SECTION 1 General Microbiology
1 Introduction to Microbiology, 3
Introduction, 3
Five-Kingdom Classifi cation of Living Organisms, 3
Types of Microbes, 3
History of Microbiology, 4
Microbiology and Nurses, 5
2 Morphology and Physiology of Bacteria, 6
Introduction, 6
Typical Features of a Prokaryotic Cell, 6
Microscopy, 6
Staining of Bacteria, 7
Shape and Arrangement of the Bacteria, 8
Bacterial Anatomy, 8
Bacterial Appendages, 12
Bacterial Spores, 13
Bacterial Growth, 13
Bacterial Nutrition, 13
Oxygen Requirement, 14
Temperature Requirements, 14
Bacterial Growth Curve, 14
Synchronous Growth, 14
3 Culture Media, 16
Introduction, 16
Defi nitions, 16
History, 16
Agar, 16
Types of Culture Media, 16
Some Important Bacteriological Culture Media, 17
Anaerobic Culture Media, 19
4 Culture Methods, 20
Introduction, 20
Types of Culture Methods, 20
Anaerobic Culture Methods, 22
5 Laboratory Methods in Identifi cation of
Microorganisms, 25
Introduction, 25
Collection and Transport of Specimen, 25
Transport Medium, 26
Storage of Specimen, 26
Identifi cation of Bacteria, 26
SECTION 2 Infection Control
6 Infection, 35
Introduction, 35
Pathogen, 35
Infection, 35
Mode of Transmission, 36
7 Sterilization and Disinfection, 40
Introduction, 40
Defi nitions, 40
Difference Between Sterilization and Disinfection, 40
Factors that Influence the Degree of Sterilization and
Disinfection, 40
Methods of Sterilization and Disinfection, 41
Physical Methods of Sterilization, 41
Chemical Methods of Sterilization, 45
8 Hospital-Acquired Infection and Its Control, 48
Introduction, 48
Sources of Hospital-Acquired Infections, 48
Factors Influencing Hospital-Acquired Infections, 48
Microorganisms Causing Hospital Infection, 48
Routes of Transmission, 49
Common Hospital-Acquired Infections, 49
Infection Control Committee, 49
Role of Nurses in Prevention and Control of Infections, 50
9 Chemotherapy and Antibiotics, 52
Introduction, 52
Antibiotic, 52
Mechanisms of Action of Antibiotics, 52
Drug Resistance, 54
Antibiotic Sensitivity Test, 54
10 Hospital Waste Disposal, 57
Introduction, 57
Universal Precautions, 57
Defi nition of Biomedical Waste (BMW), 57
Types of Biomedical Waste, 57
Categories of Biomedical Waste, 58
Waste Segregation, 58
Treatment and Disposal Technologies for Health Care
Wastes, 58
SECTION 3 Medical Bacteriology
11 Staphylococcus, 63
Introduction, 63
Classifi cation, 63
Staphylococcus aureus, 63
Other Staphylococci, 65
12 Streptococcus, 67
Introduction, 67
Classifi cation of Streptococci, 67
Haemolytic Activity, 67
Serological Properties, 67
Biochemical (Physiologic) Properties, 67
Streptococcus pyogenes, 68
Virulence Factors of S. pyogenes, 68
Laboratory Diagnosis, 70
Treatment, 71
Other Pathogenic Streptococci, 71
Group B Streptococci: Streptococcus agalactiae, 71
Diseases, 71
Laboratory Diagnosis, 71
Group D Streptococci, 72
Enterococcus, 72
Characteristics of Enterococci, 72
Identifi cation, 72
Diseases, 72
Vancomycin-Resistant Enterococci, 72
Treatment, 72
Viridans Streptococci, 72
Streptococcus pneumoniae, 72
13 Neisseria, 76
Introduction, 76
Neisseria meningitidis (Meningococcus), 76
Neisseria gonorrhoeae (Gonococcus), 77
14 Corynebacterium, 80
Introduction, 80
Corynebacterium diphtheriae, 80
15 Clostridium, 85
Introduction, 85
Clostridium perfringens, 85
Clostridium tetani, 87
Clostridium botulinum, 89
Clostridium diffi cile, 90
16 Nonsporing Anaerobic Bacteria, 92
Introduction, 92
Classifi cation of Nonsporing Anaerobic Bacteria, 92
17 Mycobacteria, 94
Introduction, 94
Mycobacterium tuberculosis Complex, 94
Mycobacterium Tuberculosis, 94
Mycobacterium Leprae, 96
18 Haemophilus, Bordetella and Brucella, 99
Haemophilus, 99
Haemophilus influenzae, 99
Bordetella, 101
Bordetella pertussis, 101
Brucella, 102
19 Enterobacteriaceae, 104
Introduction, 104
Escherichia coli, 104
Shigella, 105
Klebsiella pneumoniae, 106
Salmonella typhi, 107
Proteus, 108
20 Vibrios, 110
Introduction, 110
Vibrio cholerae, 110
21 Pseudomonas, 113
Introduction, 113
Pseudomonas aeruginosa, 113
22 Mycoplasma, Chlamydia and Rickettsia, 115
Mycoplasma, 115
Mycoplasma pneumoniae, 115
Chlamydia, 116
Chlamydia trachomatis, 116
Chlamydia pneumoniae, 116
Chlamydia psittaci, 116
Genus rickettsia, 116
Rickettsia rickettsii, 117
23 Spirochaetes, 119
Introduction, 119
Treponema, 119
Treponema pallidum, 119
Borrelia, 120
B. recurrentis – Relapsing Fever, 121
Borrelia vincentii (Treponema vincentii) – Vincent’s
Angina, 121
B. burgdorferi – Lyme Disease, 121
Leptospira, 121
Leptospira interrogans, 121
24 Actinomycetes, 124
Introduction, 124
Actinomyces, 124
Nocardia, 125
25 Miscellaneous Bacteria, 126
Introduction, 126
Bacillus, 126
Bacillus anthracis, 126
Anthracoid Bacilli, 127
Bacillus cereus, 128
Helicobacter, 128
SECTION 4 Medical Virology
26 General Properties of Viruses, 133
Introduction, 133
Important Properties of Viruses, 133
Structure of Viruses, 133
Symmetry of Virus, 134
Viral Replication, 134
Epidemiological Aspects of Virus, 134
Types of Viral Infection, 135
Viral Tropism, 135
Laboratory Diagnosis of Viral Infection, 135
The Baltimore Classifi cation of Viruses, 137
27 DNA-Enveloped Viruses, 138
Introduction, 138
Poxviridae, 138
Herpesviruses, 139
Herpes Simplex Virus (HSV), 139
Varicella-Zoster Virus (VZV), 140
Cytomegalovirus (CMV), 140
Epstein–Barr Virus (EBV), 141
Human Herpesvirus (HHV6), 141
Human Herpesvirus 8 (HHV8), 141
28 DNA-Nonenveloped Viruses, 143
Introduction, 143
Parvoviruses, 143
Adenoviruses, 143
29 RNA-Enveloped Viruses, 146
Introduction, 146
Orthomyxoviruses, 146
Paramyxoviruses, 147
Rhabdoviruses, 148
30 RNA-Nonenveloped Viruses, 152
Introduction, 152
Picornaviruses, 152
Poliovirus, 152
Rhinoviruses, 153
Caliciviruses, 154
Reovirus, 154
Rotavirus, 154
31 Hepatitis Viruses, 155
Introduction, 155
Hepatitis a Virus – Infectious Hepatitis, 155
Hepatitis B Virus – Serum Hepatitis, 156
Hepatitis C Virus, 158
Hepatitis D Virus, 159
Hepatitis E Virus, 159
Hepatitis G Virus, 159
32 Arboviruses, 161
Introduction, 161
Classifi cation, 161
Chikungunya Virus, 161
Dengue Virus, 161
Kyasanur Forest Disease Virus, 162
33 Tumour Viruses, 164
Introduction, 164
Viral Tumorigenesis, 164
Human Tumour Viruses, 164
34 Slow Viruses and Prions, 167
Introduction, 167
Slow Diseases Caused by Conventional Viruses, 167
Slow Diseases Caused by Atypical Agents, 167
35 Human Immunodefi ciency Virus, 169
Introduction, 169
Structure, 169
Routes of Transmission, 169
Pathogenesis, 169
Clinical Features, 169
Laboratory Diagnosis, 170
Treatment, 171
36 Miscellaneous Viruses, 173
Introduction, 173
Astroviruses, 173
BK Virus, 173
Ebola Virus, 173
Hantaviruses, 173
Lassa Fever Virus, 173
Marburg Virus, 174
SECTION 5 Medical Mycology
37 Basic Mycology, 177
Introduction, 177
Morphology, 177
Mycotic Diseases, 177
Mycotic Infections, 178
Laboratory Diagnosis of Fungal Infections, 178
Antifungal Agents, 178
38 Cutaneous and Subcutaneous Mycoses, 180
Introduction, 180
Types of Cutaneous Mycoses, 180
Other Cutaneous Mycoses, 180
Subcutaneous Mycoses, 182
39 Systemic Mycoses, 184
Introduction, 184
Histoplasmosis, 184
Coccidioidomycosis, 184
Blastomycosis, 184
Paracoccidioidomycosis, 185
40 Opportunistic Mycoses, 186
Introduction, 186
Important Risk Factors, 186
Candidiasis, 186
Cryptococcosis, 186
Aspergillosis, 186
Zygomycetes, 187
SECTION 6 Medical Parasitology
41 Intestinal Protozoa, 191
Introduction, 191
Entamoeba histolytica, 191
Giardia lamblia, 192
Cryptosporidium, 193
42 Blood and Tissue Protozoa, 195
Introduction, 195
Plasmodium, 195
Leishmaniasis, 197
Trypanosomias, 198
African Sleeping Sickness, 198
Chagas Disease, 199
43 Other Minor Protozoan Pathogens, 201
Introduction, 201
Balantidium, 201
Acanthamoeba and Naegleria, 201
Toxoplasma, 201
Trichomonas, 202
44 Helminths: Cestodes, 204
Introduction, 204
Cestodes, 204
Taenia, 204
Taenia solium, 204
Taenia saginata, 206
Diphyllobothrium, 207
Echinococcus, 207
Hymenolepis nana, 209
45 Helminths: Trematodes, 211
Introduction, 211
Schistosoma, 211
Clonorchis, 212
Paragonimus westermani, 213
46 Helminths: Nematodes, 217
Introduction, 217
Enterobius vermicularis – the Pinworm, 217
Trichuris trichiura – the Whipworm, 219
Ascaris lumbricoides, 221
Hookworm, 223
Strongyloides stercoralis – Thread Worm, 224
Trichinella spiralis, 224
Filarial Worms, 225
Wuchereria bancrofti and Brugia malayi, 225
47 Laboratory Methods in Identifi cation of Parasites, 229
Introduction, 229
Stool Examination, 229
Blood Examination, 230
Serum and Plasma, 230
Sputum Examination, 230
Vaginal Swabs, 230
Urine Specimens, 230
SECTION 7 Laboratory Diagnosis of Systemic Infections
48 Respiratory Tract Infections, 233
Introduction, 233
Laboratory Diagnosis of Upper Respiratory Tract
Infections, 233
Laboratory Diagnosis of Lower Respiratory Tract
Infections, 234
49 Urinary Tract Infections, 236
Introduction, 236
Aetiology of UTIs, 236
Laboratory Diagnosis, 236
50 Diarrhoeal Infections, 238
Introduction, 238
Aetiology, 238
Laboratory Diagnosis, 238
51 Central Nervous System Infections, 240
Introduction, 240
Encephalitis, 240
Meningitis, 240
52 Skin and Soft Tissue Infections, 242
Introduction, 242
Aetiology of SSTIs, 242
Laboratory Diagnosis, 242
53 Infective Endocarditis, 244
Introduction, 244
Predisposing Factors, 244
Aetiology of Infective Endocarditis, 244
Laboratory Diagnosis, 244
54 Pyrexia of Unknown Origin, 246
Introduction, 246
Microbial Aetiology of PUO, 246
Laboratory Diagnosis of PUO, 246
SECTION 8 Immunology
55 Immunity, 251
Introduction, 251
Types of Immunity, 251
56 Antigens and Antibodies, 254
Introduction, 254
Antigens, 254
Types of Antigen, 254
Antigens of Microorganisms, 254
Autoantigens, 254
Tumour Antigens, 255
Characteristics of Antigens, 255
Haptens or Incomplete Antigens, 255
Factors Infl uencing Immunogenicity, 255
Epitopes, 255
Superantigens, 255
Heterophilic Antigens, 255
Sequestered Antigens, 255
Antibody, 255
Structure of Immunoglobulin, 255
Enzymatic Digestion of Immunoglobulin, 256
Immunoglobulin Isotypes: Classes of Antibodies, 256
Functions of Antibodies, 256
57 Antigen–Antibody Reaction, 258
Introduction, 258
Types of Antigen–Antibody Reactions, 258
Precipitation Reactions, 258
Agglutination, 260
Labelled Immunoassay Techniques, 261
58 Serological Tests, 264
Introduction, 264
Important Serological Tests, 264
59 Hypersensitivity Reactions, 268
Introduction, 268
Type I: Immediate Hypersensitivity, 268
Type II: Cytotoxic Hypersensitivity, 269
Type III: Immune Complex Hypersensitivity, 270
Type IV: Hypersensitivity Reaction, 270
60 Vaccines, 272
Introduction, 272
Types of Vaccines, 272
Live Vaccines, 272
Toxoids, 273
Killed or Inactivated Whole Cell Vaccines, 273
Subunit Vaccines, 273
Conjugate Vaccines, 273
Recombinant DNA-Derived Antigen Vaccines, 273
Synthetic Peptide Vaccines, 273
Anti-Idiotypic Vaccines, 273
Immunization Schedule, 273
Herd Immunity, 273
Vaccine Storage or Cold Chain, 273
Glossary, 276
Index, 279
