Full seminar presentation on Neisseria and Moraxella. I m sure this ppt will give you full information about this topic.

1. MICROBIOLOGY
SEMINAR
Prepared by-
Arpita Chandra

2. Neisseria and Moraxella

3. gram negative diplococci
Aerobic, Non Motile
Catalase – positive
Oxidase – Positive
2 Species are Pathogenic To humans
Neisseria meningitidis
Neisseria gonorrhoeae
GENUS
NEISSERIAE

4. COMMENSALS OF GENITAL TRACT OR
ORAL CAVITY
N. lactamica
N. flavescens (Pigment production)
N. mucosa (Capsulated)
N. sicca
N. subflava
N. elongata (Rod shaped)

5. NEISSERIA MENINGITIDIS
(MENINGOCOCCUS)
Capsulated
Gram negative diplococci
Lens shaped – Half moon shaped
Commensal in Nasopharynx
Ferment Glucose and Maltose

6. Capsular polysaccharide
 It protects the bacteria from phagocytosis.
 Based on antigenic nature of the capsule
-13 serogroups (A-D, X-Z, 29E, W135, H, I, J and L)
 5 serogroups invasive disease – A, B, C, Y, and W135
16% of isolates – Non-capsulated
- colonize the naso-pharynx
-asymptomatic carriers

7. 1. Outer membrane proteins
 Porin proteins present beneath the capsule
 2 types- PorA and PorB
 Responsible for serotyping and serosubtyping.

8. meningococcus endotoxins
Binds to CD4 (with TLR4)
Activate endothelial cells
Inflammation response
Release Tumor necrosis factor,
IL-1,IL-6, IL-8, IL10
ENDOTHELIAL INJURY

9. IgA protease – cleave mucosal IgA
Transferrin binding protein- Uptake of iron from
transferrin.
EPIDEMIOLOGY
Worldwide, nearly 5 lakh cases of meningococcal disease
occur each year, 10% of those die.
Outbreak- due to serogroup C
Hyper-endemic disease (>10 cases/100,000 population)-
due to serogroup B
Sporadic cases- due to all important serogroups A,B,C,Y
and W135.

10.  High prevalence area : Sub saharan belt of
Africa (from Ethiopia to Senegal)
 In India- (3.2%), endemic in Delhi , outbreak
(1966 and 1985).
 Seasonality – Common in winter and spring
 Age- early childhood (3 month to 5 years)
second peak occuring in adolescent (15-25
years of age)

11. RISK FACTORS
-Overcrowding
-Travellers
-Smoking
-Viral and Mycoplasma infection of respiratory tract

12. Mode of transmission-Droplet inhalation and portal of entry is
nasopharynx.
Spread infection-
From nasopharynx meningococci
reach the
Meninges Meningitis
Either by-
Hematogenous route
Direct olfactory nerve spread through cribriform plate
Rarely through conjunctiva

13. CLINICAL
MANIFESTATION

14. Capsular antigen detection
Biochemical analysis- CSF
pressure, Protein and
Glucose,
-Culture (Blood
agar)
-Chocolate agar
-Wet mount
Supernatant Sediment
Gram stain
& wet
mount
BHI broth

15. Gram-negative diplococci
Bean shaped, flat adjacent sides
0.8 μm in size

16. ON BLOOD AGAR ON CHOCOLATE AGAR
1mm,Non- hemolytic
Grey , round,
Smooth, moist, glistening convex
Circular colonies
Small, grey to white,
mucoid smooth, circular,
convex with glistening
surface

17.  Nasopharyngeal swab culture- On Thayer Martin
Medium
 Biochemical tests
- Oxidase and Catalase Positive
- Ferment glucose and maltose but not sucrose

18. - Serogrouping by Latex agglutination test
- ELISA
- Molecular diagnosis – By multiplex PCR
TREATMENT-
Drug of choice 3rd generation cephalosporin (CTR,
CTX) given for 7 days , Penicillin can also be given.
Symptomatic treatment
Such as aggressive fluid resuscitation (for shock) and
measures to decrease intracranial pressure.

19. PREVENTION
Chemoprophylaxis-
Rifampicin and ciprofloxacin against meningococcal
infections.
Vaccine Prophylaxis-
Polysaccharide vaccines- as bivalent (serogroups A
and C) or quadrivalent (serogroups A, C, Y, and
Wl35).
Dose: 50 µg , two doses, 2-3 months
-for children of 3-18 months of age
-single dose to older children or adults.

20. NEISSERIA
GONORRHOEAE
Non capsulated
diplococcus
Commensal in Genital tract
Ferment only glucose

21.  Pilli or fimbriae (hair like structures)
 Outer membrane protein
 Protein-I – Form transmembrane
 Protein-II – Adhesion to gonococci
 Transferrin binding protein
 IgA1 protease
 Lipooligosaccharide- endotoxin activity

22. Venereal disease
Various infection in males, females and also in new
borns
MALES – Acute urethritis ( Purulent urethral
discharge)
Females- Less severe in females
Mucopurulent cervicitis

23. Vulvovaginitis
Infection may spread to bartholin’s gland,
endometrium, and fallopian tube.
In neonates (Ophthalmia neonatorum) – purulent eye
discharge with in 2-5 days of birth (Transmission by
maternal genital flora).

24.  Specimen – Urethral swab in men and Cervical swab
in women ( Dacron or Rayon swabs , cotton swab
inhibitory for gonococci)
 Transport media – Stuart’s and Amies transport
medium
 Microscopy – Gram negative intracellular kidney
shaped diplococci, 0.6 to 1 μm in size

25.  Thayer Martin medium – Small, grey to white,
smooth 0.5 mm in diameter , glistening surface,
convex and mucoid colonies
 Modified thayer martin medium
 Modified New York City medium – Small colonies,
0.5- 1mm in size,
greyish white, mucoid,

26. Oxidase and catalase test positive
Ferment only glucose but not maltose and
sucrose

27. 3rd generation cephalosporins
( both the sexual partners should be treated)
( Ceftriaxone- 250 mg given IM, single dose)
( Cefixime – 400 mg given orally, single dose)
If Chlamydial Co-infection present (Azithromycin or
doxycycline can be added to the regimen)

28. PPNG Penicillinase producing strains of Neisseria gonorrhoeae
Originated from Africa and Asia in 1976
Plasmids coding for Beta lactamases are transferred horizontally by
conjugation
CMRNG Chromosomally mediated resistant N. gonorrhoeae:
Resistance to penicillin and tetracycline,
decrease the permeabillty of the cell to antibiotics
TRNG
Tetracycline resistant N. gonorrhoeae; plasmid·borne
QRNG
Quinolone-resistant N. gonorthoeae

29.  No Vaccination available
General prophylactic include
1. Early detection of cases
2. Treatment of both partners
3. Tracing of contacts
4. Health education for safe sexual contacts

30. N. meningitidis N. Gonorrhoeae
Capsulated Non capsulated
Lens- shaped / Half moon shape
(Diplococcus ,flattened adjacent
sides)
Kidney shape (diplococcus,
concave adjacent sides)
Ferment glucose & maltose Ferment only glucose
Intra- and extracellular Intracellular
Circular colony Irregular margin
Habitat- Nasopharynx Genital tract
Meningitis Urethritis, cervicitis

32.  Chronic urethritis where gonococcci cannot be demonstrated
Agents responsible-
 Bacteria- Chlamydia trachomatis, Ureaplasma urealyticum,
Mycoplasma haminis.
 Viruses- HSV-II and Cytomegalo virus
 Fungi- Candida albicans
 Parasites- Trichomonas vaginalis

34. MORAXELLA CATARRHALIS
Morphology- Gram negative diplococci, 0.6-1 µm
oval with flattened adjacent sides.
Harmless commensal of upper respiratory tract and
genital tract

35. Culture- blood agar and chocolate agar
Remel Catarrhalis selective medium
Biochemicals
Catalase and Oxidase positive, do not ferment any
Carbohydrate
DNase test positive

36.  Opportunistic lower tract infection ( In adults with
chronic obstructive airways disease.
 Otitis media,
 endocarditis and sinusitis
Moraxella lacunata
Non fermenting gram negative rod shaped in pairs.
Causes catarrhal conjunctivitis, and angular
conjuctivitis.

37. C. P. Baveja ( Textbook of Microbiology)
Apurba S. shashtry (Textbook of
Microbiology)
Bailey & scott (Diagnostic Microbiology)