3. Morphology:
gram nagative, diplococci,
adjacent sides concave,
typically kidney shaped
intracellular,
pili on surface
4. more difficult to grow than meningococci
aerobic, may grow anerobically,
pH 7.2-7.6.
temperature 35- 36C
essential 5 to 10 % CO2.
chocolate agar, muller hinton agar,
Selective medium:Thayer-Martin
medium(chocolate agar with antibiotics:
vancomycin,colistin,nystatin), Modified Thayre-
Martin medium: Trimethoprim added to prevent
swarming of proteus spp
5. Small, round,transluscent,convex or slightly umbonated,
granular surface.
Easily emulsifiable
Four types of colonies: T1-T4
Type 1 & 2: small, brown, pili present, autoagglutinable,
virulent (P+ & P++)
Type 3 & 4 : larger, granular non pigmented, pili absent,
avirulent (P-)
Fresh sample: T1 & 2 colonies are isolated
Serial subcultures: change to T 3 & 4
6. Similar to meningococci,
Only difference is only utilise glucose
not maltose.
Produce acid but no gas.
7. Antigenically heterogenous.
Pili:hair like structures
Trilaminar outer membrane:contains proteins
1.protein I :has IA and IB,for typing the strains,
constant for a single strain,
variations in different strains,
one strain carries either IA or IB,
classified A1 to 24 & B1 to 32.
2.protein II: opacity associated(OPA) outer
membrane protein form opaque colonies, attachment,
clumping
3. protein III: associated with protein I in formation
of pores on the cell surface, plays role in exchange of
molecules across the outer memb
8. Very delicate,
Readily killed by heat, drying and antiseptic,
Strict parasite dies within 1-2 hours outside
body,
In cultures, dies in 3-4 days, survives in slant
cultures if kept under sterile paraffin oil.
Stored for years if frozen quickly and left at
-70C.
9. sexual contact
adhesion to mucosa
penetration & reach
subepithlial tissue 3rd
day
incubation period is
2-8 days
10. Chronic urethritis leads stricture may spread to
periurethral tissue cause watercan perineum
In women:
urethritis, cervicitis,
vaginal mucosa resistant in adults due to strtified
squamous epithelium.
vulvovaginitis in prepubertal girls,
spread to : bartholins gland, endometrium,fallopian
tubes, salphigitis may lead sterility peritonitis may
develop with perihepatic inflammation (Fitz-Hugh-
Curtis syndrome).
11. other diseases:
Proctatitis : in both sexes
Conjunctivitis : autoinoculation
Arthritis
ulcerative endocarditis
rarely meningitis.
Non venereal: ophthalmia in newborn
Gonoccocal bacteremia : skin lesions
12. 1.specimens:
Acute gonorrhoea: urethral discharge, cervical
swab.
Chronic gonorrhoea: morning drop of secretion,
centrifuged deposits of urine
2.Trasport:
culture done immediately if not possible,
collection with charcoal impregnated swabs & sent
in Stuart’s transport medium.
13. 3.Direct microscopy:
gram negative intracellular cocci,
fluroscent antibody teqniques.
4.culture:
done readily, on chocolate agar, Muller Hinton agar or
Thayer-Martin medium. At 35-36C, 5-10% CO2.
5.Colony morphology and gram staining:
6.Biochemical reactions:
7.serological tests:
14. 1.sulphonamides: resistance developed
now
2.penicillins: from 1976, gonococci
producing beta lactamase have
appeared.
3.The centre for disease control &
prevention, USA in 1993:
ceftriaxone 125 mg single dose
i.m.or ciprofloxacin 500mg or
ofloxacin 400mg single oral and
doxycyclin100 mg twice daily for 7
day or erythromycin 1 gm single
oral dose.
4.Updated regimens by
CDC, USA April 2007:
ceftriaxone 125 mg i.m.
single dose OR cefixime
400mg orally in a single
dose PLUS
treatment for chlamydia if
it is not ruled out.
15. Early detection,
Contact tracing,
Health education, general measures,
vaccination has no role.
16. In chronic urethritis cases : gonoccoci are not
detected
In some cases urethritis is a part of some syndrome
(Reiter’s syndrome)
Organisms causing urethritis: Chlamydia
trachomatis, Ureaplasma urealyticum &
Mycoplasma hominis. Herpes virus, CMV. Gardnella
vaginalis, Acinetobacter spp, Fungi (Candida
albicance), Protozoa (Trichomonas vaginalis)
17. Normal inhabittants of respiratory tract
N. flavescence, N. catarrhalis
N. lactamica: present in nasopharynx, usually
avirulent
