40: Neisseria and Moraxella catarrhalis

Oxidase positive, gramnegative diplococci

that do not elongate when exposed to
subinhibitory concentrations of penicillin
Normal inhabitant of upper respiratory
tract, except Neisseria
Neisseria rodlike, humans are the only
natural hosts of Neisseria, sensitive to
Sodium Polyethanol Sulfonate (SPS should
not exceed 0.025%) found in blood culture
broths
5% SBAP, enriched ChocoAgar, GC-LECT
Agar, Martin-Lewis, Modified Thayer Martin
medium
3-7% CO2, can be achieved using candle
jar, CO2 generating pouch, or CO2
incubator

substituted for nystatin, and

Vancomycin conc is increased

N. meningitidis transmited through

contaminated respiratory droplets

NEISSERIA

N. gonorrhoeae pathogenic, in urogenital tract,

never considered normal flora. Sexually

transmitted. Requires enriched chocolate agar for
growth on primary culture, but can be ThayerMartin.

Leading cause of STD, localized in mucosal

surfaces where host is exposed to the
organism (cervix, conjunctiva, pharyngeal
surface, anorectal area, urethra of males)
May be asymptomatic or with pronounced
purulent response
Isolates with nutritional requirement for
Arginine, hypoxanthine, and Uracil (AHU
strains) usually from women, but also from
asymptomatic males
Presence of polyl-hydroxylprolyl
aminopeptidase
Transport medium should contain charcoal
(Ames medium) to inhibit toxic fatty acids
present in fibers. Calcium alginate is also
inhibitory. Dacron or rayon fibers are
recommended. Should be placed in a
container able to sustain CO2 during
transport. In labs, stored at 3-5% CO2.
Swabs of sample are plated within 6 hours.
Plated on JEMBEC systems. Incubated at
35C.
If volume >1mL, centrifuge at RT at 1500x
g for 15 mins.
Modified Thayer Martin contains:
o IsoVitaleX (enrichment
supplement)
o Colistin (inhibits gn bacilli)
o Nystatin (inhibits yeast)
o Vancomycin (inhibits gp bacteria)
o Trimethoprim (inhibits Proteus)
o Martin Lewis medium is similar, but
anisomycin (antifungal) is

Leading cause of fatal bacterial

meningitidis
Antigen detection of capsular
polysaccharide antigen in body fluids
(urine, serum, CSF) no longer
recommended in USA
Presence of beta-galactosidase (use ONPG
test) and gamma-glutamyl
aminopeptidase
In ONPG test indicates lactose utilization:
o N. lactamica ONPG+
o N. meningitidis ONPGo N. amanoloris propagates well on
routine media, doesnt ferment
carbohydrates other than glucose;
indole negative, arginine
dihydrolase+

MORAXELLA
M. catarrhalis involve a patients endogenous
strain.

Grow on blood agar at 22C, on NA 35C,

reduction of nitrate to nitrite, inability to
utilize carbohydrates, production of DNAse
Only one to hydrolyze DNA

SEROTYPING
12 groups for N. meningitidis: A, B, C, H, I, K, L, X,
Y, Z, W135, 29E.
Performed on slide agglutination. A, B, C, Y and
W135 cause systemic disease in US.
IDENTIFICATION:

Biochemical, immunologic, enzymatic,

nonamplified DNA probe
STD if it oxidase+, gn diplococci, grows on
gonococcal selective agar

SERODIAGNOSIS
GC agar containing 1% growth supplement
for N. gonnorhoeae disk diffusion methods
Increasing resistance to quinolones of
Neisseria
Gonococcal Surveillance Project:

PPNGplasmid-mediated betalactamase positive

TRNGplasmid-mediated tetracycline
resistance
PPNG-TRNG
Penr & Tetr chromosomal-mediated
resistance patterns

CMRNG = Penr + Tenr

Cephalosporins should be treatment of

choice
-lactamase production in N. meningitidis is
rare, although resistance to penicillin is
emerging