Fourth Edition
Rajesh Bhatia MD (Medical Microbiology)
Formerly Director National Institute of Biologicals, New Delhi
and Department of Microbiology Maulana Azad Medical College,
New Delhi India
Rattan Lal Ichhpujani MD (Medical Microbiology)
Additional Director and Chief of Division of HIV/AIDS and Related Diseases National Institute of Communicable Diseases, Delhi
Formerly Department of Microbiology Medical College,
Rohtak Haryana India
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Essentials of Medical Microbiology
© 2008, Jaypee Brothers Medical Publishers
Editorial Consultant: Ms Peromila MA (English)
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition: 1994
Second Edition: 1999
Third Edition: 2004
Fourth Edition: 2008
9788184481549
Typeset at JPBMP typesetting unit
To
Indu, Peromila,
Parul, Vrinda and Tushar
for being so wonderful and
understanding during the
genesis of this work
5Preface to the Fourth Edition
Teaching of Medical Microbiology to the MBBS students is changing rapidly. This is primarily due to emergence of newer pathogens, newer diagnostic tools, emerging and re-emerging infections and above all shrinking time available to accommodate all this. Microbiology continues to be the backbone of understanding diagnosing and controlling the communicable diseases. Our primary focus of this Fourth Edition is to update various chapters, delete the contents that have become relatively unimportant and enhanced focus on the topics of current interest. For easy assimilation and reproducibility of the subject by the students, a lot of tables, figures and flow charts have been included. The book is for the first time being printed in colour which will definitely enhance its acceptability by our valued readers.
We are deeply indebted to Shri Jitendar P Vij, Chairman and Managing Director, Jaypee Brothers Medical Publishers and his dedicated team for their magnificent support in bringing this book to its current shape. We continue to be thankful to our family members, friends, well-wishers and above all our dear students for their continuous support.
We are optimistic that this revised edition will be liked by our readers. We look forward to their patronage.
Rajesh Bhatia
RL Ichhpujani
6Preface to the First Edition
The development of the science of medical microbiology—from Leeuwenhoeck's astonishing observations of animalcules to Pasteur's first use of rabies vaccine on a human being; to Fleming's discovery of penicillin; to today's race to develop a vaccine against AIDS—has been indeed one of the most amazing stories of mankind behind which is hidden the intricate and intimate relationship between the man and the microbe. For every single cell in the human body, ten microbes are harboured by the man. At any time an adult human being harbours 100 trillion microorganisms. These organisms are most of the times beneficial to man. Pathogenicity is a trait exhibited by only a few of them. Yet, tremendous mortality and morbidity have been inflicted on the mankind by these organisms since time immemorial. Rapid advances in medical sciences may have brought down the incidence of microbial infections in some parts of the world but an overwhelming population is still afflicted by a variety of infectious diseases. Medical microbiology is the science which deals with the study of organisms that cause infectious diseases.
This book has been designed chiefly for the students pursuing an undergraduate course in medical microbiology or any of the allied fields. This has deliberately been written in a simple, straightforward, functional, easily reproducible and user-friendly style. Special attention has been given to provide the updated information. Clear, attractive and easy-to-make illustrations have been used in abundance to ensure better understanding of the subject. About three dozen coloured figures have been appended in the beginning of the book to create long-lasting impressions of the appearances of the microorganisms. Numerous boxes coupled with tables have been inserted to highlight salient features.
So much has been the information explosion in medical microbiology that no book, however, hefty it may be, can stake a claim to be complete and up-to-date in all aspects of the subject. Apropos to this reality we decided to present in this book a prudent mix of essentials of fundamentals, recent advances and applications to the practice of medicine. The book has been accordingly titled as Essentials of Medical Microbiology. For those desirous of going into details, a few relevant references have been appended at the end of the text of each chapter.
While we derived immense pleasure in conceiving the concept of this book and giving it the shape of the manuscript, getting it through various stages of publication was also an scintillating experience. We are deeply indebted to Shri Jitendar P Vij of Jaypee Brothers, and his dedicated team for the magnificent support extended by them.
Finally, we thank our affectionate families for their constant encouragement without which we would have never contemplated, let alone complete, this book.
Rajesh Bhatia
RL Ichhpujani