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Essentials of Medical Microbiology. Fourth Edition

Essentials of Medical Microbiology. Fourth Edition

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Rajesh Bhatia
MD (Medical Microbiology)
Formerly Director National Institute of Biologicals, New Delhi
and
Department of Microbiology
Maulana Azad Medical College, New Delhi
India

Rattan Lal Ichhpujani
MD (Medical Microbiology)
Additional Director and
Chief of Division of HIV/AIDS and Related Diseases
National Institute of Communicable Diseases, Delhi
Formerly Department of Microbiology
Medical College, Rohtak
Haryana
India

First Edition: 1994
Second Edition: 1999
Third Edition: 2004
Fourth Edition: 2008

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Book Details
 Price
 3.00
 Pages
 517 p
 File Size 
 12,244 KB
 File Type
 PDF format
 ISBN
 81-8448-154-3  
 Copyright©   
 2008,
 Jaypee Brothers Medical Publishers 

Preface to the Fourth Edition
Teaching of Medical Microbiology to the MBBS students is changing rapidly. This is primarily due to emergence of newer pathogens, newer diagnostic tools, emerging and re-emerging infections and above all shrinking time available to accommodate all this. Microbiology continues to be the backbone of understanding diagnosing and controlling the communicable diseases. Our primary focus of this Fourth Edition is to update various chapters, delete the contents that have become relatively unimportant and enhanced focus on the topics of current interest. For easy assimilation and reproducibility of the subject by the students, a lot of tables, figures and flow charts have been included. The book is for the first time being printed in colour which will definitely enhance its acceptability by our valued readers.
We are deeply indebted to Shri Jitendar P Vij, Chairman and Managing Director, Jaypee Brothers Medical Publishers and his dedicated team for their magnificent support in bringing this book to its current shape. We continue to be thankful to our family members, friends, well-wishers and above all our dear students for their continuous support. We are optimistic that this revised edition will be liked by our readers. We look forward to their patronage.
Rajesh Bhatia
RL Ichhpujani

Table of Contents
PART I: History and Scope of Medical Microbiology
1. History of Medical Microbiology 1
Contributions of Louis Pasteur 1; Contributions of Robert Koch 2; 
Antimicrobial Agents 3; Discovery of Viruses 4; Nobel Laureates 5
2. Scope of Medical Microbiology 6
Microorganism 6; Microbiology and Patient 6; Microbiology and Healthy Individual 7; Microbiology and Community 7; Branches of Microbiology 7; Role of Medical Microbiology 7

PART II: Cellular and Molecular Microbiology
3. Bacterial Morphology 8
The Bacterial Cell 9; Bacterial Spores 15; 
Classification of Bacteria 17; Techniques to Study Morphology of Bacteria 17
4. Nutrition and Growth of Bacteria 22
Nutrients 22; Oxygen and Carbon Dioxide 22; 
Temperature 23; Moisture and Desiccation 24;
Bacterial Metabolism 24; Bacterial Growth 24
5. Bacterial Genetics 27
Mutations 29; Gene Transfer 29; 
Newer Approaches to Bacterial Genetics 32; Genetic Engineering 32
6. Bacteriophage 38
7. In Vitro Cultivation of Bacteria 41
Bacteriological Media 41; Cultivation of Bacteria 43; Anaerobic Cultures 45
8. Identification of Bacteria 46

PART III: Microbial Control and Mechanism of Pathogenicity
9. Disinfection and Sterilization 49
Definitions 49; Physical Agents 49; 
Chemical Agents 53; Ideal Disinfectant 56; Combined Treatments 59
10. Antimicrobial Chemotherapy 60
Antiviral Drugs 62; Antifungal Drugs 62;
 Drug Resistance 63; Biochemical Mechanisms of
Drug Resistance 63
11. Infection and Disease 65
Dynamics of Infectious Diseases 66
12. Microbial Pathogenicity 69
Pathogenic Microorganisms 69; 
Virulence Factors of Microorganisms 69

PART IV: Immunology
13. Nonspecific Defenses of Host 74
Host-parasite Relationship 74; Resistance of Host to Microorganisms 74
14. Overview of Acquired Immunity 78
15. Functional Anatomy and Development of Immune System 82
16. Biology of Immune Response 85
Dynamics of Antigen Elimination 85; 
Immune Response 85; 
Uses of Primary and Secondary Immune Responses 86; 
Factors Influencing Antibody Production 87
17. Antigen 88
18. Antibody 91
Monoclonal Antibody (Hybridomas) 94
19. Cells of Immune System 95
Major Cells of Immune System 95
20. The Complement System 100
21. Antigen-Antibody Reactions 105
Precipitation 106; Agglutination 110; 
Complement Fixation Test 112; Neutralisation Tests 113;
Immunofluorescence 114; Enzyme Immunoassays 115; 
Radioimmunoassay 115; Miscellaneous Tests 116; Opsonisation 117
22. Hypersensitivity 118
Type I Hypersensitivity 118; Type II Hypersensitivity 120; 
Type III Hypersensitivity 121; Type IV
Hypersensitivity 122; Type V Stimulatory Hypersensitivity 123
23. Immunodeficiency 125
24. Autoimmunity 128
Major Histocompatibility Complex (MHC) 128; Autoimmunity 128
25. Transplantation and Malignancy 131
Tumour Immunology 132
26. Blood Group Antigens 135
PART V: Gram-positive Bacteria
27. Staphylococcus 139
Species of Staphylococcus 139; Staphylococcus aureus 139; 
Coagulase Negative Staphylococci 146; 
Staphylococcus epidermidis 146; 
Staphylococcus saprophyticus 146; Micrococcus 147; Planococcus 147
28. Streptococcus 148
Streptococcus pyogenes 149; Other Pathogenic Streptococci 154;
 Group C and G Streptococci 155;
Group D Streptococci 155; Viridans Streptococci 156
29. Pneumococcus 158
30. Corynebacterium 162
Corynebacterium Diphtheriae 162; Other Corynebacteria 167
31. Mycobacterium 169
Mycobacterium tuberculosis 169; 
Tests for Confirmation of Identity 175 
Mycobacterium leprae 178; Atypical Mycobacteria 181; 
Mycobacteria Producing Skin Ulcers 182; Saprophytic mycobacteria 183
32. Bacillus 184
Bacillus anthracis 184; Anthracoid bacilli 187;
 Bacillus cereus 187; Bacillus stearothermophilus 188; Other Bacillus Species 188
33. Clostridium 189
Clostridium botulinum 190; Clostridium difficile 192; 
Clostridium perfringens 193;
Clostridium novyi 196; Clostridium septicum 196; 
Other Histotoxic Clostridia 197; Clostridium tetani 197
34. Actinomycetes 200
Actinomycosis 200; Nocardiosis 201; Actinomycotic Mycetoma 202

PART VI: Gram-negative Bacteria
35. Neisseria 203
Neisseria meningitidis 203; Neisseria gonorrhoeae 206; 
Other Neisseriae 208
36. Haemophilus 209
Haemophilus influenzae 209; Other Haemophilus Species 212; 
Gardnerella vaginalis 213
37. Bordetella 214
Bordetella parapertussis 217;
 Bordetella bronchiseptica 217; Bordetella avium 217
38. Brucella 218
39. Enterobacteriaceae 222
Escherichia coli 224; Klebsiella 228; Proteeae 228; 
Other Members of Enterobacteriaceae 230
40. Salmonella 232
Enteric Fever 235; Salmonella Gastroenteritis 240; 
Salmonella bacteraemia with Focal Lesions 240
41. Shigella 241
42. Yersinia 245
Yersinia pestis 245; Yersinia pseudotuberculosis 248; 
Yersinia enterocolitica 249
43. Vibrio 251
Vibrio cholerae 251; V. parahaemolyticus 256; 
Aeromonas 256; Plesiomonas 257
44. Pseudomonas 258
Pseudomonas aeruginosa 258; 
Other Species of Pseudomonas 260; Burkholderia mallei 260; Burkholderia
pseudomallei 260; Burkholderia cepacia 260

PART VII: Spirochaetes and Other Bacteria
45. Treponemes 261
Treponema 262; Treponema Pallidum 262; 
Pinta 269; Endemic Syphilis 270
46. Leptospira 271
47. Borrelia 274
Borrelia vincenti 275; Lyme Disease 275
48. Mycoplasma 276
49. Chlamydia 278
Psittacosis 280; Trachoma 280; 
Lymphogranuloma venereum 280
50. Rickettsia 282
Epidemic Typhus 284; Brill-Zinsser Disease 284; 
Endemic or Murine Typhus 284; Scrub Typhus 284; 
Trench Fever (Quintana Fever) 285; 
Rocky Mountain Spotted Fever 285 Q-fever 285; 
Laboratory Diagnosis of Rickettsial Diseases 286; 
Ehrlichia 287; Rochalimaea 287
51. Non-sporing Anaerobes 288
Anaerobic Gram-negative Bacilli 288; Bacteroides, 
Prevotella and Porphyromonas 288; 
Fusobacteria and Leptotrichia 290; 
Anaerobic Gram-positive Bacilli 290; Anaerobic Cocci 290; 
Peptostreptococcus and Peptococcus 290; 
Veillonella and Acidaminococcus 291; 
Spiral Shaped Motile Anaerobes 291
52. Legionella 292
Legionella pneumophila 292
53. Campylobacter and Helicobacter 294
Helicobacter pylori 295; Gastrospirillum hominis 296
54. Miscellaneous Bacteria 297
Pasteurella multocida 297; Actinobacillus 297; 
Francisella tularensis 297; Streptobacillus moniliformis 298; 
Spirillum minus 298; Listeria monocytogenes 298; 
Erysipelothrix rhusiopathiae 299; Calymmatobacterium 
granulomatis 299; Eikenella 299; Cardiobacterium 300; 
Chromobacterium 300; Achromobacter 300; 
Capnocytophaga 300; DF-2 Bacteria 300; 
Flavobacterium meningosepticum 300; Kingella 300;
acinetobacter 301; Alcaligenes 301; Bartonella 301
55. Normal Microbial Flora of the Human Body 302
Sites with Normal Flora 303

PART VIII: General Virology
56. Nature and Classification of Viruses 306
Viroids 308; Prions 308
57. Morphology of Viruses 209
58. Replication of Viruses 313
Release 314; Defective Viruses 315
59. Cultivation and Assay of Viruses 316
60. Genetics of Viruses 320
Mutations 320; Genetic Recombination Between Viruses 320; 
Interaction Between Viral Gene Products 320;
Genetic Variation in Nature 321; Viral Vectors 321
61. Viral Pathogenesis and Host Response 322
Pathogenicity of Viruses 322; Host Response to Viral Infections 323
62. Oncogenic and Teratogenic Viruses 328
Oncogenic Viruses 328; Teratogenic Viruses 329

PART IX: DNA Viruses
63. Adenoviruses 330
Adenoviruses Associated Defective Viruses 332
64. Herpesviruses 333
Herpes Simplex Virus 334; Varicella-zoster Virus 336; 
Cytomegalovirus 337; Human Herpesvirus 6 339;
Human Herpesvirus 7 340
65. Poxviruses 341
Smallpox 341; Human Monkeypox 342; 
Cowpox 342; Buffalopox 342; Tanapox 343; Milker’s Nodules 343;
ORF 343; Molluscum contagiosum 343
66. Papovaviruses 344
Human Papillomaviruses 344; Human Polyomaviruses 345
67. Parvoviruses 346

PART X: RNA Viruses
68. Picornaviruses 348
Poliovirus 348; Coxsackieviruses 351; 
Echoviruses 352; Enteroviruses Types 68-72 353; Enterovirus 71 353;
Rhinoviruses 353
69. Paramyxoviruses 355
Measles 355; Mumps 357; Infections Caused 
by Parainfluenza Viruses 359; Infections Caused by
Respiratory Syncytial Virus 359
70. Orthomyxoviruses 361
Avian Influenza (Bird Flu) 364
71. Retroviruses 367
Human T Cell Leukaemia Viruses 367; 
Human Immunodeficiency Virus 368
72. Rhabdoviruses 382

PART XI: Multiple Viral Complexes
73. Viral Hepatitis 389
Hepatitis A Virus 389; Hepatitis B Virus 391; 
Hepatitis C 396; Hepatitis E 397; Hepatitis D 398;
Hepatitis G 399; Hepatitis F 400; Overview of Viral Hepatitis 400
74. Arboviruses 401
Definition 401; Virology of Common Arboviruses 401;
 Togaviridae 402; Bunyaviridae 402; General Clinical
Features 403; Laboratory Diagnosis of Arboviruses 404; 
Arboviral Diseases in India 404; Dengue Fever
and Dengue Haemorrhagic Fever 405; 
Kyasanur Forest Disease 406; Chikungunya Virus 407
75. Miscellaneous Viruses 408
Rubella 408; Rotavirus 410; Coronaviridae 411; 
Arenaviridae 412; Lymphocytic Choriomeningitis 413;
Argentinian Haemorrhagic Fever 413; 
Bolivian Haemorrhagic Fever 413; 
Lassa Fever 413; Filoviruses (Ebola and Marburg Virus) 413

PART XII: Mycotic Infections
76. Medical Mycology 415
Spore Formation in Fungi 416; Economic Importance of Fungi 419; Mycoses 419; Tinea Versicolor 419; White Piedra (Piedra Alba) 420; Black Piedra (Piedra Nigra) 420; Dermatophytes 421; Dermatophytids (ID Reaction) 424; Paracoccidioidomycosis 424; Blastomycosis 425; Histoplasmosis (Darling’s Disease) 426; Candidiasis 427; Mycetoma 429; Cryptococcosis 430; Rhinosporidiosis 431; Sporotrichosis 432; Coccidioidomycosis 433; Opportunistic Fungi 434; Otomycosis 435; Fungal Contaminants 435; Absidia Species 436; Mucor Species 436; Rhizopus Species 436; Septate Contaminants 437; Dematiaceous Contaminants 437; Alternaria Species 437; Cladosporium (Hormodendrum Species) 437; Curvularia Species 438; Penicillium Species 438; Mycotoxicosis 438; Immunodiagnosis of Fungal Infections 438

PART XIII: Applied Microbiology
77. Microbiology of Water, Milk and Air 440
Examination of Milk 444; Bacteriological Examination of Milk 445; Examination of Milk for Specific Pathogens 446; Examination of Air 446
78. Nosocomial Infections 448
Role of Microbiology Laboratory in Prevention and Control of Nosocomial Infections 450
79. Blood Transfusion Associated Infections 452
Blood Culture 453
80. Quality Assurance in Microbiology 455
81. Immunoprophylaxis Against Infectious Diseases 458
Vaccine 458; Immunoglobulins and Antisera 460
Essentials of Medical Microbiology

PART XIV: Clinical Microbiology
82. Laboratory Diagnosis of Important Clinical Syndromes 462
Laboratory Diagnosis of Meningitis 462; Laboratory Diagnosis of Tetanus 465; Laboratory Diagnosis of Gas Gangrene 466; Laboratory Diagnosis of Urinary Tract Infections 467; Laboratory Diagnosis of Pertussis 468; Laboratory Diagnosis of Pyrexia of Unknown Origin 470; Laboratory Diagnosis of AIDS 472; Molecular Level Detection 474; Laboratory Diagnosis of Syphilis 474; Laboratory Diagnosis of Sore Throat 476; Laboratory Diagnosis of Cholera 478; Laboratory Diagnosis of Diarrhoeal Diseases (Gastroenteritis) 480; Laboratory
Diagnosis of Acute Respiratory Infections (ARI) 484
Index 489

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