1. NEISSERIAE DON XAVIER N.D

2. Neisseria gonorrhoeae MORPHOLOGY Gram negative Diplococci Strict parasites Pathogenic ones encapsulated Humans – the only reservoirs. Fastidious organisms Strict aerobes, Grow best at 7.2-7.6 at 35’c- 36’c. Oxidase positive Nonmotile, non-spore forming, and non-acid fast. Both pathogenic species possess pili, which vary in their antigenic composition, and several classes of outer membrane proteins (OMPs), which also vary antigenically

3. Grow well in Chocolate – Blood Agar, MHA Selective media– THAYER – MARTIN media Colonies observed as Small, grey, glistening colonies. Produce 4 types Type 1 & 2 – Brown,Pilate, Virulent Type 3 & 4 -- Non pilate, Avirulent Enriched agar with blood and antibiotics ( Vancomycin, Colistin, Nysatin, Trimethoprim)

5. Neisseria gonorrhoeae PATHOGENSIS CAPSULE Polyphosphate capsule, not antiphagocytic, but enable intra cellular survival of pathogen PILIN PROTEINS Adhesion to epithelial cells. High variation shown by the pil gene with a conserved amino terminal end and highly variable carboxy terminal end POR PROTEINS (Protein I) Form pores in the outer membrane, promote intracellular survival by inhibiting Phagolysosomal fusion in PMN’s. Show Ag variation. OPA PROTEINS ( Protein II ) Mediate adhesin of Bacterium within colonies, Anti phagocytosis

8. RMP Protein ( Protein III) With Protein I form pores in cell membrane, Protect other surface Ag from bactericidal activity. Tbp 1, Tbp 2 & Lactoferin binding protein (LBP) Iron acqusition CELL WALL LOS, IgA Protease, beta – Lactamase (Plasmid encoded)

9. Neisseria gonorrhoeae PATHOGENSIS SPREAD IN MALE Adhesion of cocci to urethra & Mucosal surface Cocci Intercellular space 3 days Enter Subepithelial cells Infection along Urethra prostrate seminal vesicles Epididymis Lead to urethral infection in periurethral area & give mutiple discharging sinuses WATERCAN PERINEUM SPREAD IN FEMALE Infection to only urethera & cervix do not affect vagina due to low pH. Infectin occur in Bartholin’s Gland, Endometrium, Fallopian tubes Cause Pelvic inflammation & Salphingitis ( inflammation of Fallopian tubes) Infection leads to Pertonotis & hepatitis FITZ HIGH CURTIS SYNDROME

10. How infection is established ? After attachment OPA mediates tight adhesion POR protein act against Phagolysosomal Fusion LOS mediate inflammatory response Release TNF- alpha If IgG & IgA are direced against RMP it can stop protection against bactericidal activity.

11. Neisseria gonorrhoeae LAB DIAGNOSIS Specimens are collected from urethral & cervical discharge. Gram Stain Direct Immunofluroscence. Culture Biochemical tests : Only glucose is used for acid Production. Serology : CFT Blood Culture Skin lesions Studied.