+), Catalase (+), capnophillic, Glucose
Fermenter EXCEPT: Moraxella catarrhalis

Neisseria gonorrhoeae/ GONOCOCCUS

Cocci in pairs/ diplococcic, kidney or coffee bean shaped with flattened

adjacent side
CATALASE (+), OXIDAZE (+), QUELLANG TEST (+) (Encapsulated yet no
polysacharride in capsule)
Non motile, non spore forming, canpnophiles

DISEASES CAUSED BY THE PATHOGENIC SPECIES OF NEISSERIA

1. Neisseria gonorrhoeae
a. Gonorrhoeae FLOW OF SEED most common STD, characterized by
foul smelling urethral discharged. (HPV: most common STD in US)
Adult Male
Adult Female
Young Female (Children)
Newborns
OPTHALMIA NEOTARUM: gonorrhea
conjunctivitis acquired at birth when urethral
discharge from infected mother accumulates on
their conjunctiva
1-2% SILVER NITRATE (CREDES PROPHYLAXIS)
b. Disseminated Gonococcal Infection (DGI)
Endocarditis
Gonococcal Arthritis
c. Fitz Hugh Curtis Syndrome

PATHOGENIC DETERMINANTS OF Neisseria gonorrhoeae

1. PILI
T1 T2
T3 T4 T5
2. Immunoglobulin A (IgA) Protease
3. Cell Wall Proteins
CW Protein I (porB): Protective against inflammation
CW Protein II (opa): adherence ot phagocytic and epithelial cells

1
 CW Protein III (Rmp): blocks host serum IgG
4. ENDOTOXIN
Mediate damage to body tissues

Cultural Characteristics:
1. Fastidious organisms requiring Enrcihed medium
2. Convex, glistening, elevated, mucoid , non transparent, non hemolytic,
and non pigmented
3. SUGAR FERMENTATION used as single test to differentiate gonococci
from other species
LAB. DIAGNOSIS:
Cytochrome Oxidase: 1% tetramethyl-p-phenylenediamine dihydrochloride
(+) purple/ black within 10 secs
BETA-LACTAMASE TEST on PRIMARY CULTURE (+) COLOR CHANGE
Chromogenic cephalosporin test (+) pink.red
Iodometric: iodine (+) colorless (-) purple
Acidimetric: phenol red (+) yellow (-) red
1. Thayer martin: Selective allow growth of Neisseria
Colistin
Vancomycin
Nystatin
Trimethoprim lactate: MTM
2. Martin Lewis: ANISOMYCIN
3. New York City Medium: Amphothericin B
4. Cystine Trypticase Agar: 1 % individual carbohydrate and phenol red
as indicator
5. Chocolate agar
6. Transgrow medium: used for transport: contains glucose, 2% agar
trimethoprim lactate in CO2 incorporated bottle
7. Amies medium with charcoal
***Cotton swabs: inhibits the grow of Neisseria, Used DACRON or RAYON swabs

Neisseria meningitides/ MENINGOCOCCUS

Colonies on BAP: small, tan may be mucoid and convex

Neufueld Quellung- Capsular Swelling Test (+) polysacharride capsule
Cytochrome Oxidase: 1% tetramethyl-p-phenylenediamine dihydrochloride
(+) purple/ black within 10 secs
FERMENTS: Glucose and Maltose
Dnase, Beta lactamase, Nitrate reduction (-)

Serological Classification
1. Group A & C: capsulated and mucoid, gray colonies (common in US)
2. Group B: non capsulated, smaller rough and yellow colonies
3. Group 29 & 135: creamy white in the area of heavy inoculation

2
***Group A,B and C strains are generally involved in epidemic meningitis
***Group D, 135 may be isolated from sporadic cases

PATHOGENIC DETERMINANTS OF Neisseria meningitidis

1. CAPSULE

2. Immunoglobulin A (IgA) Protease

3. Cell Wall Proteins

CW Protein I
CW Protein II
CW Protein III
4. ENDOTOXIN

CLINICAL INFECTIONS:
1. Meningitis: inflammation of meniges
Serotype A
Serotype B
Serotype C
Serotype Y
Serotype W 135
2. Waterhouse Friderichsen Syndrome: severe form of
meningococcemia
3. Meningococcemia
Acute
Chronic

Table 13-2 Differentiation of Neisseria and Branhamella/Moraxella species

CATALAS OXIDAS SUPEROXO CARBOHYDRAT ONP Neufeld

E E L TEST E UTILIZATION G Quellun
TEST Test g
**Cystine Reactio
Trypticase Agar n
(CTA)
N.
gonorrhoea
e
N.
meningitidi
s

3
N.
lactamica
N. sicca
N.
flavescens
B/M.
catarrhalis

***SUPEROXOLCATALASE TEST- 30% H2O2

MISCELLANEOUS Neisseria:

1. N. cinerea
Bacteremia, conjunctivitis and nosocomial pneumonia
NF or oropharynx and genital tract
Ferments glucose
N. cinerea N. gonorrheae
Collistin (10ug)
Growth on MHA

2. N. mucosa: NF of respiratory tract, rare cause meningitis, endocarditis

and cellulitis
3. N. polyscchareae: utilize glucoase and maltose
4. N. elongate: catalase (-) and rod shape
5. N. weaveridog bites, catalase (+) and rod shape

Branhamella/ Moraxella

Moraxella catarrhalis
NF of oropharynx and naso pharynx
Pathogenicity: endocarditis, bronchitis, pnueomia, sinusitis,
otitis media (3rd cause)
Encapsulated with pili, non motile
Compared with Neisseria, can grow on ordinary media at room
temperature, grow as grayish white (NON PIGMENTED) febrile
granular colonies which are difficult to emulsify
Smooth opaque, gray to white, Colony may be swept intact
(HOCKEY POCKEY) 48 hours colony-Wagon Wheel
Do not ferment glucose, lactose and maltose
Beta lastamase, Dnase, Oxidase (+)
Non hemolytic on BAP
Catalase (-)
DISTINGUISHING CHARACTERISTICS:

4
 1. It may grow on Nutrient Agar at 22C
2. Failure to grow in TMA
3. It reduces nitrate to nitrite
4. Assacharolytic, TRIBUTYRIN HYDROLYSIS (+)

Veillonella
Cocci in paris
Rare cause of human infections (non pathogenic)