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Textbook of Microbiology for BSc Nursing
Surinder Kumar
SECTION I: GENERAL MICROBIOLOGY
CHAPTER 1:
Historical Development of Microbiology
INTRODUCTION AND SCOPE
IMPORTANCE AND RELEVANCE OF MICROORGANISMS
Beneficial Influence
Harmful Influence
Importance of Microbiology in nursing
THE DISCOVERY OF MICROORGANISMS
Antony van Leeuwenhoek (1632–1723)
SCIENTIFIC DEVELOPMENT OF MICROBIOLOGY
Louis Pasteur (1822–1895)
Joseph Lister (1827–1912)
Robert Koch (1843–1910)
Contributions of Robert Koch
Discovery of Viruses
Edward Jenner (1749–1823)
NOBEL PRIZES AWARDED FOR RESEARCH IN MICROBIOLOGY
CHAPTER 2:
Microscopy and Morphology of Bacteria
MICROSCOPY
Light Microscopy
Compound Light Microscopy
Methods of Use of Light Microscope
MORPHOLOGY OF BACTERIA
Naming and Classifying Microorganisms
Nomenclature
Comparison of Prokaryotic Cells and Eukaryotic Cells
Size of Bacteria
Study of Bacteria
Stained Preparations
Shape of Bacteria
ARRANGEMENT OF BACTERIAL CELLS
ANATOMY OF THE BACTERIAL CELL
BACTERIAL CELL COMPONENTS
A. CELL ENVELOPE AND ITS APPENDAGES
The Outer Layer or Cell Envelope
1. Cell Wall
2. Cytoplasmic (Plasma) Membrane
Cellular Appendages
i. Capsule or Slime Layer
Demonstration of Capsule
Functions of Capsule
Parts and Composition
Arrangement/Types (Fig. 2.8)
B. CELL INTERIOR
L-FORMS OF BACTERIA (CELL-WALL-DEFECTIVE ORGANISMS)
CHAPTER 3:
Physiology of Bacteria
PRINCIPLES OF BACTERIAL GROWTH
Bacterial Division
Generation Time or Doubling Time
Bacterial Count
BACTERIAL GROWTH CURVE
Phases of Bacterial Growth Curve
1. Lag Phase
2. Log (logarithmic) or Exponential Phase
3. Stationary Phase
4. Decline or Death Phase
Bacterial Nutrition
Categories of Requirements
1. Temperature
2. Oxygen
3. Carbon Dioxide
4. Moisture and Drying
5. pH
6. Light
7. Osmotic Effect
8. Mechanical and Sonic Stresses
CHAPTER 4:
Culture Media and Culture Methods
INTRODUCTION
CLASSIFICATION OF MEDIA
A. Phases of Growth Media
B. Based on nutritional Factors
1. Simple Media (Basal Media)
2. Complex Media
3. Synthetic or Chemically Defined Media
C. Special Media (Table 4.2)
1. Enriched Media (Table 4.2)
2. Enrichment Media (Table 4.3)
3. Selective Media (Table 4.2)
4. Indicator Media (Table 4.2)
5. Differential Media
6. Sugar Media
7. Transport Media
D. Anaerobic Media (Table 4.3)
CULTURE METHODS
CHAPTER 5:
Sterilization and Disinfection
INTRODUCTION
Definitions of Frequently used Terms
APPLICATIONS OF STERILIZATION AND DISINFECTION
METHODS OF STERILIZATION AND DISINFECTION (TABLE 5.1)
A. Physical Agents
Mechanism of Action
Chemical Agents
MECHANISMS OF ANTIMICROBIAL ACTION
A. Agents that Damage the Cell Membrane
1. Surface-active Agents
2. Phenols and Phenolics
Alcohols
CHAPTER 6:
Infection and Asepsis
MICROORGANISMS AND HOST
A. Saprophytes
B. Parasites
Pathogens
Commensals
INFECTION
Sources of Infection
1. Human beings
2. Animals
MODES OF TRANSMISSION OF INFECTION
FACTORS PREDISPOSING TO MICROBIAL PATHOGENICITY
Pathogenicity and virulence
SECTION II: IMMUNOLOGY
CHAPTER 7:
Immunity
DEFINITION
CLASSIFICATION
IMMUNITY
Innate or Natural Immunity
Nonspecific and Specific Immunity
Mechanisms of Innate Immunity
Types of Immunity
Acquired immunity
CHAPTER 8:
Antigens
ANTIGENS
Types of Antigen
Antigenic determinant or epitome
Determinants of antigenicity
CHAPTER 9:
Antibodies—Immunoglobulins
INTRODUCTION
ANTIBODY STRUCTURE
Classes of L Chains
Classes of H Chains
Constant and Variable Regions
Fc Fragment
IMMUNOGLOBULIN CLASSES
ROLE OF DIFFERENT IMMUNOGLOBULIN CLASSES
CHAPTER 10:
The Complement System
COMPLEMENT
Complement System
Components of Complement
Classical Complement Pathway
Alternative Complement Pathway
BIOLOGICAL EFFECTS OF COMPLEMENT
CHAPTER 11:
Antigen-Antibody Reactions
INTRODUCTION
Uses
GENERAL CHARACTERISTICS OF ANTIGEN-ANTIBODY REACTIONS
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
B. Agglutination Reactions
C. Complement Fixation Test (CFT)
CHAPTER 12:
Structures and Functions of the Immune System
INTRODUCTION
TYPES OF IMMUNE RESPONSE
ORGANS AND TISSUES OF THE IMMUNE SYSTEM
The lymphoid System
Lymphoid Cells
Lymphoid Organs
i. T Lymphocytes
ii. Cells and Plasma Cells
B Cell Maturation
MAJOR HISTOCOMPATIBILITY COMPLEX
CHAPTER 13:
Immune Response
DEFINITION
TYPE OF IMMUNE RESPONSE
a. Antibody Mediated Immunity (AMI)
b. Cell Mediated Immunity (CMI)
HUMORAL IMMUNITY
Synthesis of Antibody
Primary and Secondary Responses
Primary Humoral Response
Secondary Humoral Response
PRODUCTION OF ANTIBODIES
CHAPTER 14:
Hypersensitivity Reactions
HYPERSENSITIVITY
Classification of Hypersensitivity Reactions
GELL AND COOMBS CLASSIFICATION
Type 1 Hypersensitivity (IgE dependent)
Anaphylaxis
Type II Hypersensitivity: Cytolytic and Cytotoxic
Type III Hypersensitivity: Immune Complex-mediated
Models of Immune Complex: Mediated Disease
Diseases Associated with Immune Complexes
Types of Delayed Hypersensitivity
CHAPTER 15:
Autoimmunity
INTRODUCTION
DEFINITION
MECHANISMS OF AUTOIMMUNITY
CLASSIFICATION OF AUTOIMMUNE DISEASES
SECTION III:
CHAPTER 16:
Staphylococcus
INTRODUCTION
STAPHYLOCOCCUS AUREUS
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
ANTIGENIC STRUCTURE OF STAPHYLOCOCCUS AUREUS
COAGULASE-NEGATIVE STAPHYLOCOCCI
Staphylococcus epidermidis
Clinical Infection
CHAPTER 17:
Streptococcus and Enterococcus
INTRODUCTION
CLASSIFICATION (FIG. 17.2)
A. Hemolytic Activity
B. Serological Properties
C. Biolochemical (Physiologic) Properties
STREPTOCOCCUS PYOGENES
Morphology
A. Suppurative Streptococcal Disease
B. Non-suppurative Sequelae
1. Acute Suppurative Infections
OTHER STREPTOCOCCI PATHOGENIC FOR HUMANS
Group B Streptococci: Streptococcus agalactiae
Clinical Diseases
Diagnosis
Group D streptococci
CHAPTER 18:
Pneumococcus
INTRODUCTION
MORPHOLOGY
CULTURAL CHARACTERISTICS
BIOCHEMICAL REACTIONS
A. Capsular Antigens
B. Somatic Antigen
Pathogenesis
Laboratory Diagnosis
CHAPTER 19:
Neisseria and Moraxella
INRODUCTION
NEISSERIA MENINGITIDIS
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Classification
Three Stages
NEISSERIA GONORRHOEAE (GONOCOCCUS)
CHAPTER 20:
Corynebacterium
CORYNEBACTERIUM
CORYNEBACTERIUM DIPHTHERIAE
Morphology
Cultural Characteristics
Biochemical Reactions
Toxin
1. Specimens
2. Microscopy
3. Culture
4. Identification Tests
DIPHTHEROIDS
CHAPTER 21:
Bacillus
INTRODUCTION
BACILLUS ANTHRACIS
Morphology
Cultural Characteristics
Pathogenicity
Laboratory Diagnosis
ANTHRACOID BACILLI
BACILLUS CEREUS
CHAPTER 22:
Clostridium
INTRODUCTION
CLOSTRIDIUM PERFRINGENS (CLOSTRIDIUM WELCHII)
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
Alpha Toxin
Enterotoxin
CLOSTRIDIUM TETANI
CLOSTRIDIUM BOTULINUM
CHAPTER 23:
Nonsporing Anaerobes
INTRODUCTION
Classification
Laboratory Diagnosis
CHAPTER 24:
Mycobacterium Tuberculosis
INTRODUCTION
MYCOBACTERIUM TUBERCULOSIS
Morphology
Cultural Characteristics
Solid Medium
Liquid Media
A. Specimens
B. Microscopy
C. Concentration Methods
D. Culture
KOCH PHENOMENON
CHAPTER 25:
Mycobacterium Leprae
INTRODUCTION
MYCOBACTERIUM LEPRAE
Morphology
Cultivation
Classification
Pathogenesis
Procedure
Uses of lepromin reaction
1. Specimens
2. Microscopy
CHAPTER 26:
Nontuberculous Mycobacteria
INTRODUCTION
Classification
Group 1-Photochromogens
Group II-Scotochromogens
Group III-Nonphotochromogens
PATHOGENESIS
LABORATORY DIAGNOSIS
CHAPTER 27:
Actinomycetes: Actinomyces, Nocardia
INTRODUCTION
ACTINOMYCES
Morphology
Cultural Characteristics
Pathogenesis
Actinomycosis
NOCARDIA
CHAPTER 28:
Enterobacteriaceae: Escherichia, Klebsiella, Proteus and other Genera
CHARACTERISTICS OF THE FAMILY ENTEROBACTERIACEAE
CLASSIFICATION OF ENTEROBACTERIACEAE
ESCHERICHIA COLI
Morphology
Cultural Characteristics
Biochemical Reactions
Antigenic Structure
1. Diarrhea
2. Urinary Tract Infection (UTI)
3. Pyogenic Infections
4. Septicemia
EDWARDSIELLA
CHAPTER 29:
Shigella
INTRODUCTION
MORPHOLOGY
CULTURAL CHARACTERISTICS
ANTIGENIC STRUCTURE
Group A (S. dysenteriae)
Group B (S. flexneri)
Group C (S. Boydii)
Group D (S. sonnei)
Identification
CHAPTER 30:
Enterobacteriaceae III—Salmonella
INTRODUCTION
SALMONELLA
Morphology
Cultural Characteristics
Biochemical Reactions
Resistance
1. Enteric Fever
2. Bacteremia with Focal Lesion
3. Gasteroenteritis or Food Poisoning
4. Asymptomatic Carrier State
SALMONELLA GASTROENTERITIS
CHAPTER 31:
Vibrio
INTRODUCTION
Vibrio
VIBRIO CHOLERAE
Morphology
Cultural Characteristics
A. Ordinary Media
B. Special Media
Biochemical Reactions
Classification
HALOPHILIC VIBRIOS
CHAPTER 32:
Campylobacter and Helicobacter
CAMPYLOBACTER
Introduction
Campylobacter jejuni and Campylobacter coli
Morphology
Cultural Characteristics
Biochemical Reactions
Pathogenesis
HELICOBACTER
Helicobacter pylori
CHAPTER 33:
Pseudomonas, Stenotrophomonas and Burkholderia
INTRODUCTION
PSEUDOMONAS AERUGINOSA
Morphology
Cultural Characteristics
Pigment Production
Biochemical Reactions
A. Community Infections
B. Hospital Infections
STENOTROPHOMONAS MALTOPHILIA
BURKHOLDERIA CEPACIA
CHAPTER 34:
Legionella
INTRODUCTION
LEGIONELLA PNEUMOPHILA
Morphology
Culture
Biochemical Reactions
Pathogenesis
CHAPTER 35:
Yersinia, Pasteurella and Francisella
INTRODUCTION
YERSINIA PESTIS
Morphology
Cultural Characteristics
Biochemical Reactions
Pathogenesis
YERSINIOSIS
CHAPTER 36:
Haemophilus
INTRODUCTION
HAEMOPHILUS INFLUENZAE
Morphology
Cultural Characteristics
V Factor
Satellitism
A. Invasive Infections
B. Non-invasive Disease
1. Specimens
2. Collection and Transport
HAEMOPHILLUS DUCREYI
CHAPTER 37:
Bordetella
INTRODUCTION
BORDETELLA PERTUSSIS
Morphology
Cultural Characteristics
Biochemical Reactions
Pathogenesis
CHAPTER 38:
Brucella
INTRODUCTION
MORPHOLOGY
CULTURAL CHARACTERISTICS
BIOCHEMICAL REACTIONS
Types of Human Infection
CHAPTER 39:
Spirochetes
INTRODUCTION
TREPONEMA
Treponema pallidum
Morphology
Cultivation
Antigenic Structure
A. Non-specific Antigen
B. Specific Antigens
Congenital Syphilis
A. Specimen Collection and Handling
NON-VENEREAL TREPONEMATOSES
NON-PATHOGENIC TREPONEMES
CHAPTER 40:
Mycoplasma and Ureaplasma
INTRODUCTION
CLASSIFICATION
MORPHOLOGY
CULTURAL CHARACTERISTICS
Mycopmsma pneumoniae
Ureaplasma urealyticum
Clinical Manifestations
Mycoplasma hominis
CHAPTER 41:
Miscellaneous Bacteria
LISTERIA MONOCYTOGENES
Morphology
Cultural Characters
Biochemical Reactions
Pathogenicity
ERYSIPELOTHRIX RHUSIOPATHIAE
ALCALIGENES FAECALIS
CHROMOBACTERIUM VIOLACEUM
CHAPTER 42:
Rickettsiaceae, Bartonellaceae and Coxiella
INTRODUCTION
CLASSIFICATION
GENUS RICKETTSIA
Morphology
Cultivation
Pathogenesis
A. Typhus Fever Group (Table 42.2)
B. Spotted Fever Group
GENUS ORIENTIA
Laboratory Diagnosis
1. Isolation of Rickettsiae
2. Direct Detection of the Organisms and their Antigens
CHAPTER 43:
Chlamydia and Chlamydophila
INTRODUCTION
CLASSIFICATION
CHLAMYDIA
Morphology
Growth Cycle
Laboratory Propagation
Chlamydia trachomatis
CHLAMYDOPHILA
SECTION IV: VIROLOGY
CHAPTER 44:
General Properties of Viruses
INTRODUCTION
MAIN PROPERTIES OF VIRUSES
MORPHOLOGY OF VIRUSES
Size
Shape of the Virus
Structure and Chemical Composition of the Viruses
Viral Capsid
Virus Symmetry (Fig. 44.2)
Viral Envelope
Viral Nucleic Acids
CULTIVATION OF VIRUSES
A. Animal Inoculation
CHAPTER 45:
Laboratory Diagnosis, Prophylaxis and Chemotherapy of Viral Diseases
LABORATORY DIAGNOSIS OF VIRAL INFECTIONS
IMMUNOPROPHYLAXIS OF VIRAL DISEASES
A. Active Immunization
B. Passive Immunization
CHEMOPROPHYLAXIS AND CHEMOTHERAPY OF VIRUS DISEASES
CHAPTER 46:
DNA Viruses
INTRODUCTION
DNA Viruses
POXVIRUSES
Introduction
Morphology
Cultivation and Host Range
HERPESVIRUSES
VARICELLA-ZOSTER VIRUS
CHAPTER 47:
Hepatitis Viruses
INTRODUCTION
TYPE A HEPATITIS (HAV)—INFECTIOUS HEPATITIS
Morphology
Epidemiology
Clinical Features
Laboratory Diagnosis
HEPATITIS B VIRUS (SERUM HEPATITIS)
HEPATITIS TYPE C
CHAPTER 48:
RNA Viruses
PICORNAVIRUSES
Introduction
Classification
Poliovirus
Morphology
Types
Pathogenesis
Clinical Features
ORTHOMYXOVIRUS
Influenza Viruses
PARAMYXOVIRUSES
RHABDOVIRUSES
CHAPTER 49:
Retroviruses: Human Immunodeficiency Virus
RETROVIRUSES
HUMAN IMMUNODEFICIENCY VIRUS
Structure
Routes/Modes of Transmission
Clinical Features of HIV Infection
Acquired Immune Deficiency Syndrome (Aids)
A. Specific Tests for HIV Infection
B. Non-specific Tests
C. Tests for Opportunistic Infections and Tumors
SECTION V: MEDICAL MYCOLOGY
CHAPTER 50:
General Properties, Classification and Laboratory Diagnosis of Fungi
INTRODUCTION
DIFFERENCES OF FUNGI FROM BACTERIA
GENERAL PROPERTIES OF FUNGI
CLASSIFICATION OF FUNGI
Morphological Classification
Systematic Classification
A. Direct Microscopy
B. Culture
CHAPTER 51:
Superficial, Cutaneous and Subcutaneous Mycoses
A. SUPERFICIAL MYCOSES
B. CUTANEOUS MYCOSES
Dermatophytes
Classification
Clinical Findings
Laboratory Diagnosis
C. SUBCUTANEOUS MYCOSES
RHINOSPORIDIOSIS
CHAPTER 52:
Systemic Mycoses
SYSTEMIC MYCOSES
1. Blastomycosis
Morphology
Pathogenesis
2. Paracoccidioidomycosis
Clinical Manifestaions
Laboratory Diagnosis
3. Coccidioidomycosis
4. Histoplasmosis
CHAPTER 53:
Opportunistic Mycoses
OPPORTUNISTIC FUNGI
CAUSATIVE FUNGAL AGENTS
YEAST AND YEAST-LIKE FUNGI
Candidiasis
Morphology
Species of Candida
Pathogensis
Laboratory Tests
CRYPTOCOCCOSIS
Morphology
Serotypes
Pathogenesis
SECTION VI: MEDICAL PARASITOLOGY
CHAPTER 54:
Protozoology
INRODUCTION
CLASSIFICATION OF PARASITES
PROTOZOA
Entamoeba histolytica
Morphology
Life Cycle
Pathogenesis and Clinical Features
Laboratory Diagnosis
Entamoeba coli
FLAGELLATES
Giardia lamblia ( Giardia intestinalis)
Trichomonas vaginalis
CHAPTER 55:
Helminthology
INTRODUCTION
A. CESTODES
TAENIA SAGINATA
Habitat
Morphology (Table 55.1)
Eggs (Fig. 55.1)
TAENIA SOLIUM
Morphology
Life Cycle of T. solium ( Fig. 55.2).
Cysticercus Cellulosae or ‘Bladder Worm’ (Fig.55.3)
Cysticercus bovis
a. Symptoms Due to the Migrating larvae
SECTION VII: MISCELLANEOUS
CHAPTER 56:
Infective Syndrome*
1. MENINGITIS
A. Purulent Meningitis (Acute Pyogenic Meningitis)
Laboratory Diagnosis
B. Aseptic Meningitis
Laboratory Diagnosis
Tuberculous Meningitis
2. URINARY TRACT INFECTIONS
3. SORE THROAT
4. DIARRHEA
CHAPTER 57:
Laboratory Control of Antimicrobial Therapy
INTRODUCTION
ANTIBIOTIC SENSITIVITY TESTS
A. Diffusion Methods
Disc Diffusion Methods
Kirby-Bauer Disc Diffusion Method
Stokes Disc Diffusion Method
Dilution Methods
CHAPTER 58:
Normal Microbial Flora of the Human Body
INTRODUCTION
NORMAL FLORA OF THE SKIN
NORMAL FLORA OF THE CONJUNCTIVA
NORMAL FLORA OF THE NOSE, NASOPHARYNX AND ACCESSORY SINUSES
CHAPTER 59:
Hospital-Acquired Infection
INTRODUCTION
SOURCES OF INFECTIONS
MICROORGANISMS CAUSING HOSPITAL INFECTION
Routes of Transmission
COMMON HOSPITAL-ACQUIRED INFECTION
CHAPTER 60:
Antimicrobial Chemotherapy
ANTIMICROBIAL AGENT
ANTIBIOTIC
CHEMOTHERAPEUTIC AGENTS
ANTIBACTERIAL AGENTS
1. Inhibiton of Bacterial Cell Wall Synthesis
β-Iactam Agents
Other b-Lactam Antibiotics
2. Inhibition of Bacterial Cytoplasmic Membrane Function
3. Inhibitors of Nucleic Acid Synthesis
Quinolones
Rifamycins
4. Inhibition of Bacterial Protein Synthesis
CHAPTER 61:
Immunoprophylaxis
INTRODUCTION
IMMUNIZING AGENTS
Vaccines
Types of Vaccines
IMMUNIZATION
A. Active Immunization
Immunization Schedules
B. Passive Immunization
a. Normal Human Immunoglobulin
b. Specific Human Immunoglobulin
INDIVIDUAL IMMUNIZATION
CHAPTER 62:
Hospital Waste Management
INTRODUCTION
UNIVERSAL PRECAUTIONS
DEFINITION OF BIOMEDICAL WASTE
CATEGORIES OF BIOMEDICAL WASTE
Waste Segregation
Yellow Bags
Red Bags
Blue/White Translucent
Black
Waste Treatment
Disposal
CHAPTER 63:
Vehicles, Vectors and Rodents
VEHICLES AND VECTORS
VEHICLE-BORNE
VECTOR-BORNE
Definitive Host
Intermediate Host
Infestation
RODENTS
Classification
Mode of Transmission
Antirodent Measures
CHAPTER 64:
Standard Precautions in Health Care
INTRODUCTION
APPLICATIONS OF STANDARD PRECAUTIONS
Important Advice
Health-care Facility Recommendations for Standard Precautions
SECTION VIII: DIAGNOSTIC MEDICAL MICROBIOLOGY
CHAPTER 65:
Diagnostic Procedures in Clinical Microbiology
INTRODUCTION
SPECIMENS
Collection of Specimens
Infections of Wounds and other Tissues
Upper Respiratory, ear and eye Infections
From the Gastrointestinal Tract
From the lower Respiratory Tract
Laboratory Methods for Identification of Microorganisms from Specimens
CHAPTER 66:
Staining Methods
INTRODUCTION
Examination of living Bacteria in unstained Preparations
A. Wet Coverslip Preparation
B. Hanging Drop Preparation
Important Points for Observing Motility of Organisms
Motile Gram Negative Bacilli
Non-motile Gram Negative Bacteria
STAINING METHODS
Preparing Film or Smear for Staining
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