CONTENTS

• Microbiology – What It Means 1
• Why a Nurse Must Study Microbiology 1
• Historical Perspective (Milestones in Microbiology) 2

• Introduction 8
• Normal Flora of the Skin 10
• Normal Flora of the Eye (Conjunctiva) 10
• Normal Flora of Mouth and Upper Respiratory Tract 10
• Normal Flora of Gastrointestinal Tract 11
• Normal Flora of Genitourinary Tract 11

• Introduction 13
• Structure of Bacteria 14
• Morphology of Bacteria 15
• Microscopic Examination 15
• Microscopy 19

• Bacterial Growth 23
• Bacterial Nutrition 25
• Other Factors Affecting Bacterial Growth 25

• Introduction 27
• Culture Media, Methods and Characteristics 28
• Biochemical Reactions 32
• Antigenic Characters 34
• Animal Pathogenicity 35
• Resistance to Antibiotics and Other Agents 35
• Typing Techniques 36

• Introduction 39
• Blood 40
• Cerebrospinal Fluid 42
• Respiratory Tract Specimens 42
• Urine 43
• Stool 43
• Serous Fluids 43
• Tissue 43
• Eye Swabs 44
• Genitourinary Tract Specimens 44
• Specimens Collected for Viral Culture 44
• Specimens Collected for Anaerobic Culture 44
• Specimens Collected for Fungal Culture 45

• Introduction 47
• Definition 48
• Prevalence and Importance 48
• Microbial Causes of Hospital Infection 49
• Sources and Mode of Spread of Hospital Infection 50
• Control of Hospital-Associated Infections 51
• Microbiological Surveillance 52

• Introduction 58
• Definitions 59
• Types of Disinfection 59
• Types of Disinfectants/Antiseptics 59
• Disinfection Policy 62
• Other Recommended Disinfection Procedures 63
• Testing of Disinfectants 64

• Introduction 66
• Sterilization by Dry Heat 67
• Sterilization by Moist Heat 68
• Sterilization by Filtration 72
• Sterilization by Radiation 73
• Ultrasonic and Sonic Vibrations 73
• Sterilization of Heat-Labile Equipment 74

• Introduction 76
• Classification of Hospital Waste 77
• Segregation of Biomedical Waste 78
• Storage and Transportation of Biomedical Waste 79
• Treatment and Disposal of Biomedical Waste 79
• Education 80

• Introduction 81
• Four Major Global Challenges for Patient Safety 81

• Introduction 83
• Recognition of an Outbreak 84
• Notification of the Outbreak 84
• Investigation of a Suspected Outbreak 84
• Control Measures 85

• Introduction 87
• Primary Prevention of Exposure 88
• Viral Hepatitis 89
• Human Immunodeficiency Virus (HIV) 92
• Tuberculosis 95
• Prevention of Transmission of Blood-Borne Pathogens from HCWs to Patients 95

• Introduction 97
• Mechanism of Action of Antimicrobial Agents 99
• Some Antimicrobial Agents in Use 100
• Resistance to Antimicrobial Agents 101
• Control of Nosocomial Antimicrobial-Resistant Bacteria 101

• Introduction 103
• Immunity 104

• Introduction 110
• Classification of Antigens 111
• Properties of Antigenicity 111

• Introduction 112
• Structure of Immunoglobulins 113
• Classification of Immunoglobulins 113
• Cross-reactivity 115

• Introduction 117
• Types of Antigen–Antibody Reactions 118

• Introduction 124
• Functions of the Complement System 125
• Pathways of the Complement System 125

• Introduction 128
• Humoral Immune Response 129
• Cell-mediated Immune Response 131
• Immunological Tolerance 132

• Introduction 133
• Types of Hypersensitivity Reactions 133

• Introduction 136
• Specific Host Responses to Vaccines 139
• Vaccines Available in India 139
• Adverse Reactions Associated with Immunization 141
• Future Vaccines 141

• Water-Borne Diseases 143
• Food-Borne Diseases 146

• Introduction 148
• Staphylococcus aureus 149
• Streptococcus 153
• Streptococcus pyogenes 154
• Enterococcus 157
• Pneumococcus 159
• Meningococcus 161
• Gonococcus 163

• Bacilli Associated with the Respiratory Tract 167

• Corynebacterium diphtheriae
• Haemophilus influenzae
• Bordetella pertussis
• Legionella pneumophila
• Klebsiella sp.

• Bacilli Associated with Intestinal Canal 176

• Escherichia coli
• Salmonella Typhi, Salmonella Paratyphi A, B, C
• Food Poisoning Bacilli
• Shigella sp.
• Proteus sp.
• Pseudomonas sp.

• Acid-Fast Bacilli 186

• Mycobacterium tuberculosis
• Mycobacterium leprae

• Spore-Bearing Bacilli 190

• Clostridium tetani
• C. welchii (perfringens), C. septicum and C. oedematiens (novyi)
• Clostridium botulinum
• Clostridium difficile
• Bacillus anthracis

• Bacilli Derived from Infected Animals 198

• Yersinia pestis
• Brucella abortus, Brucella melitensis and Brucella suis

• The Vibrios 201

• Vibrio cholerae, Vibro choleare O139

• Campylobacters 204
• Helicobacter 204
• Bacteroides 205

• Syphilis Spirochaete 207
• Congenital Syphilis 209
• Pinta and Yaws Spirochaetes 211
• Vincent’s Angina Spirochaete 212
• Relapsing Fever Spirochaetes 212
• Lyme’s Disease Spirochaete 213
• Leptospirosis Spirochaetes 214

• Introduction 217
• Mycoplasmas 218
• Chlamydiae 220
• Rickettsiae 222
• Ehrlichia 225

• Introduction 227
• Classification of Fungi 228
• Superficial Mycoses 229
• Subcutaneous Mycoses 233
• Systemic Mycoses 235
• Opportunistic Mycoses 239

• Introduction 244
• Poxviruses 246
• Herpes Viruses 247
• Adenoviruses 252
• Papovaviruses 253
• Hepadnavirus (Hepatitis B Virus or HBV) 255
• Parvovirus 258

• Introduction 261
• Orthomyxoviruses 261
• Paramyxoviruses 264
• Togaviruses 268
• Flaviviruses 269
• Bunyaviruses 274
• Caliciviruses 275
• Coronaviruses 277
• Reoviruses 279
• Picornaviruses 280
• Arenaviruses 285
• Rhabdoviruses (Rabies Virus) 286
• Filoviruses 289
• Retroviruses 290

• Introduction 295
• Tests for Detection of Antibodies 296
• Tests for Detection of Microbial Antigens in Tissues and Body Fluids 300
• Tests for Detection of Nucleic Acids 303
• Tests for Detection of Metabolites 305
• Rapid Culture Methods 305

• Introduction 307
• Protozoa 308
• Helminths 321

• Introduction 340
• Mosquitoes 341
• Housefly 342
• Sand Fly (Phlebotomus) 343
• Tsetse Fly (Glossina) 343
• Black Fly 344
• Louse/Lice 344
• Rat Flea (Xenopsylla cheopis) 345
• Reduviid Bug 346
• Ticks 346
• Mites 346
• Cyclops 347

Bibliography 349

Glossary 353

Index 359