Neisseria

🦠NEISSERIA: আমরা জানি এটা একটা gram(-) cocci. 📌classification of Neisseria: 👉pathogenic: 1.Neisseria gonorrhoeae 2.Neisseria meningitidis 👉Non-pathogenic: 1. Neisseria flava 2.Neisseria subflava 3.Neisseria mucosa 4.Neisseria lacti 5.Neisseria sica 🦠Neisseria Gonorrhoeae: Imp. properties : 1.Gm(-)ve diplocococcus(মানে জোড়ায় জোড়ায় থাকে) 2.kidney shaped (each having concave margin & convex margin, concave sides are adjacent) 3. oxidase positive 4.এরা সাধারনত intracellular within neutrophil in lesions &exudates 5. Non-flagellated,Non-spore forming,Non-capsulated

📌Virulence factor of N.gonorrhoeae: 1.pili: এটা pillinn protein দিয়ে তৈরী। N.gonorrhoeae ১০০ টা serotypes আছে এই pillin protein এর antigenicity উপর ভিত্তি করে। ফলে তারা সহজেই reinfection করতে পারে। 2.Endotoxin(Lipo-oligosaccharide) 3.Por protein 4.IgA 1 protease : it cleaves IgA that defends mucosal surface. 5. Ferric binding protein 🗣️Nice to know: 👉প্রায় সকল gm(-)ve bacteria এর endotoxin হলো lipo-ploysaccharide(LPS),কিন্ত N.gonorrhoeae এর endotoxin lipo-oligosaccharide(LOS)

👉Other IgA producing bacteria : 1 S.pneumoniae 2 N.meningitidis 3 H.influenzae 📢CLINICAL FEATURES : 👉In Male: 1.Acute case: -urethritis -dysuria -yellow purulent discharge. 2.chronic case: -prostatitis -epididymitis -seminal vesiculitis 👉In Female: 1. Acute case: -cervicitis -purulent vaginal discharge 2.chronic case -salphingitis -fibrosis -pelvic peritonitis 👉New born -Opthalmia neonatorum: এটা সাধারনত develop করে যখন new born infant কোন infected birth canal দিয়ে pass করে। 🗣️Some viva questions : 👉why N.gonorrhoeae don't cause vaginitis? N.gonorrhoeae শুধুমাত্র infect করে columner epithelium কে,আবার urethra,cervix এর lining columner epithelium,কিন্ত vagina এর lining squamous epithelium.তাই এরা vaginitis করে না। 👉 N.gonorrhoeae দিয়ে আক্রান্ত patient কি protective immunity develop korbe?? উত্তর না। why? -patient কোন protective immunity develop করবে না। কারন N.gonorrhoeae antigenically heterogeneous তাই তারা এদের surface structures পরিবর্তন করতে সক্ষম। ⚗️Laboratory diagnosis: 🔹 Specimen: (a)Male: -Acute case: urethral discharge -chronic case: prostatic secretion by prostatic massage(early morning before passing urine) ( b)Female: -endocervical swab(both acute &chronic case). (c)New born: conjunctival swab. ♦️Microscopic Examination : Gram staining : gm(-)ve diplococci within polymorphonuclear leukocytes. 🧫Culture: ▪️chocolate agar media: এখানে sterile specimen ব্যবহার করা হয়।e.g. blood ▪️Thayer martin media: Non-sterile specimen ব্যবহার করা হয়।e.g. cervical sawb এই media তে কিছু antibiotics থাকে।যেমন: vancomycin,colistin,Amphotricin-B, trimethoprim.মনে রাখার জন্য VANT. ▪️Modified New york city media: incubation temp 37,incubation period 18-24 hour,incubation environment 5-10% CO২. 🧪Biochemical test: ▪️oxidase positive ▪️Fermemts only glucose. 🧬Nucleic acid amlification test:PCR this is higly specific &sensitive. 🔹serological tests: ELISA,DNA probe assay. 🗣️ viva: what is the role of antibiotics in Thayer martin media? 👉vancomycin-inhibit gm(+)ve bacteria 👉Amphotericin-B inhibit fungul growth. 👉colistin-kills gm(-)ve bacteria except Neisseria. 👉Trimethoprim- prevent swarming growth of proteus. 🦠Neisseria Meningitidis 🔹 also Known as meningococus. ♦️properties : ▪️Gm(-)ve diplococci. ▪️oval shape with flattened apposed surface. ▪️Usually intrecellular within neutrophil. ▪️polysaccharide capsule present. ▪️Have endotoxin composed of lipcpolysaccharide. ▪️Non spore forming,Non flagellated. ♦️Virulence factor ▪️polysaccharide capsule ▪️Endotoxin ▪️IgA protease. ♦️Pathogenesis of meningococcal meningitis: 🔹Route of infection: direct transmission by air borne droplets. 🔹steps : organism দেহে প্রবেশ করে air borne droplet দিয়ে →যা nasopharynx এর membrane এ colonize করে→ become a part of normal flora →blood stream এ প্রবেশ করে, spread করে meninges, joints or disseminated throughout the body(meningococcemia)→ পরবর্তীতে blood brain barrier cross করে এবং তা sub-arachniod space এ পৌছায়→meningitis 🗣️Viva: ♦️what are the clinical findings? ▪️Fever,headache stiff neck,progress to coma within a few hours. ▪️Arthritis ▪️petechial hemorrhages in skinn ▪️Intestinal myocarditis. ♦️what are the organisms respnsible for meningitis? ▪️please follow pictures 📢Nice to know: ♦️waterhouse friderichen syndrome: 🔹it is fulminant form of meningococcemia যেখানে adrenal gland failure হয়, adrenal gland এ bleeding এর জন্য। 🔹characteristic: ▪️High fever ▪️circulatory failure ▪️Hypotension ♦️Laboratory diagnosis : 🔹specimen : ▪️CSF ▪️Blood ▪️Nasopharyngeal swab. 🔹Microscopic examination : ▪️Gm(-)ve diplicocci with plenty of polymorhonuclear leukocytes with plenty of pus cell. 🔹Culture: ▪️chocolate agar media ▪️Thayer martin media. 🔹Biochemical test: ▪️fermentation reaction→ferments both glucose & maltose ▪️oxidase (+)ve 🔹Serological test: ▪️Latex agglutinatiom test ▪️Haemaglutination test. 🔹Examination of CSF: ▪️physical : →Appearance : turbid →color: purulent →pressurer:⬆️ ▪️Biochemical: →sugar:⬇️ →protein: ⬆️ →chloride:⬇️ ▪️cytological test: →WBC count :⬆️ (predominantly neutrophil) 🗣️Viva: ♦️why N.gonorrhoeae & N. meningitidis can't be cultured in blood agar media? ▪️কারন blood agar plate এর toxic trace metal আর fatty acids organism এর growth inhibit করে। ♦️CSF findings in different type of meningitis