Microbiology gonorrhea

1. Neisseria gonorrhoeae
(N.gonorrhoeae)

2. • Family Neisseriaceae
• Genus Neisseria
• Species Neisseria gonorrhoeae
(N.gonorrhoeae)

3. Моrphology of N.gonorrhoeae
• Bacteria are visualized as gram-
negative, bean-shaped
diplococci. Gonococci are non-
sporeforming non-motile
microorganisms.
• Unlike meningococci, Neisseria
gonorrhoeae is lack of capsule.

4. • The bacteria express multiple pili and
fimbriae.
• They carry a large number of
plasmids. Some of them confer
resistance of gonococci to
antimicrobial drugs resulting from
beta-lactamase expression.

5. N.gonorrhoeae under the
electron microscope

6. N.gonorrhoeae
Loefflers stain
The demonstration of intracellular diplococcus same coffee

7. N.gonorrhoeae
Gram stain
Intracellular diplococcus same coffee

8. Culture properties
• Aerobic
• Grow on culture
medium with
blood, serum
and ascitic
fluid, incubated
under 5-10%
СО2
• Gonococci
produce very
small convex
colonies

9. • Pathogenesis of gonorrhea

10. • Gonococcus is the strictly human pathogen.
Gonorrhoea is a typical sexually
transmitted disease that affects
predominantly urogenital tract.
Also gonococci produce gonorrhoeal
conjunctivitis in adults and ophthalmia
neonatorum (or blennorrhoea) in newborn
infants transmitted by contact route.
Infectious dose of bacteria is generally
low – about 103 cells of virulent strains

11. • Rectal gonorrhea
• Blennorrhagia
• Pharyngitis
• The pathogens can penetration into the
bloodstream and in different organs and
tissues. In 1-2% of patients develop
disseminated gonorrhea infection, which is
characterized by arthritis and other lesions
of the musculoskeletal system,
endocarditis, meningitis, sepsis, and others.
Extragenital gonorrhea

12. Pharyngitis
Blennorrhagia
Conjuctivitis
Extragenital gonorrhea

13. Immunity
• Humoral immunity and cell immunity
• Antibodies appear in the serum on the 5th-7th day
of the disease, the peak titer of antibodies is
observed on the 14th day, then the titer gradually
decreases.
• The greatest role in protecting the infection
belongs to the factors of local immunity, sIgA.
• short-term immunity, may be secondary disease
(reinfection)

14. Laboratory diagnostics of
gonorrhea
• Clinical material: urethral smear, endocervical
smear, urine sediment, blood
• Methods:
• Bacterioscopic (staining of the smear by
Gram and Leleffler ), use for acute
gonorrhea;
• Bacteriological (culture);
• Serological (main)-Bordet-Gengou test
(complement fixation test) for detection
of antibodies in serum, use for chronic
gonorrhea;

15. Bacterioscopic metod
Gram-stained smears of secretions
show typical gram-negative
beanshaped cocci within
polymorphonuclear leukocytes
(incomplete phagocytosis) or
extracellularly.

16. Bacteriological method
• Grow on culture
medium with blood,
serum and ascitic
fluid, incubated under
5-10% СО2

17. Bacteriological method
• Stage 1: seeding of clinical material on
blood agar (selective media), incubation
at a temperature of 35-37 C. It is
essential to provide 5-10% CO2.
• Stage 2: Macroscopic study of
colonies, smear according to Leffler
and Gram; Stage
• 3: Identification of the set of
properties: cultural, morphological,
tinctorial, biochemical, sensitivity to
antibiotics.

18. Biochemical reaction

19. Oxidase test

20. Treatment and Prophylaxis
of Gonorrhoea
• Because of rapidly growing
resistance of gonococci to antimicrobial
agents, third generation cephalosporins
(e.g., ceftriaxone) and
macrolides/azalides (azithromycin) are
currently recommended for treatment of
gonorrhoea.

21. • However, in 2011 the first ceftriaxone-
resistant isolates of gonococci
were registered.
• Later in 2013 a new drug combination of
azithromycin and gentamycin was
introduced into clinical practice that is
efficient against multiresistant gonococcal
strains.
For treatment of chronic gonorrhoea the
injections of gonococcal killed vaccine can
be administered to stimulate host
immunity.

22. • For protection of newborns against
ophthalmia neonatorum, urgent
eye instillations of sulfacetamide
(sulfacyl-sodium) solution as well as
applications of tetracycline or
azithromycin ophthalmic ointments are
administered immediately after birth.