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Essentials of Microbiology
Surinder Kumar
SECTION 1: GENERAL BACTERIOLOGY
CHAPTER 1:
Historical Development of Microbiology
INTRODUCTION
INFECTION AND CONTAGION
DISCOVERY OF MICROORGANISMS
Antony van Leeuwenhoek (1632–1723)
Contributions of Antony van Leeuwenhoek
CONFLICT OVER SPONTANEOUS GENERATION
Spontaneous Generation (Abiogenesis)
ROLE OF MICROORGANISMS IN DISEASES
SCIENTIFIC DEVELOPMENT OF MICROBIOLOGY
LOUIS PASTEUR (1822–1895)
Contributions of Louis Pasteur in Microbiology (Box 1.1)
JOSEPH LISTER (1827–1912)
ROBERT KOCH (1843–1910) (FIG. 1.2)
Contributions of Robert Koch
PAUL EHRLICH (1854–1915)
Contributions of Paul Ehrlich
DISCOVERY OF VIRUSES
IMMUNITY AND IMMUNIZATION
SEROTHERAPY AND CHEMOTHERAPY
Antibiotics—A Fotunate Accident
NOBEL PRIZES AWARDED FOR RESEARCH IN MICROBIOLOGY
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 2:
Microscopy
INTRODUCTION
MICROSCOPY: INSTRUMENTS
Microscopic Methods
A. LIGHT MICROSCOPY
Principles of Light Microscopy: The Brightfield Microscopy
1. Compound Light Microscopy
Resolution
2. Darkground (Darkfield) Microscopy
Use
3. Phase-contrast Microscopy
Uses
Differential Interference Contrast (DIC) Microscopy
Fluorescence Microscopy
Principal Use
Epifluorescence Microscopy
Confocal Microscopy
B. ELECTRON MICROSCOPY
Types of Electron Microscopes
(i) Transmission Electron Microscope (TEM)
(ii) Scanning Electron Microscope (SEM)
C. SCANNING-PROBE MICROSCOPY
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 3:
Morphology of Bacteria
INTRODUCTION
COMPARISON BETWEEN PROKARYOTIC AND EUCARYOTIC CELLS
SIZE OF BACTERIA
STUDY OF BACTERIA
Stained Preparations
Shape of Bacteria
ARRANGEMENT OF BACTERIAL CELLS
Cocci Arrangement
Bacilli Arrangement
ANATOMY OF THE BACTERIAL CELL
Bacterial Cell Components
A. Cell Envelope and its Appendages
a. The Outer Layer or Cell Envelope
b. Cellular Appendages
Demonstration of Capsule
B. Cell Interior
1. Cytoplasm
2. Ribosomes
3. Mesosomes (Chondroids)
4. Intracytoplasmic Inclusions
5. Bacterial Nucleus
6. Bacterial Spore
Properties of Endospores (Fig 3.11)
Germination
Shape and Position of the Spore
Resistance
Demonstration
Uses of Spores
PLEOMORPHISM AND INVOLUTION FORM
L-FORMS OF BACTERIA (CELL-WALL-DEFECTIVE ORGANISMS)
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 4:
Physiology of Bacteria
I. PRINCIPLES OF BACTERIAL GROWTH
A. Bacterial Division
Generation Time or Doubling Time
Bacterial Count
B. Bacterial Growth Curve
Batch Culture or Closed System
BACTERIAL NUTRITION
Categories of Requirements for Microbial Growth
1. Major Elements (Macroelements or Macronutrients)
2. Trace Elements
3. Growth Factors
B. Physical Factors Influencing Microbial Growth
BACTERIAL METABOLISM
Energy Production
Generation of ATP
Oxidation–Reduction (O–R) Potential (Redox Potential)
IMPORTANT QUESTIONS
MULIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 5:
Sterilization and Disinfection
DEFINITIONS OF FREQUENTLY USED TERMS
Applications of Sterilization and Disinfection
METHODS OF STERILIZATION AND DISINFECTION (TABLE 5.1)
A. Physical Agents
1. Sunlight
2. Drying
3. Heat
Mechanism of Action
a. Dry Heat Sterilization (Table 5.1)
Preparation of Load
Sterilizing Cycle
Uses of Hot Air Oven
Sterilization Controls
b. Moist Heat Sterilization (Table 5.1)
Autoclave
Principle of Autoclave
Procedure
Precautions
Sterilization Controls
4. Filtration
Types of Filters
5. Radiation
Applications
B. Chemical Agents
Characteristics of a Disinfectant
Categories of Disinfectants
Mechanisms of Antimicrobial Action
A. Agents that Damage the Cell Membrane
B. Agents that Denature Proteins
C. Agents that Modify Functional Groups of Proteins and Nucleic Acids
RECOMMENDED CONCENTRATIONS OF VARIOUS DISINFECTANTS
TESTING OF DISINFECTANTS
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 6:
Culture Media
INTRODUCTION
COMMON INGREDIENTS OF CULTURE MEDIA
CLASSIFICATION OF MEDIA
A. Phases of Growth Media
1. Liquid (Broth) Media
2. Solid (Agar) Media
3. Semisolid Media
B. Based on Nutritional Factors
Types of Nutrient Broth
Nutrient Agar (Table 6.3 and Fig. 6.1)
3. Synthetic or Chemically Defined Media
C. Special Media
i. Enriched Media (Table 6.2)
Examples of Enriched Media
ii. Enrichment Media (Table 6.2)
iii. Selective Media (Table 6.3)
iv. Indicator Media
v. Differential Media
vi. Sugar Media
vii. Transport Media
Anaerobic Media (Table 6.2)
i. Thioglycollate Broth
ii. Cooked Meat Broth or RCM Broth (Robertson's Cooked Meat Broth) for more details, refer to Chapter 7
Process of Media Making
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 7:
Culture Methods
INTRODUCTION
METHODS OF BACTERIAL CULTURE
1. Streak Culture (Surface Plating)
2. Lawn Culture or Carpet Culture
Uses
3. Stroke Culture
4. Stab Culture
Uses
5. Pour-plate Culture
Uses
6. Liquid Culture
Uses
Disadvantages
AEROBIC CULTURE
ANAEROBIC CULTURE
METHODS OF ANAEROBIOSIS
A. Production of Vacuum
B. Displacement of Oxygen by Other Gases
Candle Jar
C. Absorption of Oxygen by Chemical or Biological Methods
i. Chemical Methods
ii. Biological Methods
D. Displacement and Combustion of Oxygen
Anaerobic Jars
Procedure
Catalyst
Indicator
Disadvantage
E. By Reducing Agents
Principle
Method
Interpretation
Uses of CMB
F. Other Anaerobic Culture Systems
METHODS OF ISOLATING PURE CULTURES
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 8:
Identification of Bacteria
METHODS USED TO IDENTIFY BACTERIA
1. PHENOTYPIC CHARACTERISTICS
A. Microscopic Morphology
B. Staining Reactions
C. Metabolic Differences
i. Cultural Characterstics or Macroscopic Morphology
ii. Biochemical Reactions
1. Sugar Fermentation
Interpretation (Figs 8.3 and 8.4)
Examples of Fermentative Bacteria
2. Indole Production
Interpretation (Fig. 8.5)
3. Methyl Red (MR) Test
Interpretation (Fig. 8.6)
MR Positive and Negative Bacteria
4. Voges-Proskauer (VP) Test for Acetoin Production
Interpretation of VP Test (Fig. 8.7)
VP Positive and Negative Bacteria
5. Citrate Utilization
Interpretation (Fig. 8.8)
Citrate Positive and Negative Bacteria
6. Nitrate Reduction Test
Interpretation (Fig. 8.9) of Nitrate Reduction Test
Nitrate Reduction Positive and Negative Bacteria
7. Urease Test
Principle
Procedure
Interpretation (Fig. 8.10) of Urease Test
Urease Positive and Negative Bacteria
8. Catalase Production
Principle
Method
Interpretation
Positive and Negative Bacteria
9. Oxidase Test
Principle
Method
Interpretation
Oxidase Positive and Negative Bacteria
10. Phenylalanine Deaminase Test
Procedure
Interpretation
Positive and Negative Bacteria
11. Hydrogen Sulfide Production
Principle
Procedure
Interpretation
Positive and Negative Bacteria
12. Potassium Cyanide Test
Principle
Method
Interpretation
Positive and Negative Bacteria
13. Triple-sugar Iron (TSI) Agar
Principle
Media
Procedure
Interpretation (Table. 8.3)
D. Serology
E. Antibiotic Tolerance Tests, Dye Tolerance, and Other Inhibition Tests
F. Bacteriophage and Bacteriocin Typing
G. Pathogenicity
2. GENOMIC CHARACTERIZATION
Characterization of Strain Differences
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 9:
Bacterial Taxonomy
TAXONOMY
1. IDENTIFICATION
2. CLASSIFICATION
Three-domain System
Five-kingdom System
Taxonomic Hierarchies
Example
Species Concept in Bacteria
CLASSIFICATION SYSTEMS
Phenetic System
1. Adansonian or Numerical Classification
2. Phylogenetic Classification
3. Molecular or Genetic Classification
4. Intraspecies Classification
3. Nomenclature
Casual or Common Name
Scientific or International Name
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 10:
Bacterial Genetics
INTRODUCTION
STRUCTURE AND FUNCTIONS OF THE GENETIC MATERIAL
Nucleic Acid Structure
Parts of Nucleotide
A. Deoxyribonucleic Acid (DNA) Structure
Code and Codon
B. Ribonucleic Acid (RNA) Structure
Gene Expression
EXTRACHROMOSOMAL GENETIC ELEMENTS
Plasmids
GENOTYPIC AND PHENOTYPIC VARIATIONS
A. Phenotypic Variation
Examples of Environmental Influence on Bacteria
Regulation of Gene Expression
B. Genotypic Variation
Mutation
Importance of Bacterial Mutation
Mutant Selection in Laboratory
TRANSMISSION OF GENETIC MATERIAL (GENE TRANSFER)
A. Transformation
Griffith's Experiment Demonstrating Genetic Transformation
B. Transduction
Types of Transduction
Role of Transduction
C. Lysogenic Conversion
Medical Importance
D. Conjugation
Types of Conjugation
2. Chromosomal Transfer
3. Plasmid and Chromosomal Transfer
Medically Important Factors Transferred by Conjugation
A. Colicinogenic (Col) Factor
B. Resistance Factors or R Plasmids
GENETIC MECHANISMS OF DRUG RESISTANCE IN BACTERIA
Mechanisms of Drug Resistance in Bacteria
A. By Mutation (Chromosomal)
B. By Genetic Exchange
TRANSPOSABLE GENETIC ELEMENTS
Structure of Transposons
Significance of Transposons
MOLECULAR GENETICS
Genetic Engineering
Genetic Engineering Procedure (Fig. 10.16)
Basic Tools of Genetic Engineering
Applications of Genetic Engineering
GENETIC PROBES
DNA Probes
Applications of Nucleic Acid Probes
BLOTTING TECHNIQUES
POLYMERASE CHAIN REACTION (PCR)
Detection of PCR Products
Applications of PCR
Derivations/Modifications of the PCR Method
GENE THERAPY
Applications
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 11:
Infection
INTRODUCTION
MICROORGANISMS AND HOST
A. Saprophytes
B. Parasites
1. Pathogens
2. Commensals
INFECTION AND INFECTIOUS DISEASE
Infection
CLASSIFICATION OF INFECTIONS
SOURCES OF INFECTION
A. Human Beings
Carrier
B. Animals
C. Insects
Arthropod-borne Diseases
Vectors
D. Soil and Water
i. Soil
ii. Water
E. Food
MODES OF TRANSMISSION OF INFECTION
1. Contact
2. Inhalation
3. Ingestion
4. Inoculation
5. Insects
Vector-borne
6. Congenital
Vertical Transmission
7. Iatrogenic and Laboratory Infections
FACTORS PREDISPOSING TO MICROBIAL PATHOGENICITY
Pathogenicity and Virulence
DETERMINANTS OF VIRULENCE
1. Transmissibility
2. Adhesion
3. Invasiveness
4. Toxigenicity
a. Exotoxins
b. Endotoxins
5. Avoidance of Host Defence Mechanisms
a. Capsules
b. Streptococcal M Protein
c. Resistance to Killing by Phagocytic Cells
d. Antigenic Variation
e. Serum Resistance
f. Siderophore and Iron Acquisition
6. Enzymes
7. Plasmids
8. Bacteriophages
9. Communicability
10. Infecting Dose
11. Route of Infection
TYPES OF INFECTIOUS DISEASES
A. Localized
B. Generalized
EPIDEMIOLOGICAL TERMINOLOGIES
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
SECTION 2: IMMUNOLOGY
CHAPTER 12:
Immunity
DEFINITION
CLASSIFICATION
i. Innate or Natural Immunity
a. Nonspecific and Specific Immunity
MECHANISMS OF INNATE IMMUNITY
1. Mechanical Barriers and Surface Secretions
a. Mouth or Oral Cavity
b. Gastrointestinal Tract
c. Upper Respiratory Tract
d. Genitourinary Tract
e. Conjunctiva
2. Antibacterial Substances in Blood and Tissues
3. Microbial Antagonisms
4. Cellular Factors in Innate Immunity
5. Inflammation
6. Fever
7. Acute Phase Proteins
ii. Acquired Immunity
a. Active Immunity
Immune Response
A. Primary Response
B. Secondary Response
Types of Active Immunity
Examples of Vaccines
b. Passive Immunity
1. Natural Passive Immunity
2. Artificial Passive Immunity
Types of Immunoglobulin Preparations
Indications of Passive Immunization
Combined Immunization
Adoptive Immunity
LOCAL IMMUNITY
HERD IMMUNITY
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 13:
Antigens
TYPES OF ANTIGENS
A. Complete Antigen
B. Haptens (Incomplete Immunogen)
Types of Haptens
ANTIGENIC DETERMINANT OR EPITOME
DETERMINANTS OF ANTIGENICITY
1. Size
Molecular Weight
2. Chemical Nature
3. Foreignness
4. Susceptibility to Tissue Enzymes
5. Antigenic Specificity
Chemical Groupings
6. Species Specificities
7. Isospecificities
Examples of Isoantigens
8. Autospecificity
Sequestrated Antigens
Examples of Sequestrated Antigens
9. Organ Specificity
Example
10. Heterogenetic (Heterophile) Specificity
Examples of Heterophile Antigens
SUPERANTIGENS
Examples
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 14:
Antibodies—Immunoglobulins
ANTIBODY STRUCTURE
1. Classes of L-chains
2. Classes of H-chains
3. Constant and Variable Regions
4. Fc Fragment
Functions of Fc
5. Immunoglobulin Domain
IMMUNOGLOBULIN CLASSES
1. Immunoglobulin G (IgG) (Fig. 14.3)
Examples of its Functions
2. Immunoglobulin A (IgA)
Functions of IgA
3. Immunoglobulin M (IgM)
4. Immunoglobulin D (IgD)
5. Immunoglobulin E (IgE)
Role of Different Immunoglobulin Classes
Abnormal Immunoglobulins
A. Multiple Myeloma
B. Heavy Chain Disease
C. Cryoglobulinemia
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 15:
Complement System
COMPLEMENT SYSTEM
General Properties of Complement
Complement Activation
PRINCIPLE PATHWAYS OF COMPLEMENT ACTIVATION
A. Classical Complement Pathway
B. Alternative Complement Pathway
1. Production of Alternative Pathway C3 Convertase
2. Production of Alternative Pathway C5 Convertase and MAC
Biological Effects of Complement (C)
Regulation of the Complement System
QUANTITATION OF COMPLEMENT (C) AND ITS COMPONENTS
BIOSYNTHESIS OF COMPLEMENT
COMPLEMENT DEFICIENCIES
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 16:
Antigen–Antibody Reactions
INTRODUCTION
Uses
ANTIGEN–ANTIBODY INTERACTIONS
GENERAL CHARACTERISTICS OF ANTIGEN–ANTIBODY REACTIONS
ANTIGEN AND ANTIBODY MEASUREMENT
Titer
PARAMETERS OF SEROLOGICAL TESTS
Sensitivity
Specificity
SEROLOGICAL REACTIONS
TYPES OF ANTIGEN AND ANTIBODY REACTIONS
A. Precipitation Reactions
Three Zones
Mechanism of Precipitation
Applications of Precipitation Reaction
Types of Precipitation and Flocculation Tests
Advantages
Types of Immunodiffusion Tests
Uses
Example
5. Immunoelectrophoresis
Uses
6. Electroimmunodiffusion
i. Counterimmunoelectrophoresis (CIE) or Countercurrent eletrophoresis (CIEP)
Clinical Applications
ii. One-dimensional Single Electroimmunodiffusion (Rocket Electrophoresis)
Main Application
Laurell's Two-dimensional Electrophoresis
B. Agglutination Reactions
APPLICATIONS OF AGGLUTINATION REACTION
1. Slide Agglutination
Uses
2. Tube Agglutination
Uses of Tube Agglutination
3. Antiglobulin (Coombs’) Test
Principle of the Antiglobulin Test
Types of Coombs’ Test
Uses
4. Passive Agglutination Test
Examples of Passive Agglutination
Uses
C. Complement Fixation Test (CFT)
Standardization of Complement and Amboceptor
Complement Fixation Tests
Principle
Procedure
Interpretation—Positive CF Test—Absence of Lysis
Negative CF Test Lysis of The Indicator Cells
Uses
Anticomplementary Effect
Indirect complement fixation test
D. Neutralization Tests
1. Viral Neutralization
2. Toxin Neutralization
Examples
E. Opsonization
F. Immunofluorescence
Sandwich Technique
Types of Immunofluorescence
1. Direct Immunofluorescence (Fig. 16.14A)
Uses
Disadvantage
2. Indirect Immunofluorescence (Fig. 16.14B)
Uses
G. Radioimmunoassay (RIA)
Principle of RIA
Procedure
Uses
H. Enzyme-linked Immunosorbent Assay (ELISA) (Fig. 16.15)
Principle
Types of ELISA (Fig 16.15)
USES OF ELISA
Examples
1. Parasites
2. Bacteria
3. Viruses
Cassette-based Membrane-bound ELISA Assays
Examples of Cassette ELISA
Slot-blot and Dot-blot Assays
I. Immunoelectroblot Techniques
Application
J. Immunochromatographic Tests
K. Immunoelectron microscopic Tests
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 17:
Structures and Functions of the Immune System
INTRODUCTION
TYPES OF IMMUNE RESPONSE
1. Humoral or Antibody-mediated Immunity (HMI or AMI)
2. Cellular or Cell-mediated Immunity (CMI)
ORGANS AND TISSUES OF THE IMMUNE SYSTEM
A. Primary (Central) Organs or Tissues
B. Secondary (Peripheral) Organs and Tissues
A. Central (Primary) Lymphoid Organs
B. Peripheral (Secondary) Lymphoid Organs
CELLS OF THE LYMPHORETICULAR SYSTEM
Lymphoid Cells: Cells of the Immune System
Differences between T- and B-Cells
T-lymphocytes
a. On the Basis of Surface Markers
b. On the Basis of Functions
ii. B-cells and Plasma Cells
B-cell Maturation
iii. Null Cells
a. Natural Killer (NK) Cells
b. Antibody-dependent Cell-mediated Cytotoxicity (ADCC)
c. Lymphokine-activated Killer (LAK) Cells
Phagocytic Cells
Functions of Macrophages
Polymorphonuclear Microphages
MAJOR HISTOCOMPATIBILITY COMPLEX
HLA Complex
HLA Molecules
Role of MHC Diversity
HLA Typing
Uses of HLA Typing
MHC RESTRICTION
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 18:
Immune Response
DEFINITION
TYPE OF IMMUNE RESPONSE
a. Antibody-mediated Immunity (AMI)
b. Cell-mediated Immunity (CMI)
HUMORAL IMMUNITY
Synthesis of Antibody
1. Lag Phase
2. Log Phase
3. A Plateau or Steady State
4. The Phase of Decline
Primary and Secondary Responses
a. Primary Humoral Response
b. Secondary Humoral Response (Fig. 18.2)
FATE OF ANTIGEN IN TISSUES
PRODUCTION OF ANTIBODIES
Uses of Monoclonal Antibodies
Factors Influencing Antibody Production
1. Genetic Factors
2. Nutritional Status
3. Route of Administration
4. Age
5. Multiple Vaccines
6. Adjuvant
7. Immunosuppressive Agents
8. Effect of Antibody
9. Superantigens
10. Mitogens
CELL-MEDIATED IMMUNE RESPONSES
Scope of CMI
Induction of CMI
Primary Cell-mediated Immune Response
Secondary Cell-mediated Immune Response
CYTOKINES
A. Interleukins
Immunological Effects of IL-1
B. Colony-stimulating Factors (CSF)
C. Tumor Necrosis Factors (TNF)
D. Interferons (lFNs)
E. Other Cytokines
Detection of CMI
Transfer Factor
Applications of Transfer Factor
IMMUNOLOGICAL TOLERANCE
Types of Immunological Tolerance
Parameters that Affect the Induction of Tolerance
1. Age
2. Dose of Antigen
3. Route of Tolerogen Administration
4. Nature of Tolerogen
5. Various Treatments
6. Genetic Background
Mechanism of Tolerance
1. Clonal Deletion
2. Clonal Anergy
3. Suppression
THEORIES OF ANTIBODY FORMATION
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 19:
Immunodeficiency Diseases
INTRODUCTION
CLASSIFICATION OF IMMUNODEFICIENCY DISEASES
PRIMARY IMMUNODEFICIENCIES
A. DISORDERS OF SPECIFIC IMMUNITY
I. Humoral Immunodeficiencies (B-cell Defects)
a. X-linked Agammaglobulinemia (XLA)
b. Transient Hypogammaglobulinemia of Infancy
c. Common Variable Immunodeficiency (CVID)
d. Selective Immunoglobulin Deficiencies
e. X-linked Hyper-IgM Syndrome (XHM)
f. Transcobalamin II Deficiency
II. Cellular Immunodeficiencies (T-cell Defects)
III. Combined Immunodeficiencies (B- and T-cell Deficiencies)
a. Cellular Immunodeficiency with Abnormal Immunoglobulin Synthesis (Nezelof Syndrome)
b. Ataxia Telangiectasia
c. Wiskott–Aldrich Syndrome (WAS)
d. Immunodeficiency with Thymoma
e. Severe Combined Immunodeficiency (SCID)
B. DISORDERS OF COMPLEMENT
a. Complement Component Deficiencies
b. Complement Inhibitor Deficiencies
C. DISORDERS OF PHAGOCYTE
SECONDARY IMMUNODEFICIENCIES
Deficiencies of Humoral and Cellular Immune Response
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 20:
Hypersensitivity Reactions
CLASSIFICATION OF HYPERSENSITIVITY REACTIONS
Gell and Coomb Classification
Type I (Anaphylactic, IgE or Reagin-dependent)
Type II (Cytotoxic or Cell-stimulating)
Type III (Immune Complex or Toxic Complex Disease)
Type IV (Delayed or Cell-mediated Hypersensitivity)
Type V: Hypersensitivity (Stimulatory Type) Jones-Mote Reaction (or) Cutaneous Basophil Hypersensitivity
TYPE I HYPERSENSITIVITY (IGE DEPENDENT)
Anaphylaxis
A. Systemic Anaphylaxis (or Anaphylactic Shock)
Sensitizing Dose and Shocking Dose
Target Tissues or ‘Shock Organs’
Systemic Anaphylaxis in Humans
i. Cutaneous Anaphylaxis
ii. Passive Cutaneous Anaphylaxis (PCA)
iii. Anaphylaxis in Vitro (Schultz–Dale Phenomenon)
Mechanism of Anaphylaxis
A. Primary Mediators of Anaphylaxis
B. Secondary Mediators of Anaphylaxis
Other Mediators of Anaphylaxis
Anaphylactoid Reaction
B. Localized Anaphylaxis (Atopy)
Mechanism of Atopy
Clinical Expression of Atopic Reactions
Methods to Detect Type I Hypersensitivity Reactions
TYPE II HYPERSENSITIVITY: CYTOLYTIC AND CYTOTOXIC
Examples
TYPE III HYPERSENSITIVITY: IMMUNE COMPLEX-MEDIATED
A. Arthus Reaction (Local Immune Complex Disease)
B. Serum Sickness (Systemic Immune Complex Disease)
TYPE IV HYPERSENSITIVITY—DELAYED HYPERSENSITIVITY
Causes of Type IV Reactions
1. Tuberculin (Infection) Type
2. Contact Dermatitis Type
3. Granulomatous Hypersensitivity
TYPE V: HYPERSENSITIVITY (STIMULATORY TYPE) JONES–MOTE REACTION (OR) CUTANEOUS BASOPHIL HYPERSENSITIVITY
SCHWARTZMAN REACTION
Mechanism
Clinical Conditions
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 21:
Autoimmunity
INTRODUCTION
Definition
MECHANISMS OF AUTOIMMUNITY
1. Forbidden Clones
2. Neoantigens or Altered Antigens
3. Molecular Mimicry
4. Polyclonal B-cell Activation
5. Activity of Helper and Suppressor T-cells
6. Sequestered Antigens
Examples
7. Defects in the Idiotype–Anti-idiotype Network
8. Genetic Factors
CLASSIFICATION OF AUTOIMMUNE DISEASES
A. Localized (Organ-specific) Autoimmune Diseases (Table 21.1)
B. Systemic (or Nonorgan-specific) Autoimmune Disease (Table 21.1)
Pathogenesis of Autoimmune Disease
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 22:
Immunology of Transplantation and Malignancy
DEFINITION
TYPES OF TRANSPLANTS (TABLE 22.1)
ALLOGRAFT REACTION
Mechanism of Allograft Rejection
Histocompatibility Antigens
HISTOCOMPATIBILITY TESTING
Tissue Matching
Factors Favoring Allograft Survival
FETUS AS AN ALLOGRAFT
GRAFT-VERSUS-HOST REACTION
IMMUNOLOGY OF MALIGNANCY
TUMOR ANTIGENS
IMMUNE RESPONSE IN MALIGNANCY
IMMUNOLOGICAL SURVEILLANCE
IMMUNOTHERAPY OF CANCER
A. Active Immunotherapy
B. Passive Immunotherapy
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 23:
Immunohematology
HISTORY
ABO Blood Group System
H Antigen
Rh (Rhesus) Blood Group System
OTHER BLOOD GROUP SYSTEMS
MEDICAL APPLICATIONS OF BLOOD GROUPS
COMPLICATIONS OF BLOOD TRANSFUSION
HEMOLYTIC DISEASE OF THE NEWBORN
Factors Influencing the Incidence of Hemolytic Disease
Detection of Rh-antibodies
Prevention of Rh-isoimmunization
ABO Hemolytic Disease
Blood Group and Diseases
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
SECTION 3: SYSTEMIC BACTERIOLOGY
CHAPTER 24:
Staphylococcus
INTRODUCTION
Species
STAPHYLOCOCCUS AUREUS
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Structure of Staphylococcus aureus
A. Cell-associated Polymers
B. Cell Surface Proteins
Toxins and Enzymes
A. Toxins
B. Extracellular Enzymes
Epidemiology
Staphylococcal Diseases
Bacteriophage Typing
Laboratory Diagnosis
Treatment
Control
OTHER COAGULATE-POSITIVE STAPHYLOCOCCI
COAGULASE-NEGATIVE STAPHYLOCOCCI
Staphylococcus epidermidis
Clinical Infection
Staphylococcus saprophyticus
Other Coagulase-negative Staphylococci
Sensitivity to Antibiotics
Methicillin-resistant Staphylococcus aureus (MRSA)
Laboratory Diagnosis
MICROCOCCI
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 25:
Streptococcus and Enterococcus
INTRODUCTION
CLASSIFICATION
1. Hemolytic Activity
A. Alpha-hemolytic (α) Streptococci
B. Beta (β) Hemolytic Streptococci
C. Gamma (γ) or Non-hemolytic Streptococci
2. Serological Properties
Lancefield Grouping
Griffith Typing
Biolochemical (Physiologic) Properties
STREPTOCOCCUS PYOGENES
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Structure (Fig. 25.3)
1. Inner layer of Peptidoglycan
2. Group-specific Polysaccharide Antigen
3. Outer layer
Toxins and Enzymes
A. Toxins
B. Enzymes
Epidemiology
Pathogenesis
A. Suppurative Streptococcal Disease
B. Nonsuppurative Sequelae
Pathogenesis
LABORATORY DIAGNOSIS
1. Acute Suppurative Infections
A. Specimens
B. Microscopy
C. Culture
D. Identification
E. Antigen Detection
2. Non-suppurative Complications
Serological Tests
Treatment
Prophylaxis
OTHER STREPTOCOCCI PATHOGENIC FOR HUMANS
Group B Streptococci: Streptococcus agalactiae
Clinical Diseases
Group C Streptococci
Group G Streptococci
Group D Streptococci
ENTEROCOCCUS
Species
Characteristics of Enterococci
Distinctive Features of Enterococci
Identification
Clinical Infections
Treatment
Nonenterococcal Species of Group D
VIRIDANS STREPTOCOCCI
Classification
Clinical Infections
1. Dental Caries
2. Subacute Endocarditis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 26:
Pneumococcus (Diplococcus pneumoniae: Streptococcus pneumoniae)
INTRODUCTION
PNEUMOCOCCUS (DIPLOCOCCUS PNEUMONIAE, STREPTOCOCCUS PNEUMONIAE)
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Structure
1. Capsular Antigens
2. Somatic Antigen
Genetic Variation
Virulence Factors
Pathogenesis
1. Pneumonia
2. Acute Exacerbations in Chronic Bronchitis
3. Meningitis
4. Bacteremia
5. Other Infections
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Collection and Transport
3. Microscopy and Antigen Detection
4. Capsule Swelling Tests
5. Culture
6. Identification
7. Intraperitoneal Injection into Mice
8. Blood Culture
9. Antibiotic Sensitivity Test
Prophylaxis
Treatment
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 27:
Neisseria and Moraxella
INTRODUCTION
Species
NEISSERIA MENINGITIDIS (MENINGOCOCCUS; DIPLOCOCCUS INTRACELLULARIS MENINGITIDIS)
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Classification
Resistance
Pathogenicity
Stages of Meningococcal Infections
First Stage—Nasopharyngeal Infection
Second Stage—Meningococcal Septicemia
Third Stage—Meningitis
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Examination of CSF
3. Blood Cultures
4. Pus, Aspirates and Swabs
5. Petechial Lesions
6. Serological Diagnosis
7. Polymerase Chain Reaction (PCR)
Treatment
Prophylaxis
NEISSERIA GONORRHOEAE (GONOCOCCUS)
Morphology
Cultural Characterstics
Biochemical Reactions
Antigenic Structure
Resistance
Pathogenesis
Gonorrhea
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Transport
3. Direct Microscopy
4. Culture
5. Identification
6. Genetic Probes
7. Serological Diagnosis
Treatment
Prophylaxis
NONGONOCOCCAL (NONSPECIFIC) URETHRITIS
Causative Agents
A. Bacterial
B. Viral
C. Fungi
D. Protozoa
Diagnosis
Treatment
COMMENSAL NEISSERIAE
MORAXELLA
Moraxella (Branhamella) Catarrhalis
Morphology
Cultural Characteristics
Biochemical Reactions
Pathogenesis
Treatment
Moraxella lacunata (Morax–Axenfeld Bacillus)
Morphology
Culture
Biochemical Reactions
Pathogenesis
Treatment
KINGELLA
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 28:
Corynebacterium
INTRODUCTION
CORYNEBACTERIUM DIPHTHERIAE
Morphology
Cultural Characteristics
Biochemical Reactions
Toxin
Synthesis
Lysogeny and toxin Production
Iron for toxin Production
Properties of toxin
Mode of Action
Resistance
Antigenic Structure
Bacteriophage Typing
Pathogenesis
A. Respiratory Diphtheria
B. Cutaneous Diphtheria
Laboratory Diagnosis
1. Specimens
2. Microscopy
3. Culture
4. Identification Tests
5. Virulence Tests
Schick Test
Prophylaxis
A. Active Immunization
B. Passive Immunization
C. Combined Immunization
Treatment
OTHER MEDICALLY IMPORTANT CORYNEBACTERIA
1. Corynebacterium ulcerans
2. Corynebacterium pseudotuberculosis (C. ovis)
3. Corynebacterium minutissimum
4. Corynebacterium jeikeium
5. Corynebacterium xerosis
6. Corynebacterium bovis
DIPHTHEROIDS
OTHER CORYNEFORM GENERA
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 29:
Bacillus
INTRODUCTION
GENERAL CHARACTERSTICS OF BACILLUS
BACILLUS ANTHRACIS
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Structure
Virulence Factors
Pathegenesis
A. Animal Infection
B. Human infection
Laboratory Diagnosis of Human Anthrax
6. Polymerase Chain Reaction (PCR)
Treatment
Prophylaxis
Immunization
ANTHRACOID BACILLI
Bacillus cereus
Pathogenesis
Laboratory Diagnosis
Prevention
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 30:
Clostridium
INTRODUCTION
GENERAL FEATURES OF CLOSTRIDIA
CLASSIFICATION
Clostridium perfringens (Clostridium welchii)
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Toxins
Classification
Alpha Toxin
Nagler's Reaction
Other Major Toxins
Minor Toxins
Enterotoxin
Pathogenesis
1. Soft Tissue Infections
2. Septicemia
3. Food Poisoning
4. Enteritis Necroticans (Necrotizing Jejunitis, Necrotic Enteritis)
5. C. perfringens Colitis
6. Clostridial Endometritis
Laboratory Diagnosis
A. Specimens
B. Microscopy
C. Culture
D. Identification
Animal Pathogenicity
Laboratory Diagnosis of Food Poisoning
Prophylaxis and Therapy
CLOSTRIDIUM TETANI
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
Tetanus Toxin
Tetanospasmin
Tetanolysin
Pathogenicity
Epidemiology
Laboratory Diagnosis
Prophylaxis
Treatment
CLOSTRIDIUM BOTULINUM
Morphology
Cultural Characteristics
Classification
Botulinum Toxin
Pathogenicity
1. Food-borne Botulism
2. Wound Botulism
3. Infant Botulism
Laboratory Diagnosis
Prophylaxis
Treatment
CLOSTRIDIUM DIFFICILE
Morphology
Pathogenesis
Laboratory Diagnosis
Treatment and Prophylaxis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 31:
Nonsporing Anaerobes
INTRODUCTION
CLASSIFICATION
ANAEROBIC COCCI
Peptococcus
Peptostreptococcus
GRAM-NEGATIVE ANAEROBIC COCCI
Veillonella
ANAEROBIC, NONSPORE-FORMING, GRAM-POSITIVE BACILLI
1. Eubacterium
2. Bifidobacterium
3. Lactobacillus
4. Mobiluncus
5. Propionibacterium
Propionibacterium propionicus
ANAEROBIC GRAM-NEGATIVE BACILLI
1. Bacteroides
a. Bile-tolerant
b. Bile Sensitive species
2. Fusobacterium (Bacilli with pointed ends)
3. Leptotrichia (Large bacilli)
1. Bacteroides
a. Bile-tolerant Species
b. Bile-sensitive Species
1. Prevotella
2. Porphyromonas
ii. Nonpigmented Species
2. Fusobacterium
3. Leptotrichia
ANAEROBIC INFECTIONS
Laboratory Diagnosis
A. Specimen Collection and Transport
B. Direct Microscopy
C. Culture
D. Identification
E. Antibiotic Sensitivity Tests
F. Other Anaerobic Techniques
Treatment of Anaerobic Infections
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 32:
Mycobacterium tuberculosis
INTRODUCTION
M. TUBERCULOSIS COMPLEX OR MTC
MYCOBACTERIUM TUBERCULOSIS
Morphology
Cultural Characteristics
Solid Medium
Liquid Media
Resistance
Biochemical Reactions
Antigenic Structure
1. Cell Wall Antigens
2. Cytoplasmic Antigens
Mycobacteriophages
Pathogenesis
1. Primary Tuberculosis
2. Postprimary (Secondary) Tuberculosis
Epidemiology
Laboratory Diagnosis
Pulmonary Tuberculosis
1. Specimens
2. Microscopy
3. Concentration Methods
4. Culture
5. Animal Inoculation
6. Immunodiagnosis
7. Hybridization and Nucleic Acid Technology
8. Chromatography
Extrapulmonary Tuberculosis
Sensitivity Testing
Allergy and Immunity
Koch Phenomenon
Components of Koch Phenomenon
Tuberculin Test
Reagents
Method
Result
I. Positive Test
II. False-positive reactions
III. False-negative Tests (Tuberculin Anergy)
Uses of Tuberculin Test
Prophylaxis
BCG Vaccination
Protective Efficacy
Complications of BCG Vaccine
Chemoprophylaxis
Treatment
Multidrug Resistant Mycobacterium Tuberculosis (MDR-TB)
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 33:
Mycobacterium leprae
INTRODUCTION
MYCOBACTERIUM LEPRAE
Morphology
Cultivation
Antigenic Structure
Resistance
Classification
Classification System of Ridley and Jopling
Pathogenesis
1. Lepromatous Leprosy
2. Tuberculoid (TT) Leprosy
3. Borderline (BT) Leprosy
4. Indeterminate Type
Epidemiology
Immunity
Reactions
Lepromin Test
Procedure
Uses of Lepromin Reaction
Laboratory Diagnosis
1. Specimens
i. Skin Smears
ii. Nasal Scrapings
2. Microscopy
3. Animal Inoculation
4. Lepromin Test
5. Serological Test
6. Molecular Diagnostic Methods
Treatment
Immunotherapy
Prophylaxis
Immunoprophylaxis
MYCOBACTERIUM LEPRAEMURIUM
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 34:
Nontuberculous Mycobacteria
INTRODUCTION
PROPERTIES OF NONTUBERCULOUS MYCOBACTERIA (TABLE 34.1)
CLASSIFICATION
Group I: Photochromogens
Group II: Scotochromogens
Group III: Nonphotochromogens
Group IV: Rapid Growers
SAPROPHYTIC MYCOBACTERIA
Pathogenesis
Laboratory Diagnosis
Epidemiology
Treatment
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 35:
Actinomycetes
INTRODUCTION
ACTINOMYCES
Morphology
Cultural Characteristics
Pathogenesis
Human Actinomycosis
Laboratory Diagnosis
1. Specimens
2. Microscopy
3. Culture
4. Identification
5. Biopsy
Epidemiology
Treatment
NOCARDIA
Morphology
Cultural Characteristics
Pathogenesis
Laboratory Diagnosis
1. Specimens
2. Microscopy
3. Culture
Treatment
ACTINOMYCOTIC MYCETOMA
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 36:
Enterobacteriaceae: Escherichia, Klebsiella, Proteus and Other Genera
INTRODUCTION
CHARACTERISTICS OF THE FAMILY ENTEROBACTERIACEAE
CLASSIFICATION OF ENTEROBACTERIACEAE
Lactose Fermentation
CLASSIFICATION OF ENTEROBACTERIACEAE BY TRIBES
ESCHERICHIA COLI
Introduction
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
Virulence Factors
A. Surface Antigens
B. Toxins
Clinical Infections
1. Diarrhea
A. Enteropathogenic E. coli (EPEC)
B. Enterotoxigenic E. coli (ETEC)
C. Enteroinvasive E. coli (EIEC)
Pathogenesis
D. E. coli Verocytotoxin or Verotoxin (VT)
E. Enteroaggregative E. coli (EAEC)
2. Urinary Tract Infection
Etiology of UTI
3. Pyogenic Infections
4. Septicemia
Laboratory Diagnosis
a. Laboratory Diagnosis of EPEC
b. Laboratory Diagnosis of ETEC
c. Laboratory Diagnosis of EIEC
d. Laboratory Diagnosis of VTEC
Laboratory Diagnosis of UTI
A. Collection of Specimen
B. Transport
INFECTIONS
Laboratory Diagnosis of Septicemia
Laboratory Diagnosis of Pyogenic Infection
EDWARDSIELLA
CITROBACTER
KLEBSIELLA
Introduction
Classification
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
Typing Methods
Laboratory Diagnosis
Treatment
ENTEROBACTER
HAFNIA
SERRATIA
Pathogenesis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 37:
Tribe Proteeae: Proteus, Morganella and Providencia
CLASSIFICATION
PROTEUS
Proteus Bacilli
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
Pathogenesis
Labortory Diagnosis
Treatment
MORGANELLA
PROVIDENCIA
Laboratory Diagnosis
ERWINIA
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 38:
Shigella
INTRODUCTION
Morphology
Cultural Characteristics
Resistance
Biochemical Reactions
Antigenic Structure
Classification
Group A (S. dysenteriae)
Group B (Shigella flexneri)
Group C (Sh. boydii)
Group D (S. sonnei)
Pathogenic Mechanisms
Pathogenicity
Epidemiology
Laboratory Diagnosis
A. Specimens
B. Transport
C. Microscopy
D. Culture
Identification
E. Colicine Typing
F. Serology
Treatment
Control
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 39:
Enterobacteriaceae III: Salmonella
INTRODUCTION
SALMONELLA
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Structure
Antigenic Variations
Classification and Nomenclature
A. Classification Based on Biochemical Reactions
B. Kauffmann–White Scheme of Classification
Differentiation of Antigenically Similar Strains
Bacteriophage Typing
Biotyping
Pathogenesis
Host-adapted Serotypes
Clinical Syndromes
1. Enteric Fever
a. Typhoid Fever
b. Paratyphoid Fever
2. Bacteremia with Focal Lesion
3. Gasteroenteritis or Food Poisoning
4. Asymptomatic Carrier State
Epidemiology
Laboratory Diagnosis
A. Isolation and Identification of the Bacilli
Blood Culture
Clot Culture
Feces Culture
Urine Culture
Other Materials for Culture
B. Demonstration of Circulating Antigen
C. Demonstration of Antibodies in Patient's Serum
i. Widal Test
Interpretation of Widal Test
ii. Other Serological Tests
D. Other Laboratory Tests
Diazo Reagent
DIAGNOSIS OF CARRIERS
PROPHYLAXIS
Vaccines against Typhoid Fever
Killed whole Cell Vaccine: TAB Vaccine
Oral Vaccine–Live Oral (Ty21) Typhoid Vaccine
Vaccine of Purified Vi Antigen (Typhim-Vi)
DRUG RESISTANCE
SALMONELLA GASTROENTERITIS
Source of Infection
Clinical Features
Laboratory Diagnosis
Treatment
SALMONELLA SEPTICEMIA
MULTIRESISTANT SALMONELLAE
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 40:
Vibrio Aeromonas and Plesiomonas
INTRODUCTION
VIBRIO
VIBRIO CHOLERAE
Morphology
Cultural Characteristics
A. Ordinary Media
B. Special Media
b. Enrichment Media
C. Plating Media
Biochemical Reactions
RESISTANCE
Antigenic Structure
Classification
Serological Classification
Biotypes of V. cholerae 01
Subtypes of V. cholerae 01
V. cholerae 0139
Phage Typing
Pathogenesis
Cholera Toxin (CT)
Mechanism of Action
Cholera
Epidemiology
Laboratory Diagnosis
A. Specimen
B. Collection of Specimen
C. Transportation
D. Microscopy
E. Culture
Selective Media
Biochemical Reactions
F. Serological Diagnosis
Detection of Carriers
Examination of Water Samples
Treatment
Immunity
Prophylaxis
1. General Measures
2. Specific Measures—Vaccines
HALOPHILIC VIBRIOS
Vibrio parahaemolyticus
Biochemical Reactions
Pathogenesis
Laboratory Diagnosis
Vibrio Vulnificus
Vibrio alginolyticus
Other Vibrio Species
AEROMONAS
PLESIOMONAS
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 41:
Campylobacter and Helicobacter
CAMPYLOBACTER
Morphology
Cultural Characteristics
Biochemical Reactions
Pathogenesis
Mechanism of Producing Diarrhea
Epidemiology
Laboratory Diagnosis
A. Specimens
B. Microscopy
C. Culture
D. Identification
E. Serology
Treatment
Other Campylobacters
1. Campylobacter fetus
2. C. concisus
3. C. jejuni subsp. doylei
4. C. coli
5.C. lari
6. C. sputorum subsp. sputorum
HELICOBACTER
Helicobacter pylori
Morphology
Cultural Characteristics
Biochemical Reactions
Virulence Factors
Pathogenesis
Laboratory Diagnosis
A. Noninvasive tests
B. Invasive Tests
Treatment
Helicobacter cinaedi
Helicobacter fennelliae
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS
CHAPTER 42:
Pseudomonas, Stenotrophomonas, Burkholderia
INTRODUCTION
PSEUDOMONAS AERUGINOSA
Morphology
Cultural Characteristics
Pigment Production
Biochemical Reactions
Antigenic Characteristics
Epidemiological Typing Methods
Virulence Factors
Resistance
Epidemiology
Pathogenesis
A. Community Infections
B. Hospital Infections
Laboratory Diagnosis
Treatment
Control
Stenotrophomonas maltophilia (Formerly Pseudomonas maltophilia)
BURKHOLDERIA CEPACIA (FORMERLY PSEUDOMONAS CEPACIA)
Morphology
Culture
Biochemical Reactions
Pathogenicity
Treatment
BURKHOLDERIA MALLEI (FORMELY PSEUDOMONAS MALLEI)
Morphology
Culture
Biochemical Reactions
Animal Pathogenicity
Human Pathogenicity
Laboratory Diagnosis
Mallein Test
BURKHOLDERIA PSEUDOMALLEI
Morphology
Culture
Biochemical Reactions
Toxins
Pathogenesis
Laboratory Diagnosis
Glucose Nonfermenters
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 43:
Legionella
INTRODUCTION
LEGIONELLA PNEUMOPHILA
Morphology
Culture
Biochemical Reactions
Epidemiology
Pathogenesis
Clinical Diseases
Laboratory Diagnosis
1. Microscopy
2. Culture
3. Antigen Detection
4. Serology
Treatment
Prevention
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTION (MCQS)
CHAPTER 44:
Yersinia, Pasteurella, Francisella
INTRODUCTION
YERSINIA PESTIS (FORMERLY PASTEURELLA PESTIS)
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigens, Toxins and Other Virulence Factors
Plague
Pathogenesis
1. Bubonic Plague
2. Pneumonic Plague
3. Septicemic Plague
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Microscopy
3. Culture
4. Animal Inoculation
5. Antigen Detection
6. Serology
7. Polymerase Chain Reaction (PCR)
Diagnosis of Plague in Wild Rats
Prophylaxis
A. General Measures
B. Vaccination
Chemoprophylaxis
Treatment
YERSINIOSIS
Yersinia pseudotuberculosis
Pathogenesis
Laboratory Diagnosis
Treatment
Yesinia enterocolitica
Cultural Characters
Antigenic Structure
Pathogenesis
Types of Disease in Humans
Laboratory Diagnosis
PASTEURELLA MULTOCIDA (FORMERLY PASTEURELLA SEPTICA)
Morphology
Cultural Characteristics
Pathogenesis
Laboratory Diagnosis
FRANCISELLA TULARENSIS (PASTEURELLA TULARENSIS, BRUCELLA TULARENSIS)
Morphology
Cultural Characters
Pathogenesis
Laboratory Diagnosis
Treatment
Prophylaxis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 45:
Haemophilus
INTRODUCTION
HAEMOPHILUS INFLUENZAE
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
Resistance
Variation
Virulence Factors
Pathogenesis
A. Invasive Infections
B. Noninvasive Disease
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Collection and Transport
3. Direct Microscopy
4. Culture
5. Identification
6. Molecular Techniques
7. Antibiotic Sensitivity Tests
Treatment
Prophylaxis
Active Immunization
HAEMOPHILI OTHER THAN H. INFLUENZAE
Haemophilus influenzae Biogroup Aegyptius
(Koch-Weeks Bacillus, Formerly H. Aegypticus)
Treatment
Haemophilus ducreyi
Morphology
Cultural Characteristics
Identification
Pathogenicity
Laboratory Diagnosis
Treatment
Haemophilus parainfluenzae
Haemophilus haemolyticus
HACEK Group Bacteria
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 46:
Bordetella
INTRODUCTION
BORDETELLA PERTUSSIS
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Constituents and Virulence Factors
Adhesins
Pathogenesis
Complications
Epidemiology
Laboratory Diagnosis
1. Microscopy
2. Specimen Collection and Transport
3. Culture
4. Identification
5. Detection of Bacterial Antigens
6. Polymerase Chain Reaction (PCR)
7. Serology
Treatment
Prophylaxis
Vaccination
Acellular Pertussis Vaccine
BORDETELLA PARAPERTUSSIS
BORDETELLA BRONCHISEPTICA (BORD. BRONCHICANIS)
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 47:
Brucella
INTRODUCTION
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Antigenic Structure
Brucella Bacteriophage
Classification of Brucellae
Biotypes
Pathogenesis
Types of Human Infection
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Culture
3. Serological Tests
Polymerase Chain Reaction (PCR)
Hypersensitivity Test (Brucellin Skin Test)
Detection of Animal Infection
i. Milk Ring Test
Result
ii. Whey Agglutination Test
Prophylaxis
Treatment
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 48:
Spirochetes
INTRODUCTION
CLASSIFICATION
TREPONEMA
Treponemes Cause the Following Diseases in Humans
Treponema pallidum Subspecies pallidum
Morphology
Cultivation
Resistance
Antigenic Structure
A. Nonspecific Antigen
B. Specific Antigens
Pathogenesis
i. Primary Disease
ii. Secondary Syphilis
iii. Latent Syphilis
iv. Tertiary Syphilis or Late Syphilis
Congenital Syphilis
Syphilis Acquired Nonvenereally
Laboratory Diagnosis
Specimen Collection and Handling
A. Demonstration of Treponemes
a. Demonstration of Treponemes in the Exudate
b. Demonstration of Treponemes in Tissues
c. Demonstration of Treponemal Antigen in the Lesion
B. Serological Tests
a. Nontreponemal Tests or Standard Tests for Syphilis
Veneral Disease Research Laboratory (VDRL) Test
Method
Interpretation
Rapid Plasma Reagin Test
Advantages of RPR Test
Disadvantage
Toluidine Red Unheated Serum Test (TRUST)
Disadvantages of STS
b. Treponemal Tests (Table 48.2)
1. Group-specific Tests Using Reiter Treponeme
Reiter Protein Complement Fixation (RPCF) Test
2. Species Tests Using Pathogenic T. Pallidum (Nichol's Strain)
i. Tests Using Live T. pallidum
ii. Tests Using Killed T. pallidum
a. Treponema pallidum Immune Adherence (TPIA) Test
b. Treponema pallidum Agglutination (TPA) Test
Fluorescent Treponemal Antibody (FTA) Test
c. Fluorescent Treponemal Antibody-absorption (FTA-ABS) Test
iii. Tests Using an Extract of T. pallidum a. T. Pallidum Hemagglutination Assay (TPHA)
b. Enzyme Immunoassays (EIA)
Treponema pallidum Particle Agglutination (TP-PA)
Interpretation of Various Serological Tests
1. Serological Screening
2. Response to Treatment
3. Biological False-positive (BFP) Reactions
4. Diagnosis of Congenital Syphilis
Syphilis Associated with Human Immunodeficiency Virus (HIV) Infections
Epidemiology
Immunity
Prophylaxis
Treatment
NONVENEREAL TREPONEMATOSES
1. Endemic Syphilis (Bejel)
2. Yaws (Frambesia)
3. Pinta
NONPATHOGENIC TREPONEMES
BORRELIA
Morphology
Cultural Characteristics
Antigenic Properties
Pathogenicity
Relapsing Fever
1. Epidemic or Louse-borne Relapsing Fever
2. Endemic or Tick-borne Relapsing Fever
Pathogenicity
Epidemiology
Laboratory Diagnosis
i. Dark Ground Microscopy
ii. Giemsa or Leishman Stain
iii. Animal Inoculation
iv. Culture and Serology
Prophylaxis
Borrelia vincentii (Treponema vincentii)
Diagnosis
Lyme Disease: Borrelia burgdorferi
Pathogenesis
Laboratory Diagnosis
Treatment
LEPTOSPIRA
Classification
Morphology
Cultural Characteristics
Resistance
Antigenic Properties
Pathogenesis
Laboratory Diagnosis
1. Demonstration of Leptospiras in Blood or Urine
Microscopy
2. Culture
3. Animal Inoculation
4. Serological Diagnosis
A. Genus-specific Tests
B. Serogroup-specific Tests
Examination of Water for Pathogenic Leptospires
Prophylaxis
Treatment
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 49:
Mycoplasma and Ureaplasma
INTRODUCTION
CLASSIFICATION
General Characteristics
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
Pathogenicity
A. Mycoplasma pneumoniae
Epidemiology
Laboratory Diagnosis
1. Specimens
2. Culture
1. Isolation and Identification
2. Polymerase Chain Reaction (PCR) Amplification
3. Antigen Detection Techniques
4. DNA Probes
5. Serological Tests
A. Specific Tests Using Mycoplasmal Antigens
B. Nonspecific Serological Tests
Treatment
Infections in Immunocompromised Patients
Mycoplasma and HIV Infection
MYCOPLASMA AS CELL CULTURE CONTAMINANTS
MYCOPLASMAS AND L FORMS OF BACTERIA
Differenecs between L-forms and Mycoplasma
Atypical Pneumonia
B. Urogenital Infections
Mycoplasma hominis
Mycoplasma genitalium
Ureaplasma urealyticum
Clinical Manifetations
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 50:
Miscellaneous Bacteria
LISTERIA MONOCYTOGENES
Morphology
Cultural Characters
Biochemical Reactions
Various Species
Pathogenicity
Clinical Features
Laboratory Diagnosis
1. Specimens
2. Microscopy
3. Culture
Treatment
ERYSIPELOTHRIX RHUSIOPATHIAE
Cultural Characteristics
Biochemical Reactions
Pathogenicity
Laboratory Diagnosis
ALCALIGENES FAECALIS
CHROMOBACTERIUM VIOLACEUM
FLAVOBACTERIUM MENINGOSEPTICUM
DONOVANIA GRANULOMATIS CALYMMATOBACTERIUM GRANULOMATIS) OR KLEBSIELLA GRANULOMATIS
Morphology
Culture
Pathogenicity
Laboratory Diagnosis
Treatment
ACINETOBACTER (MIMA POLYMORPHA; BACTERIUM ANITRATUM
A. baumannii
A. lowffi
Pathogenesis
Treatment
RAT-BITE FEVER (STREPTOBACILLUS MONILIFORMIS AND SPIRILLUM MINUS)
Streptobacillus moniliformis
Morphology
Culture
Biochemical Reactions
Pathogenesis
Laboratory Diagnosis
Treatment
SPIRILLUM MINUS
Morphology
Culture
Pathogenesis
Laboratory Diagnosis
1. Microscopic Examination
2. Animal Inoculation
Treatment
EIKENELLA CORRODENS
Morphology
Culture
Biochemical Characters
Pathogenesis
Treatment
CARDIOBACTERIUM HOMINIS
CAPNOCYTOPHAGA
GARDNERELLA VAGINALIS
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 51:
Rickettsiaceae, Bartonellaceae and Coxiella
INTRODUCTION
Characteristics Similar to Bacteria
CLASSIFICATION
GENUS RICKETTSIA
Morphology
Cultivation
Resistance
Antigenic Structure
Pathogenesis
A. Typhus Fever Group
1. Epidemic Typhus (Louse-borne Typhus, Classical Typhus)
2. Brill–Zinsser Disease (Recrudescent Typhus)
3. Endemic Typhus (Murine Typhus, Flea-borne Typhus, Rat Typhus)
B. Spotted Fever Group
Tick Typhus
Rocky Mountain Spotted Fever
Other Spotted Fever Rickettsiae (Table 51.2)
Rickettsial pox
C. Scrub Typhus Group
Laboratory Diagnosis
1. Isolation of Rickettsiae
2. Direct Detection of the Organisms and Their Antigens
3. Serology
Interpretation
Treatment
Prophylaxis
EHRLICHIA, ANAPLASMA AND NEORICKETTSIA
Species
1. Ehrlichia chaffeensis
2. Ehrlichia ewingii
3. Anaplasma phagocytophilum
4. Neorickettsia sennestu
Laboratory Diagnosis
GENUS COXIELLA: Q FEVER
Morphology
Resistance
Antigenic Variation
Pathogenesis
Laboratory Diagnosis
Prophylaxis
BARTONELLA
1. Bartonella bacilliformis
Pathogenesis
Laboratory Diagnosis
2. Bartonella quintana
Pathogenesis
Laboratory Diagnosis
3. Bartonella henselae
Pathogenesis
Laboratory Diagnosis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 52:
Chlamydia and Chlamydophila
INTRODUCTION
Differences between Chlamydiae and Viruses
CLASSIFICATION
Chlamydia Species
Chlamydophila Species
Morphology
Growth Cycle
Laboratory Propagation
Antigenic Structure
Chlamydia trachomatis
1. Ocular Infections
Laboratory Diagnosis
1. Direct Cytopathologic Examination
2. Culture
ii. Inclusion conjunctivitis
2. Genital Infections
I. Genital chlamydiasis
II. Lymphogranuloma Venereum
Clinical Manifestations
Laboratory Diagnosis
A. Microscopy
B. Culture
C. Serology
D. Intradermal Test (Frei's Test)
Treatment
Chlamydophila psittaci
Laboratory Diagnosis
A. Culture
B. Antigen Detection
C. Serology
Treatment and Prevention
Chlamydophila pneumoniae
Spectrum of Disease
Laboratory diagnosis
1. Cultivation
2. Serology
3. Direct Detection Methods
Treatment
Laboratory Diagnosis of Chlamydia Infections
1. Demonstration of Inclusion or Elementary Bodies
2. Isolation of the Organisms
3. Demonstration of Chlamydial Antigen
4. Detection of Specific Antibodies or Hypersensitivity Response
5. Skin Test
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
SECTION 4: VIROLOGY
CHAPTER 53:
General Properties of Viruses
INTRODUCTION
MAIN PROPERTIES OF VIRUSES
MORPHOLOGY OF VIRUSES
Size
Measuring the Size of Viruses
Shape of the Virus
STRUCTURE AND CHEMICAL COMPOSITION OF THE VIRUSES
A. Viral Capsid
Functions of Capsid
B. Virus Symmetry
1. Icosahedral Symmetry
2. Helical Symmetry
3. Complex Symmetry
C. Viral Envelope
Functions of Peplomers
D. Viral Nucleic Acids
SUSCEPTIBILITY TO PHYSICAL AND CHEMICAL AGENTS
1. Heat and Cold
2. pH
3. Stabilization of Viruses by Salts
4. Radiation
5. Disinfectants
6. Lipid Solvents
7. Antibiotics
VIRAL HEMAGGLUTINATION
Viral Hemagglutination Test
VIRAL REPLICATION
1. Adsorption and Absorption
2. Penetration
3. Uncoating
4. Biosynthesis
Steps of Biosynthesis
5. Maturation
6. Release
ECLIPSE PHASE
ABNORMAL REPLICATIVE CYCLES
1. Incomplete Viruses
2. Abortive Infections
3. Latent Infection
4. Defective Viruses
CULTIVATION OF VIRUSES
A. Animal Inoculation
Uses of Animal Inoculation
Animals
B. Embyronated Eggs
C. Tissue Culture
Classification of Cell Cultures
DETECTION OF VIRUS GROWTH IN CELL CULTURE
1. Cytopathic Effect
Main Types of CPE
2. Metabolic Inhibition
3. Hemadsorption
4. Interference
5. Transformation
6. Immunofluorescence
7. Detection of Virus-specific Nucleic Acid
8. Detection of Enzymes
9. Electron Microscopy
VIRAL ASSAY
1. Total Virus Particles
A. Electron Microscopy
B. Hemagglutination
2. Infectious Virion Assay
A. Quantal Assays
B. Quantitative Infectivity Assay
VIRAL GENETICS
A. Mutation
Conditional lethal Mutant
B. Recombination
C. Nongenetic interactions
1. Phenotypic Mixing
2. Genotypic Mixing or Heterozygosis
3. Complementation
4. Interference
5. Enhancement
CLASSIFICATION OF VIRUSES
Main Criteria Used for the Classification of Viruses
Short Descriptions of the Major Groups of Viruses
DNA Viruses (Fig. 53.7)
RNA Viruses (Fig. 53.8)
1. Picornaviridae Family
2. Orthomyxoviridae Family
3. Paramyxoviridae Family
4. Bunyaviridae Family
5. Arenaviridae Family
6. Rhabdoviridae Family
7. Togaviridae Family
8. Coronaviridae Family
9. Retroviridae Family: (Re = reverse, tr = transcriptase)
10. Flaviviridae Family
11. Caliciviridae Family
12. Filoviridae Family
13. Reoviridae Family
VIROIDS
PRIONS
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 54:
Virus–Host Interactions: Viral Infections
INTERACTIONS BETWEEN VIRUSES AND HOST CELLS
PATHOGENESIS OF VIRAL DISEASES
TRANSMISSION OF HUMAN VIRUS INFECTIONS
1. Respiratory Tract
2. Alimentary Tract
3. Skin
4. Conjunctiva
5. Genital Tract
6. Congenital Viral Infections
SPREAD OF VIRUS IN THE BODY
Generalized Infections
SIGNIFICANCE OF THE INCUBATION PERIOD
HOST RESPONSE TO VIRUS INFECTIONS
A. Immunological Response
1. Antibody-mediated Immunity
2. Cell-mediated Immunity
B. Nonimmunological Responses
Synthesis of Interferons
Types of Interferon
Main Biological Effects of Interferons
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 55:
Laboratory Diagnosis, Prophylaxis and Chemotherapy of Viral Diseases
LABORATORY DIAGNOSIS OF VIRAL INFECTIONS
1. Indications for Laboratory Diagnosis of Viral Infections
2. Specimens
3. Methods for Laboratory Diagnosis of Viral Infections
A. Direct Detection of Virus
1. Electron Microscopy (EM)
2. Immunoelectron Microscopy
3. Fluorescence Microscopy
4. Light Microscopy
B. Virus Isolation
C. Detection of Viral Proteins
D. Detection of Viral Genetic Material
E. Serological Diagnosis
IMMUNOPROPHYLAXIS OF VIRAL DISEASES
A. Acive Immunization
I. Live-virus Vaccines
Advantages of live-virus Vaccines
Disadvantages of live-virus Vaccines
II. Killed Viral Vaccines
Advantages
Disadvantages
B. Passive Immunization
CHEMOPROPHYLAXIS AND CHEMOTHERAPY OF VIRUS DISEASES
1. Nucleoside Analogs
Acyclovir (Acycloguanosine)
Amantadine and Rimantadine
2. Protease Inhibitors
Azidothymidine (Zidovudine, AZT)
Interferons
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 56:
Bacteriophages
INTRODUCTION
ROLE OF BACTERIOPHAGES
MORPHOLOGY
LIFE CYCLE
1. Lytic Cycle
i. Adsorption
ii. Penetration
iii. Synthesis of Phage Nucleic Acid and Proteins
iv. Assembly and Maturation
v. Release
Eclipse Phase
2. Lysogenic Cycle
SIGNIFICANCE OF PHAGES
1. Virulent Phage
I. Phage Assay
II. Phage Typing
2. Temperate Phage
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 57:
Poxviruses
INTRODUCTION
CLASSIFICATION
MORPHOLOGY
PHYSICAL AND CHEMICAL PROPERTIES
Antigenic Structure
Cultivation and Host Range
A. Chick Embryo
B. Tissue Culture
C. Animals
Variola and Vaccinia Viruses
Control of Smallpox
OTHER POXVIRUS DISEASES
1. Cowpox
2. Monkeypox
3. Buffalopox
4. Milker's Node
5. Orf (Contagious Pustular Dermatitis or Sore Mouth)
6. Tanapox
7. Molluscum Contagiosum
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 58:
Herpesviruses
INTRODUCTION
STRUCTURE
CLASSIFICATION
Herpes Simplex Virus (HSV)
Properties of the Viruses
Pathogenesis
Clinical Features
Laboratory Diagnosis
1. Specimens
B. Virus Isolation
C. Serology
D. Polymerase Chain Reaction
Treatment
HERPES VIRUS SIMIAE: B VIRUS
VARICELLA-ZOSTER VIRUS
Properties of the Virus
Varicella (Chickenpox)
HERPES ZOSTER (SHINGLES, ZONA)
Pathogenesis
Complications
Immunity
Laboratory Diagnosis
Prophylaxis and Treatment
Active Immunization
Passive Immunization
Laboratory Diagnosis
Treatment
CYTOMEGALOVIRUS
Pathogenesis
Laboratory Diagnosis
Treatment and Prevention
EPSTEIN–BARR VIRUS
Pathogenesis
Epidemiology
A. Infectious Mononudeosis (Glandular Fever)
B. Oral Hairy leukoplakia
C. Chronic Disease
D. Burkitt's lymphoma
E. Nasopharyngeal Carcinoma
F. Lymphoproliferative Diseases in Immunodeficient Hosts
Laboratory Diagnosis
1. Differential White Cell Count
2. Paul–Bunnell Test
Procedure
Confirmation
3. Epstein–Barr Virus-specific Antibodies
4. Antigen Detection
5. Nucleic Acid Hybridization
6. Virus Isolation
HUMAN HERPESVIRUSES 6 (HHV6)
HUMAN HERPESVIRUS 7 (HHV7)
HUMAN HERPESVIRUS 8 (HHV8)
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 59:
Adenoviruses
INTRODUCTION
CLASSIFICATION
MORPHOLOGY
RESISTANCE
PATHOGENESIS
LABORATORY DIAGNOSIS
A. Specimens
B. Direct Demonstration of Virus
C. Virus Isolation
D. Polymerase Chain Reaction
E. Serology
TREATMENT, PREVENTION AND CONTROL
Gene Therapy
Adenovarus-associated Viruses
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 60:
Papovaviruses
INTRODUCTION
PAPILLOMAVIRUSES
Pathogenesis
1. Cutaneous Warts
Epidermodysplasia Verruciformis
2. Anogenital Warts
3. Recurrent Respiratory Papillomatosis
4. Oral Papillomatosis
5. Cancer
Laboratory Diagnosis
POLYOMAVIRUSES
1. Mouse Polyomavirus
2. Simian Vacuolating Virus 40 (SV 40)
3. JC Virus (JCV)
4. BK Polyomaviruses
Laboratory Diagnosis
1. Electron Microscopy
2. Virus Isolation
3. Viral Antigen Detection
4. Viral nucleic Acid Detection
5. Cytopathology
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 61:
Parvoviruses
INTRODUCTION
A. PARVOVIRUS
B. DEPENDOVIRUS
C. ERYTHROVIRUS
Clinical Diseases
Laboratory Diagnosis
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 62:
Picornaviruses
INTRODUCTION
CLASSIFICATION
IMPORTANT PROPERTIES OF PICORNAVIRUSES
ENTEROVIRUSES
POLIOVIRUS
Morphology
Resistance
Antigenic Properties
Host Range and Cultivation
Pathogenesis
Clinical Features
Laboratory Diagnosis
A. Specimens
B. Culture
C. Serological Tests
Immunity
Prophylaxis
Immunization
Immunization Schedule
Global Eradication
Epidemiology
COXSACKIEVIRUS
Properties of the Virus
Antigenic Characters
Clinical Features
Group A Viruses
Group B Viruses
Laboratory Diagnosis
A. Virus Isolation
B. Serology
C. Nucleic Acid Detection
ECHOVIRUSES
Clinical Features
Laboratory Diagnosis
OTHER ENTEROVIRUS TYPES
Acute Hemorrhagic Conjunctivitis
RHINOVIRUSES
Properties of the Virus
Host Range and Growth
Pathogenesis
Clinical Syndromes
Laboratory Diagnosis
Treatment and Prophylaxis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 63:
Orthomyxovirus
INTRODUCTION
Properties of Orthomyxovirus
INFLUENZA VIRUSES
Morphology
Resistance
Antigenic Structure
A. Internal Antigens
B. Surface Antigens
Antigenic Variation
Antigenic Classification
Host Range
Pathogenesis
Clinical Features
A. Uncomplicated Influenza
Complications
Reye's Syndrome
Laboratory Diagnosis
1. Demonstration of the Virus Antigen
2. Isolation of the Virus
3. Serology
Immunity
Epidemiology
Prophylaxis
A. Chemoprophylaxis
B. Influenza Vaccines
a. Inactivated Viral Vaccines
Indications
b. Live-virus Vaccines
Treatment
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 64:
Paramyxoviruses
INTRODUCTION
MORPHOLOGY AND STRUCTURAL PROTEINS OF PARAMYXOVIRUSES
CLASSIFICATION
Subfamily Paramyxoviridae
Subfamily Pneumovirinae
Differentiation of Genera
PARAINFLUENZA VIRUSES
Pathogenesis
Laboratory Diagnosis
A. Direct Identification
B. Virus Isolation
C. Serology
GENUS RUBULAVIRUS
Mumps Virus
Pathogenesis
Immunity
Laboratory Diagnosis
A. Direct Demonstration
B. Virus Isolation and Identification
C. Serology
Prophylaxis
1. Vaccination
2. Immunoglobulin
GENUS MORBILLIVIRUS
Measles (Rubeola)
Morphology
Pathogenesis
Clinical Features
Complications
Laboratory Diagnosis
A. Demonsration of Virus Antigen
B. Virus Isolation
C. Serological Diagnosis
Epidemiology
Prophylaxis
B. Active Immunization
NIPAH AND HENDRA VIRUSES
GENUS PNEUMOVIRUS
Respiratory Syncytial Virus (RSV)
Description
Clinical Features
Epidemiology
Laboratory Diagnosis
A. Demonstration of Virus Antigen
B. Virus Isolation
C. Serology
Prophylaxis
Treatment
METAPNEMOVIRUS
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 65:
Arboviruses
INTRODUCTION
CLASSIFICATION
PROPERTIES
LABORATORY DIAGNOSIS
A. Specimen
B. Virus Isolation
i. Suckling Mice
ii. Tissue Cultures
C. Arbovirus-specific RNA Detection
D. Serology
PATHOGENESIS
FAMILIES OF ARBOVIRUSES
A. Family Togaviridae
Morphology
Classification
Alphavirus
Rubivirus
Viruses of Togaviridae
B. Viruses Causing Febrile Illness
1. Chikungunya Virus
2. Onyong-nyong Virus
3. Semliki Forest Virus
4. Sindbis Virus
5. Ross River Virus
B. Family Flaviviridae
Flavivirus
Morphology
A. Mosquito-borne Group
B. Tick-borne Group
A. Mosquito-borne Group
Geographical Distribution
Problem in India
Clinical Features
Control of Japanese Encephalitis
i. Formalin Inactivated Mouse Brain Vaccine
ii. Live Attenuated Vaccine
b. Yellow Fever
Pathogenesis and Pathology
Clinical Findings
Epidemiology
Control
a. French Neurotropic Vaccine (Dakar)
b. 17D Vaccine
c. Dengue
Clinical Findings
Laboratory Diagnosis
Epidemiology
Control
B. Tick-borne Group
a. Tick-borne Encephalitis Viruses (TBEv)
Control
b. Tick-borne Hemorrhagic Fevers
1. Kyasanur Forest Disease (KFD)
History
Epidemiology
Clinical Features
Laboratory Diagnosis
Control
2. Omsk Hemorrhagic Fever
Family Bunyaviridae
Classification
A. Bunyavirus
B. Phlebovirus
C. Nairovirus
D. Hantavirus
Laboratory Diagnosis
Reoviridae
Rhabdoviridae
UNGROUPED ARBOVIRUSES
ARBOVIRUS KNOWN TO BE PREVALENT IN INDIA
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 66:
Rhabdoviruses
INTRODUCTION
Classification
RABIES VIRUS
Morphology
Resistance
Antigenic Properties
A. Animals
Street Virus
Fixed Virus
B. Chick Embryos
C. Tissue Culture
Pathogenesis
Clinical Features
A. Humans
Phases of Clinical Spectrum
B. Rabies in Dogs
Clinical Picture
Laboratory Diagnosis
1. Diagnosis of Human Rabies
A. Rabies Antigens by Immunofluorescence
B. Virus Isolation
a. Mouse Inoculation
b. Isolation in Cell Culture
C. Serology
D. Detection of Nucleic Acid
2. Animal Rabies
Prophylaxis
A. Postexposure Prophylaxis
A. Post-exposure Prophylaxis
I. Neural Vaccines
II. Non-neural Vaccines
3. Subunit Vaccine
Indications for Antirabies Treatment
Vaccination Schedules
Neural Vaccines
Classification of Exposures
Dosage Schedules
Site for Vaccination
Adverse Reactions
Cell Culture Vaccines
i. Preexposure Prophylaxis
ii. Postexposure Prophylaxis
C. Passive Immunization
ii. Human Rabies Immune Globulin
Vaccine for Animals
B. Preexposure Prophylaxis
Epidemiology
Control
RABIES RELATED VIRUSES
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS
CHAPTER 67:
Hepatitis Viruses
INTRODUCTION
HEPATITIS A VIRUS (INFECTIOUS HEPATITIS)
Morphology
Resistance
Pathogenesis
Epidemiology
Clinical Features
Laboratory Diagnosis
Prophylaxis
A. General Measures
B. Immunization
Treatment
HEPATITIS B VIRUS—SERUM HEPATITIS
Classification
Structure
Antigenic Structure
HBV Subtypes
Cultivation
Stability
Clinical Syndromes
Acute Infection
Pathogenesis
Epidemiology
Mode of Transmission
Hepatitis B Carriers
HBV Markers
Laboratory Diagnosis
Specific Diagnosis
1. Detection of Viral Markers
2. Viral DNA Polymerase
3. Polymerase Chain Reaction (PCR)
4. Biochemical Tests
Prophylaxis
Treatment
HEPATITIS C VIRUS (HCV)
Clinical Features
Laboratory Diagnosis
Prophylaxis
Treatment
HEPATITIS D VIRUS (HDV) (DELTA AGENT)
Pathogenesis
Laboratory Diagnosis
Treatment
Prophylaxis
HEPATITIS E VIRUS (HEV)
Clinical Features
Epidemiology
Laboratory Diagnosis
Prophylaxis
HEPATITIS G VIRUS
Laboratory Diagnosis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 68:
Retroviruses: Human Immunodeficiency Virus (HIV)
RETROVIRUSES
Classification
HUMAN IMMUNODEFICIENCY VIRUS
Structure
Viral Genes and Antigens
A. Genes Coding for Structural Proteins (Table 68.2)
B. Nonstructural and Regulatory Genes
Classification
Resistance
Routes of Transmission
1. Sexual Intercourse
2. Blood and Blood Products
3. Mother-to-child Transmission
Pathogenesis
Clinical Features of HIV Infection
Group I—Acute HIV Infection
Group II—Asymptomatic or latent infection
Group III—Persistent Generalized lymphadenopathy
Group IV—AIDS Related Complex
Laboratory Diagnosis
A. Specific Tests for HIV Infection (Table 68.9)
1. Antigen Detection
2. Virus Isolation
3. Detection of Viral Nucleic Acid
4. Antibody Detection
A. Screening Tests (Table 68.10)
B. Confirmatory Tests
Interpretation of Western Blot Test Results
Strategies of HIV Testing
B. Nonspecific Tests
Immunological Tests
C. Tests for Opportunistic Infections and Tumors
Applications of Serological Tests (Table 68.11)
Laboratory Monitoring of HIV Infection
Epidemiology
Routes of Transmission
Control
Prophylaxis
Treatment
Postexposure Prophylaxis (Pep)
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 69:
Slow Virus and Prion Diseases
INTRODUCTION
CHARACTERISTICS OF SLOW VIRUSES
CLASSIFICATION
Group A
Visna
Maedi (Progressive Pneumonia)
Group B (Prion Diseases)
Transmissible Spongiform Encephalopathies (Prion Diseases)
Group C
i. Subacute Sclerosing Panencephalitis (SSPE)
ii. Progressive Multifocal leukoencephalopathy (PML)
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 70:
Miscellaneous Viruses
RUBIVIRUS
RUBELLA (GERMAN MEASLES)
Epidemiology
Laboratory Diagnosis
A. Virus Isolation
B. Serology
Prophylaxis
Active Prophylaxis
VIRAL HEMORRHAGIC FEVERS
ARENAVIRUSES
Arenaviruses Causing Human Diseases
1. Lymphocytic Choriomeningitis Virus (LCM)
2. Lassa Fever
3. South American Hemorrhagic Fevers
Laboratory Diagnosis of Arenaviruses
FILOVIRUSES
Marburg Virus
Ebola Virus
Pathogenesis
Laboratory Diagnosis
CORONAVIRUSES
Laboratory Diagnosis
Severe Acute Respiratory Syndrome
Laboratory Diagnosis
Treatment and Prophylaxis
REOVIRIDAE
Classification
Rotaviruses
Classification
Animal Susceptibility
Propagation in Cell Culture
Epidemiology
Clinical Features
Laboratory Diagnosis
Treatment
Control
Rotavirus Vaccine
Other Viruses Causing Diarrhea
NORWALK VIRUS
Adenoviruses
Astrovirus
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 71:
Oncogenic Viruses
INTRODUCTION
Oncogenic Viruses
PROPERTIES OF CELLS TRANSFORMED BY VIRUSES
TYPES OF TUMOR VIRUSES
ONCOGENIC VIRUSES (TABLE 71.2)
A. Oncogenic DNA Viruses
I. Papovaviruses (See Chapter 60)
II. Poxvirus
III. Adenovirus
IV. Herpesvirus
V. Hepatitis B Virus
B. Oncogenic Rna Viruses
VIRUSES ASSOCIATED WITH HUMAN CANCER
ONCOGENES
ANTIONCOGENES
Examples
MECHANISMS OF VIRAL ONCOGENESIS
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
SECTION 5: MEDICAL MYCOLOGY
CHAPTER 72:
General Properties, Classification and Laboratory Diagnosis of Fungi
INTRODUCTION
DIFFERENCES OF FUNGI FROM BACTERIA
GENERAL PROPERTIES OF FUNGI
CLASSIFICATION OF FUNGI
A. Morphological Classification
B. Systematic Classification
REPRODUCTION AND SPORULATION
LABORATORY DIAGNOSIS
A. Collection and Processing of Specimens
B. Direct Microscopy
I. Potassium Hydroxide (KOH) Preparation
II. Potassium Hydroxide (KOH) with Calcofluor White
III. Gram-staining
IV. India Ink Preparations
V. Histology
C. Culture
D. Identification of Fungi
E. Serologic Tests
F. Polymerase Chain Reaction (PCR)
Mycoses (Fungus Infections)
CLASSIFICATION OF MYCOSES
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 73:
Superficial, Cutaneous andSubcutaneous Mycoses
A. SUPERFICIAL MYCOSES
a. Infection of Skin
Pityriasis Versicolor (Tinea Versicolor)
Laboratory Diagnosis
Tinea Nigra
Laboratory Diagnosis
b. Infection of Hair
Piedra
Black Piedra
Laboratory Diagnosis
White Piedra
B. CUTANEOUS MYCOSES
Dermatophytes
Classification
Identification
Morphology and Identification
Trichophyton
Important Species
Microsporum
M. audouinii
M. canis
M. gypseum
Pathogenicity
Clinical Findings
Laboratory Diagnosis
A. Specimens
B. Microscopic Examination
C. Culture
Epidemiology
Treatment and Prevention
C. SUBCUTANEOUS MYCOSES
1. Mycetoma
Etiology
Pathogenesis
Laboratory Diagnosis
A. Direct Examination
B. Culture
Treatment
2. Chromoblastomycosis
Laboratory Diagnosis
Phaeohyphomycosis
3. Sporotrichosis
Pathogenesis
Laboratory Diagnosis
4. Rhinosporidiosis
Laboratory Diagnosis
Demonstration of Sporangia
5. Subcutaneous Phycomycosis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 74:
Systemic Mycoses
INTRODUCTION
1. BLASTOMYCOSIS
Pathogenesis
Morphology
Laboratory Diagnosis
2. PARACOCCIDIOIDOMYCOSIS
Pathogenesis
Laboratory Diagnosis
3. COCCIDIOIDOMYCOSIS
Clinical Features
Morphology
Laboratory Diagnosis
1. Specimens
2. Microscopic Examination
3. Culture
4. Serological Tests
5. Skin Tests
4. HISTOPLASMOSIS
Pathogenesis
1. Pulmonary Infection
2. Disseminated Histoplasmosis
3. Skin and Mucosa
Laboratory Diagnosis
1. Specimens
2. Microscopic Examination
3. Culture
4. Serological Tests
5. Histoplasmin Skin Test
Epidemiology
Treatment
African Histoplasmosis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 75:
Opportunistic Mycoses
OPPORTUNISTIC FUNGI
Causative Fungal Agents
A. YEAST AND YEAST-LIKE FUNGI
Candidiasis
Morphology
Species of Candida
Pathogensis
a. Mucocutaneous Lesions
b. Skin and Nail Infections
Laboratory Tests
Treatment
Cryptococcosis
Morphology
Serotypes
Epidemiology
Pathogenesis
Cryptococcal meningitis
Other Sites of Dissemination
Laboratory Diagnosis
Treatment
B. FILAMENTOUS FUNGI
Aspergillosis
Pathogenesis
Laboratory Diagnosis
Mucormycoses (Zygomycosis)
Clinical Manifestations
Laboratory Diagnosis
Treatment
Penicilliosis
Pathogenesis
Identification
C. OTHER FUNGAL AGENTS
Pneumocystis jiroveci
Morphology
Pathogenesis
Laboratory Diagnosis
Treatment
OTHER OPPORTUNIST FUNGI
Otomycosis
Keratomycosis (Mycotic Keratitis or Fungal Keratitis)
Causes
Pathogenesis
Laboratory Diagnosis
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 76:
Mycotoxicosis
MYCETISM
MYCOTOXICOSIS
Aflatoxin
Ergot Alkaloids
Other Mycotoxicoses
PSYCHOTROPIC AGENTS
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
SECTION 6: MISCELLANEOUS
CHAPTER 77:
Normal Microbial Flora of the Human Body
INTRODUCTION
1. Resident Flora
2. Transient Flora
ROLE OF NORMAL MICROBIAL FLORA
A. Beneficial Functions of Normal Flora
B. Harmful Effects of Normal Flora
Normal Flora of the Skin
Normal Flora of the Conjunctiva
Normal Flora of the Nose, Nasopharynx and Accessory Sinuses
Normal Flora of the Mouth
Normal Flora of the Upper Respiratory Tract
Normal Flora of the Gastrointestinal Tract
Normal Flora of the Genitourinary Tract
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 78:
Infective Syndromes*
BACTEREMIA AND SEPTICEMIA
Infective Endocarditis (Table 78.2)
1. Acute Endocarditis
2. Subacute Endocarditis
Pathogenesis
Laboratory Diagnosis
1. Specimen
2. Cultures
3. Identification
4. Antibiotic Sensitivity Tests
5. Culture Negative Endocarditis
6. Other Tests for Diagnosis
Treatment
Prevention
IMPORTANT QUESTIONS
1. PURULENT MENINGITIS (ACUTE PYOGENIC MENINGITIS)
Laboratory Diagnosis
A. Collection of Specimens
B. Laboratory Examination of CSF for Cells and Microorganisms
Dilution
Gram Film of CSF
Culture
i. CSF Culture
ii. Blood Culture
Biochemical Tests
Antigen Detection
Agglutination
Demonstration of Bacterial Endotoxin
2. ASEPTIC MENINGITIS
Laboratory Diagnosis
3. TUBERCULOUS MENINGITIS
Laboratory Diagnosis
1. Specimen
2. Microscopy
3. Culture
IMPORTANT QUESTIONS
TYPES OF UTI
1. Lower UTI
2. Upper UTI
Clinical Features
Laboratory Diagnosis
A. Specimen Collection
B. Transport of Specimen
C. Laboratory Methods
1. Microscopy
2. Culture
I. Standard loop Method
Interpretation of Results
Identification and Sensitivity Tests
II. Filter Paper Method
III. Dip-slide Method
Screening Techniques
Differentiation of Upper UTI and Lower UTI
Tuberculosis of Kidney and Urinary Tract
Laboratory Diagnosis
1. Specimen
2. Direct Ziehl–Neelsen Staining
3. Culture
IMPORTANT QUESTIONS
Laboratory Diagnosis
A. Specimen
B. Direct Microscopy
C. Culture
D. Identification
2. Gram Staining or Albert Staining
i. Gram Staining
ii. Albert Staining
3. Other Tests for Confirmation
E. Antibiotic Sensitivity
PNEUMONIA
1. CLASSIFICATION
A. Community-acquired Pneumonia
Typical Pneumonia Syndrome
Atypical Pneumonia Syndrome
B. Hospital-acquired Pneumonia
C. Pneumonia in lmmunocompromized Patients
Laboratory Diagnosis
A. Specimen
B. Direct Microscopy
C. Culture
D. Detection of Bacterial Antigens
Direct Immunofluorescence Test
E. Serology
IMPORTANT QUESTIONS
A. Diarrhea
B. Gastroenteritis
C. Dysentery
D. Traveller's Diarrhea
DIARRHEA
Laboratory Diagnosis
A. Bacteria
Laboratory diagnosis
4. Shigellae
Laboratory Diagnosis
5. Campylobacter jejuni
Laboratory Diagnosis
6. Yersinia enterocolitica
Laboratory Diagnosis
7. Clostridium perfringens
Laboratory Diagnosis
8. Clostridium difficile
Laboratory Diagnosis
9. Staphylococcus aureus
Laboratory Diagnosis
10. Bacillus cereus
Laboratory Diagnosis
11. Other Bacteria
B. Viruses
Laboratory Diagnosis
C. Protozoa
Laboratory Diagnosis
a. Saline Preparation and Iodine Mount
b. Acid-fast Staining
D. Fungus
DYSENTERY
IMPORTANT QUESTIONS
A. Infective Type
B. Toxic Type
C. Infective-toxic Type
IMPORTANT QUESTIONS
Etiology
Laboratory Diagnoses
A. Syphilis
B. Lymphogranuloma Venereum (LGV)
C. Donovanosis
D. Chancroid
E. Herpes genitalis
F. Gonorrhea
G. Nongonococcal Genital Infection
Laboratory Diagnosis
H. Trichomoniasis
I. Bacterial Vaginosis-associated Organisms
J. Vulvovaginal Candidiasis
K. Genital Warts
IMPORTANT QUESTIONS
Laboratory Diagnosis
A. Naked-eye Examination
B. Microscopy
C. Culture
D. Identification of Isolates
E. Antibiotic Sensitivity
IMPORTANT QUESTIONS
Causes of PUO
Laboratory Diagnosis of PUO
A. Bacterial Infections
1. Specimens
2. Collection
3. Culture
4. Identification
5. Serology
B. Parasitic Infections
C. Viral Infections
D. Fungal Infections
E. Other Tests for Diagnosis
1. Skin Tests
2. Hematological Investigations
3. Immunologic Tests
4. Biopsy
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 79:
Hospital-acquired Infection
INTRODUCTION
SOURCES OF INFECTIONS
A. Exogenous
B. Endogenous
FACTORS INFLUENCING HOSPITAL-ASSOCIATED INFECTIONS
MICROORGANISMS CAUSING HOSPITAL INFECTION
ROUTES OF TRANSMISSION
COMMON HOSPITAL-ACQUIRED INFECTION
1. Urinary Tract Infection
2. Respiratory Infections
3. Wound and Skin Sepsis
4. Gastrointestinal Infections
5. Burns
6. Bacteremia and Septicemia
DIAGNOSIS AND CONTROL OF HOSPITAL INFECTION
INFECTION CONTROL POLICY
PREVENTION
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 80:
Laboratory Control of Antimicrobial Therapy
INTRODUCTION
ANTIBIOTIC SENSITIVITY TESTS
Disk Diffusion Methods
Medium
Control Strains
Antibiotic Disks
KIRBY–BAUER DISK DIFFUSION METHOD
Procedure
A. Preparation of Inoculum (Growth Method)
B. Testing of Antibiotics
C. Interpretation
STOKES DISK DIFFUSION METHOD
Reading and Reporting Results
Exceptions
Primary Sensitivity Tests
Epsilometer or E-test
Minimum Inhibitory and Bactericidal Concentrations
DILUTION METHODS
Broth Dilution Method
Principal Uses of MIC
Agar Dilution Method
ANTIBIOTIC ASSAYS IN BODY FLUIDS
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 81:
Antimicrobial Chemotherapy
ANTIMICROBIAL AGENT
ANTIBIOTIC
CHEMOTHERAPEUTIC AGENTS
ANTIBACTERIAL AGENTS
MECHANISMS OF ACTION OF ANTIBACTERIAL DRUGS
1. Inhibititon of Bacterial Cell Wall Synthesis
A. β-Iactam Agents
Penicillins
Cephalosporins
Other β-Lactam Antibiotics
Carbapenems
Glycopeptides
Other Inhibitors of Bacterial Cell Wall Synthesis
2. Inhibition of Bacterial Cytoplasmic Membrane Function
3. Inhibitors of Nucleic Acid Synthesis Quinolones
Rifamycins
Nitroimidazoles
Nitrofurans
Novobiocin
4. Inhibition of Bacterial Protein Synthesis
Aminoglycosides
Chloramphenicol
Tetracyclines
Macrolides
Lincosamides
Fusidic Acid
Streptogramins
Mupirocin
5. Metabolic Antagonism
Sulfonamides and Diaminopyrimidines
Mechanism of Action of Sulfonamides (Fig. 81.2)
ANTIBIOTIC RESISTANCE
Mechanisms of Drug Resistance
A. Acquired Antimicrobial Resistance
B. Genetic Basis of Antibiotic Resistance
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 82:
Immunoprophylaxis
INTRODUCTION
Immunizing Agents
A. VACCINES
Types of Vaccines
1. Live Vaccines
2. Killed (Inactivated) Vaccines
3. Toxoids
4. Cellular Fractions
5. Mixed or Combined Vaccine
6. Recombinant-vector Vaccines
7. DNA Vaccines
IMMUNIZATION
A. Active Immunization
Immunization Schedules
Expanded Program on Immunization
B. Passive Immunization
1. Normal Human Immunoglobulin
2. Specific Human Immunoglobulin
3. Antisera
C. Combined Passive and Active Immunization
Individual Immunization
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 83:
Bacteriology of Water, Milk and Air
BACTERIOLOGY OF WATER
Introduction
BACTERIAL FLORA IN WATER
FACTORS DETERMINING THE NUMBER OF BACTERIA IN WATER
WATER-BORNE PATHOGENS
COLLECTION OF WATER SAMPLES
1. Sampling from a Tap or Pump Putlet
2. Sampling from Reservoir (Streams, Rivers, Lakes and Tanks)
3. Sampling from a Dug Well
Transport
BACTERIOLOGICAL EXAMINATION OF WATER
a. Multiple Tube Test
b. Membrane Filtration Tests
A. Plate Count
B. Counting of Indicator Organisms
a. Multiple tube test
1. Total Coliform Count or Presumptive Coliform Count
2. Eijkman Test
3. Count of Fecal Streptococci
4. Count of Clostridium perfringens
b. Membrane Filtration Tests
Tests for Pathogenic Bacteria
BACTERIOLOGY OF MILK
Milk-borne Diseases
Bacteriological Examination of Milk
1. Viable Count
2. Test for Coliform Bacilli
3. Chemical Tests
4. Examination for Specific Pathogens
EXAMINATION OF AIR
Measurement of Air Contamination
1. Settle Plate Method
2. Slit Sampler Method
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 84:
Hospital Waste Management
INTRODUCTION
UNIVERSAL PRECAUTIONS
DEFINITION OF BIOMEDICAL WASTE (BMW)
CATEGORIES OF BIOMEDICAL WASTE
WASTE SEGREGATION
Yellow Bags
Red Bags
Blue/White Translucent
Black
TREATMENT AND DISPOSAL TECHNOLOGIES FOR HEALTHCARE WASTE
Waste Treatment
1. Incineration
2. Autoclaving
3. Chemical Disinfection
4. Wet and Dry Thermal Treatment
5. Microwave Irradiation
6. Inertization
DISPOSAL
Waste Management Program
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 85:
Vehicles and Vectors
INTRODUCTION
VEHICLES AND VECTORS
1. Vehicle-borne
A. Diseases Transmitted by Water and Food
B. Diseases Transmitted by Blood
1. Viruses
2. Bacteria
3. Parasites
2. Vector-borne
A. Mechanical Transmission
B. Biological Transmission
Medical Entomology
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 86:
Emerging and Re-emergingInfectious Diseases
INTRODUCTION
Examples of Emerging Pathogens
RE-EMERGING, OR RESURGING DISEASES
Important Examples of Re-emerging Infections in India
Antimicrobial Resistance
Responding to Epidemics
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
SECTION 7: DIAGNOSTIC MEDICAL MICROBIOLOGY
CHAPTER 87:
Molecular Detection of Microorganisms
INTRODUCTION
MOLECULAR METHODS
A. Hybridization (See Chapter 10 for detail)
B. Amplified Methods
C. Sequencing and Enzymatic Digestion of Nucleic Acids
APPLICATIONS OF MOLECULAR METHODS IN CLINICAL LABORATORY
1. Detection of Uncultivable and Slow Growing Microorganisms
2. Role in Clinical Virology
3. Disease Prognosis
4. Response to Treatment and Drug Resistance
IMPORTANT QUESTION
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 88:
Staining Methods
INTRODUCTION
PREPARING FILM OR SMEAR FOR STAINING
Slides
TYPES OF STAIN
A. STAINED PREPARATIONS
Common Staining Techniques
A. SIMPLE STAINS
B. DIFFERENTIAL STAINS
a. Gram Stain
Method
b. Acid Fast Stain (Ziehl–Neelsen Staining of Acid Fast Bacilli)
Principle
Fluorochrome Staining for Acid Fast Bacteria
C. SPECIAL STAINS
1. Negative Staining for Capsules
2. Endospore (Spore) Staining
3. Flagella Staining
Staining of Volutin-containing Organisms
Special Stains for Corynebacterium diphtheriae (Stains to Demonstrate Metachromatic Granules)
1. Albert's Stain
2. Neisser's Stain
3. Ponder's Stain
4. Pugh's Stain
IMPORTANT QUESTIONS
MULTIPLE CHOICE QUESTIONS (MCQS)
CHAPTER 89:
Practical Microbiology for MBBS Students
INTRODUCTION
1. SPOTS
2. STAINING FOR PRACTICAL EXAMINATION
A. Ziehl–Neelsen (Z–N) Staining or Acid Fast Staining
Procedure
Important Points in Observation
Acid-fast Organisms
B. Albert's stain
Staining Solution
Procedure
Gram Staining (See Also Chapter 88)
REAGENTS
A. Violet Dye
B. Gram's Iodine
C. Decolorizer
D. Safranine Counterstain
Procedure
Interpretation of Gram Staining
Gram Staining Mechanism
Gram-positive Cells
Gram-negative Cells
Cell Wall Integrity
GRAM-POSITIVE AND GRAM-NEGATIVE BACTERIA
3. IDENTIFICATION OF BACTERIAL CULTURE
A. Identification of Bacterial Culture: An Overview
Identification Scheme
A. Culture Plate
B. Liquid Medium
i. Liquid Culture Medium
Hanging Drop Preparation
Procedure
Important Points for Observing Motility of Organisms
C. Provisional Diagnosis
D. Final Identification of Bacteria
E. Interpretation and Practical Examination
Points to Remember for Identification of Bacteria in Practical Examination
B. Bacterial Culture Identification
1. Nutrient Agar
Observations (Fig. 89.5)
Confirmatory Biochemical Reactions for Pseudomonas aeruginosa
2. Blood Agar
A. Gram-positive cocci Observations
STAPHYLOCOCCUS
Observations
A. Solid Media
B. Liquid Media
C. Gram Staining and Hanging Drop Preparation
D. Presumptive Diagnosis- Staphylococcus sp
Streptococcus pyogenes
Observations
A. Solid Media
B. Liquid Media
C. Gram Staining and Hanging Drop Preparation
D. Presumptive Diagnosis
E. Confirmatory Tests
BACILLUS PROTEUS SP.
A. Solid Media
B. Liquid Media
C. Gram Staining and Hanging Drop Preparation
D. Presumptive Diagnosis
E. Confirmatory Tests
F. Final Diagnosis
3. MacConkey's Agar
Lactose Fermenter (LF)
A. Solid Media
B. Liquid Broth
C. Gram Staining and Hanging Drop Preparation
D. Identification
E. Presumptive Diagnosis
F. Confirmatory Tests by Various Biochemical Reactions (Table 89.5)
B. Nonlactose Fermenter (NLF) Colonies
A. Solid Media
B. Liquid Broth
C. Gram Staining and Hanging Drop Preparation
D. Presumptive Diagnosis
E. Confirmatory Tests
IV. Bacterial Growth on any Other Medium
4. STOOL/FECES EXAMINATION
Method
Caution
Precautions
Identification of Eggs and Cysts
A. Eggs—Bile stained
2. Trichuris trichiura (Fig. 89.16)
3. Taenia sp. (Fig. 89.17)
B. Eggs—Nonbile Stained (colorless)
1. Hookworm (Fig. 89.18)
2. Enterobius vermicularis (Fig. 89.19)
3. Hymenolepis nana (Fig. 89.20)
Cysts
Giardia lamblia (Fig. 89.22)
INDEX
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