Sub:-Gonococci

_Presentation By

:Ronak Antala

history

The organism was first

described by Albert L . S

Neisser (1879) in the

gonorrhoeal pus.

HABITAT

N. Gonorrhoeae is strictly parasite to human and

found primarily in the genitourinary tract of

patients suffering from gonorrhoeae ; it is never

found outside the body , or in a normal individual

.

It is usually transmitted from person to person

by sexual-intercourse.

Morphology

MORPHOLOGY

These are Gram Negative Diplococcic 0.6 to 0.8 in

diameter , kidney or bean shaped (concave)

arranged in pairs with opposed concave surfaces.

They are often stained easily with aniline dyes

like methylene blue, fuchsin etc .

They are often intracellular in smears 2o to 5o

or more in an Epithelial or pus cell, but may be

extracellularly present as well.

Cultural characters

N. gonorrhea is aerobic and the range of

temperature for growth is 35 to 36 Celsius ,

It is difficult to cultivate this organism , which

doesnot grow on nutrient agar, but grow well

on

1) Media containing 10% blood , serum, ascitic

or hydroccele fluid .

2) It grows well on chocolate agar .

3)the optimum PH for growth varies from 7.2

to 7.6 .

The medium should be fresh .

An atmosphere of 5 to 10% C02 is better for its

growth than ordinary atmosphere .

The C02 helps in buffering the medium .

Special media

Thayer Martin medium

Medium modified

MNYC ( New york city )

Growth occurs overnight

Chacko _Nair Medium

COLONIES

The growth is scanty after 24 hours and in

some cases the appearance of the colonies

may be delayed upto 48 hours .

The colonies are small 0.6 to 1mm in diameter.

On serum agar , they are semitransparent small

raised, convex and discrete but later they are

large, thin , crenated margin and formation of

papillae may occur after growth for a few days.

Viability

The organism is killed in 5 minutes at 55

celcius . It is susceptible to drying and on

desiccation it dies within 2 hours.

At room temp. it dies in 2 days when kept

outside the incubator .

Gonococci remains viable on bed sheets ,

towels, hands .

On blood sugar, it survives for about 3 weeks

at the incubator temp., if moisture is

maintained

py

In human, it produces gonorrhoea in males;

complication in females; vulvo vaginitis in

female children and ophthalmia

neonatorum in newborn .

It causes cystitis, osteomyelitis, iritis , and

meningitis.

Gonorrhoea

This infection occurs directly from person to

person by sexual intercourse.

Vulvo-vaginitis in young female children is

occasionally seen due to sleeping in same

bed.

The organism infect columnar epithelium;

stratified and squamous epithelia , the

organism passes to distant parts of body by

lymphatic channel .

Early primary lesions

In males, the infection of anterior urethra is

associated with an acute catarrhal

inflammation producing arthritis.

In females arthritis is soon followed by

inflammation of cervix uteri .

in new born infants , infection occurs at birth a

condition of purulent conjunetivitis

Secondary lesions.

These are spread by;

A. direct extension

B. Lymphatic's

C. Blood stream

D. Mechanical means.

Complication

Gonorrhoeal arthritis

Gonorrhoeal iritis

Urethritis

Acute gonococcal meningitis

Salpingitis

Tubo-ovarian abscess

Sterility

Abortion.

Laboratory diagnosis.

Based on two methods

Direct method

Indirect method

Direct method

Done by finding the organism by:

1) Microscopic examination of smear

2) Cultural method for (chronic and acute cases)

1) Microscopic examination of smear

It is very useful in acute cases. The smear

shows gram negative, intracellular diplococcic in pus cells . Secondary organisms and epithelial cells may also be present.

In chronic cases a provocative method may show positive smears after a big dose of vaccine

2) Culture : the culture should be made as soon as swab is taken . The material is incubated into fresh blood agar and chocolate agar without delay . If inoculation is not done at once, the organism may die at room temperature .

Oxidase reaction is helpful in detecting of colonies.

Indirect method

Based on two methods

Complement fixation test

Co agglutination test and direct” FA “test.

Prevention

Despite effective antimircobials and active

public health measure, an estimated 800,000

cases of gonococcal infections occur annually.

Behavioral interventions including condom use

and decreasing no. of sexual partners

Early diagnosis and treatment

Partner notification

Vaccine development and utilization.

Conclusion

The mode of transmission as well as the

biological properties of gonococci combine to

give them a unique set of characteristics .

The strong adhesion of gonococci allow them

to enter genital tract of humans.

They causes inflammation or disseminate to

other parts of the body.

Meningococci have an outstanding ability to

survive in blood stream to cause systemic

infections .

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