Pyogenic cocci Neisseriae

Pathogenesis :- Gonococci cause--gonorrhea (sexually transmitted disease STD or veneral disease)
-Ophthalemia neonatorum. Gonorrhea (example urithritis, cervicitis) Gonorrhea is usually symptomatic in men but often asymptomatic in women. Gonococci are sexually transmitted. The transmission of these bacteria is through direct contact of mucous membrane -to mucous membrane, usually sexually contact ; mother-to-neonate during birth. GC attack mucous membrane of genitourinary tract, eye, rectum and-throat.
Clinical finding :- Gonococci caused both localized infection in the genital tract and disseminated infections with seeding of organs, GC reach these organs via the bloodstream(gonococcal bacteremia),
gonorrhea -ln men is characterized primarily by urethritis accompanied by dysuria (painful urination) and purulent discharge complication include (Epididymitis and prostatis). -In women cervicitis and the most frequent complication is an ascending infection of the uterine tubes (salpingitis, PID) which can be result in sterility and ectopic pregnancy as a result of scarring of the tubes. Disseminated gonococci infections (DGI) arthritis, skin lesion. In newborn infant GC. Can cause ophthalemia neonatorum, an infection of the eye of the newborn, is acquired from the mother during passage through an infected birth canal.
Other sexually transmitted infections, example, syphilis and non gonococcal urithritis (NGU) caused by Chlamydia trachomatis, can coexist with gonorrhea therefore appropriate diagnostic and therapeutic measures must be taken.
Lab. Diagnosis :-
1. Specimens, pus, secretion from urethra, cervix, conjunctiva, throat and rectum. 2. Gram stained smear, then we look intracellular Gram-negative diplococci in PMNs) polymorphoneuclear cells) from urethral discharge in men is sufficient for diagnosis while in women false positive because of the normal flora interference 3. Culture, on A. Chocolate agar. b. Thayer-Martin agar. (selective medium) which is chocolate agar containing antibiotics (vancomycin, colistin and nystatin to suppress the normal flora found in the specimen. C. Modified Thayer-Martin agar. same as(Thayer-Martin agar plus trimethoprim) The culture is incubated in an atmosphere containing 5% COZ (candle extinction jar) at 37°c. 4. Oxidase test positive. 5. Sugar fermentation the differentiation between GC and MC is made on the bases glucose and maltose. 6. Nucleic acid amplification test. 7. Serology by ELISA, antibodies against pili. These test are not useful for diagnosis.
Treatment Ceftriaxon plus doxycyclin. Some strain of GC called penicillinase producing gonorrheae or (PPNG) possess plasmids containing the gene for penicillinase production(resistant to penicillin). Control and prevention :- Treatment of symptomatic patient with contact, cases on gonorrhea must be reported to the public health department to ensure proper follow up. Gonococci conjunctivitis is preventive by the use of erythromycin ointment. Silver nitrate drops are use less frequently. No vaccine is available.