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CLINICAL MICROBIOLOGY tnade ridiculously sitnple™ Edition 6 MarkG ladwin, MD WilliaTmr attlMeDr , C.S cotMta han,M D CLINICAL MICROBIOLOGY MADE RIDICULOUSLY SIMPLE MARK GLADWIN, M.D. WILLIAM TRATTLER, M.D. C.S COTT MAHAN, M.D. @ MedMast,eI rncM.i,a mi ClinMiiccarlo biMoaldRoeig dyi cuSliomupsallieyma stp rovidingp rgiennceoirfmpa illce rso biology anidns o itn tenadsae w do rkignugit dope a tidernuatgd ministPrlaetariseoefent r.ot he maunfactupraecrk'iasnge serfo trr ecommednrdudegod s augned,e sierffeacbtclsoe,n tnrdaiications anddr uign teiroancst. Copyri2g0ht12©40 ,1 230,1 210,0 290,0 8, 2200002607,0, 24 0,0 230,10 1,9 91999,7 1,9 9b5yM edaMstIenrc,. SecoPnrdi nt1i9n9gT5,h; i Prrdi nt1i9n9gF6,o; u rPtrhi nt1i9n9gF7,i; f Ptrhi nt1i9n9g8,; SxitPhr int1i9n9Sg9e,;nv tePhr int2i0n0Eg0i,;g hPtrhi nt2i01n0N;gi ,n Ptrhi nt2i0n0g2,; TenPtrhni ti2n0g0,E2 el;v enPtrnhit i2n0g0,T3 we;lt fhP rint2i0n0Tg4h,;i rtPereinntth2i 0n0;g4 , FourtePernintnght2, i0 0F6i;ftn etePhr int2i00n7Sg,i, x tePernitnht2 i0n0;Sg 7e,v entPerienntti2hn0 g0,8 ; EightePreinntth2i 0n0;gT8 ,w entPireitnht2 i0n0Tg9w,;e ntyP-rifinrtsi2tn0 g0T,9w; e nsteyc-oPnrdi nt2i0n0g9,; Twenty-Ptrhiinrt2di0 n1gT0,w; e nty-Pforuirntth2i 01n1gT;,w enttyh-P firfint2i0n1;gT 2,w enty-Psriixntt2hi0 n1g3,. Alrli ghrtessv eedr.T hibso oiksp rotebcyct oepdy rNiogp hatro.tfi mt ayb er eprodsutcoeriden,ad reetrviaslye smto,rt ransmiinat ntye dfoo rrbm y amneyna se,l teorcnimce,c ha,np ihcoatlocopying, recorodroi tnhges reww,ii thworuitt pteernm ifrsosmit ohcnepo yriogwhnte r. SBN# 97-8-193506--6165 CovbeyrR ichMaarrdc h Madei nt heU nited StoaftAm eesr ica Pubslhiebdy MedMsateIrn,c . P0.. B ox6 40028 MiamFiL,3 3 164 SpeciTahla nktso : Conitubrtgi CnhaptAeurt hors Prions HanHse nircLka sreMnD,( hCatpe3r3 ) One STtoewpa trdhP eo st-AntEirbai?o tic DevelopamnedSn ptr eoafAd n timicrRoebsiiaslt ance EarneAlsetx anPdhearmr,.. D TheAg entosfB ioterrorism LuciBaonraMi Doa ,n Cdal renLcaem Resotft hReN AV iruses AmyG uilAlgaerwta ,Ml Da nJdo hBne ei!gM,D Herpesviridae JohBne eilgM,D TheI lltursators MarGkl aidnwM,. D. RiCnar roll SiobAhrnaonl d GaiGle rlach Steve GoMl.dDb.e rg, JennGirfeare ber ElibzeatMha han TheBo oRke viewers StepGhoelnd bMe.rDg., PhlylGiosl degn ber OtheCro nteEndti tors JameHsw e EarneAsletx andPehram,r. D. HenyMr asuMrD, AmyG uilAlgerwtaa lM,D JohBne ei!gM,D MnemonaincdsO theCro ntbruiitons DaviFdl uMm.,D . MikSet eenvMs.,D . GregSocrhyr ank SundGereapn dhe Famyi l ChrisGtlianidanwP ,h. D. HugGhl aidnwP,h. D. MarcTiraa ttler HenyTr raetrtM,l. D. MeerdiTtrha etrt l JiTlrla ttler AliJ,e reamnyJd,o shTuraa ttler And Flo.r.a . PREFACE A weldle-velkonpoewdl eodfc glei nmiiccarlog byi olTohe hteabxset e unp dtaetdoi nclcuudrer iennfotr ­ isc ritifocrat lhp er actpihcyisnigic ni aamnne yd icamla tioonrn a piddelvye ltooppi,ins cgus cahsH IV and field.e riBavia,rucs teasn,pd r ooztoahnasv er ensop eAcItD S( avccienffeor atnsad l tlh neew anti-mHeIdV­ fort hdei isntctbieotnw eopehnt mhoallopgye,ad ticris,i catsi)Ao,van inI nflueHn5zNalS ,AR S Coornauvsi,r trausmuar goerrg ye,r iamteirdcniiceA .s a p hysicEiabnov liaurs H,an tavsiE,r. u couotlabikr ,seM ad Cow yowui bllefa cedda iwliytt hh ceo nceopfmt isc robDiiasl e,ab sreand-annetwi micarnotbiiibac,ilsa o ntd diseaansaden timictrhoebriMaaiplcy r.o obgiiysoo n le agents of bioterrorism oft hfeew c ourwsheesmr uec ohft h"em inuitrsie ag"u ­Them nemonaincdcs at roonisn t hibso odko n ot lraluys ebdyt hper actpihcyiisnaignc . intend dfoirsa rneys tppieaccruptla atrip eonpatut lion This abtotoekm tpotfa sci itlattheel a ernionfg orr acoirae lt hngriocu bpu atr seo lely parse sented microobgbiyy op lresentthiein nfogr maitnai c olne amre moyd reivcteosa ssiints htle e ranionfagc omplex anedn tertmaainnnibenrrgi mminmge mwoiratydih s . anidm ptoarnmte discuajbclet . Ouarp prohaabcshe etno : Wew elcosmueg gesfotri ofuntseu driieot nDse.si pte oubre setff ortpsr oofraenaeddd it, moiftesnst laikpe s 1)W riitnaec onverssattyfoilrroe an paailsd s imilation. to byW.e w elcocmoerr ectainodnn eswm nemoindieca s 2)I nclnuudmee rfioguusrs eesrvi nags" vismueaml­ froms tudewnhtors e atdh bioso (klp eaesmea igll ad ortyo oalnssdum"m aryc haarttst h een odef a cchh aptewri.n [email protected] wfe p ublyiosurhro c'km intone monic Thecsaebn e u sefodr" crsaemss ioanftse"tr h ceo ncepts (hsorrtymh esp,h rsaeosro, t hmeerm otrye chniques that havbee esnt udiinte hdte e xt. make itnhfoer maetaisotinoae ssri maitalen mde miorze) 3)C oncreantmteo roenc linaincida nlcfe tidoiuss­ wew irlelc ogynoiunzrae m wei tthhec ontirio!bn ut easies stuheasat rb eo tihn terestintgot haen d vital actuparla cotfmi ecdei c. ine 4)C reaatc eo ncuea,plo trganaipzpoeardc thot he MARK GLAD WIN, MD organsitsumdssi ote hdse t udreenltli eeossnsm emory WILAML ITRATILER, MD anmdo roenl oigcpaalt hoipohglyyos. C.S COTI MAHAN, MD v CONTENTS Prefa.c...e... .......................................................................................................................................................................................v.. ................ PART BACTERIA I. ..........................................................................................................................................................1... BACTERIATLAX ONOMY .... ......... ............................ ............... ..... ... 1 1 .................. ........................... ............. . ...... .. ........................ .......... CELLS TRUCTEUSRVI,R ULENCFEA CTROSa,n TdO XINS. ..................................................................... 2 . . .. . . . . . . ... . ........ ......... 9 BACTERIGAELN ETIC.S ... ..... ... .. .. ................................................2.1. .................. 3 ......................... .................................................. . ...... GRAM-POSITIBVAEC TERIA . .. . .... . 21 ................................................................................................................... STREPTOCOCCUS ............. .............. ......... ............................ ..... ......................................................................... ..........2. . 7... .. .... 4 ............ STAPHYLOC OCCUS ...................... .................. ....................... .. ......................... ......................... ... .. .... ................................4.... .0.... .... .. . 5 BACILLUaSnd C LOSTRIDI(USMP ORE-FORMRIONDGS ) .. .........................................................4..8. ..... 6 .................................. .. . . . CORYNEBACTERIaUnMd L ISTER(INAO N-SPORE-FORRMOIDNSG). . .......................................................................... 7 . .. . . . . .. . 58 GRAM-NEGATIVE BACTERIA .........................................64. ...................................................................... NEISSERIA .................. ...... ....... ... ...... ...... .... ............................... ................ ........ ............. ... . ..... ........ . .... .. .... ........ .........6 . .4 . .... 8 ................. .... ........... .. ...... ........... ..... ................................ .... . ...... ................... .... ...... ..... . ... . ... . .. ...7..2.. ... ... .. ... ... ... ... .. ... ... ... ... 9 THEE NTERIC..S.. ...... HOSPITAL-ACQUIGRRAME D NEGATIVES .. . .................................... 10 .............................................................................. . . . ..... . .. 9. 1 HAEMOPHILUBSO,R DETELLaAn,dL EGIONELLA ..... ..... .. . . ... ...............9.6. ................. 11 ............. .................................................... . YERSINIAF,R ANCISELBLRAU,C ELLaAn,dP ASTEURELLA .. ...................................................................... 12 ................. . . . . ... . . . 104 CHLAMYDIA, RICKETTSIAa,n dF RIEND.S. ......................... ........................................................ 13 ..... . .. . ........... ..... ........ ..... . . .. . ..... 110 SPIROCHETE.S . . ......... .. ........................ ..........................1.2.8. .. 14 ................................................................................ ... ...... . ........ ......... . . . ACID-FBAASCTT ERIA .........................................................................................1. 4.2. .................. .. . .. . . .. ... . . .. .. . MYCOBACTERIUM . . .... .. . ...142 15 ................................................................................................................................................................. BACTERIWAI THOUTC ELL WALLS ........................................1.5.6. ................................................ . MY PLASMA . . . . . ... ........... .........................1..5 .6 16 CO ......................................................................................................... . ..................... . . ... ANTI-BACTERIAL MEDICATIONS ...................................................... .1..6..0.. ................................. . . . . PENICILLFIANM ILAYN TIBIOTICS .. . . .. .. . . .. 160 17 .................................................................................................................................. ANTI-RIBOSOMANATLI BIOTIC.S. ...............................................................................................................1..7..4.. ............................... 18 ANTI-TaBn dA NTI-PLEROS ANTIBIOTIC.S . .... .. . .... ..............................1..8..6.. ...... 19 Y ................. ..................................................... .. . MISCELLANEOUANST IBIOTIC.S. ..........................................................................................................................1..9..4.. ................. 20 PART FUNGI 2. ....................................................................................................2..0 .2. ............................................. THEF UNGI . ..... . . ........... ............................2..0..2 21 .............. .................................................................................................... ................. . . . ANTI-FUNGMAELD ICATIONS . ... ........... .... .. ..........................2.1.6. ................. 22 ................................. ......... ...................................... . ... PART3 .V IRUSES ................................................................2.2.6. ........................................................................... VIRAL REPLICATIaOnNdT AXONOMY . . . . ... ... ...........................2.2.6. 23 .............................................................................................. . . . ORTHOMYXOa ndP ARAMYXOVIRIDAE . . .... . . . .....................2..4. 0. 24 ............................................................................................... . ... . . HEPTITSIV IRIDAE ... .. ...........................2..5..4.. ...... . 25 A .......................................................................................................................... . RETROVIRIDHAIEVa,,n dA IDS ......................... . . ..................2.6.6. .............. 26 ......................................... .... ..... ..................................... HERPESVIRI(DcAoEn triabuutthiJonrgo: h Bne igMeDl), . ..... ..........................................2.8.1. .................. 27 ...................... .. ... ...... . .. RESTO FT HED NAV IRUSES .. . . .........................................2.9.0. ... 28 ..................................................................................... .......... .... . . .. RESTO FT HE RNAVI RUSES( contriabuutthionArgms y:G uillet MADgar naJdwo ahlBn,e igMeD!),. ..............2..9..6.. ... 29 .. . ANTI-VIRAL MEDICATIONS . ..... .. ............. . 314 30 ..................................................................................................................... .. .............. PART PARASITES 4. ....................................................................................................................................... 336 PROTOZOAN.S. 31 .. ................ .............. ......................... .. .... ... ................... ... ............... .... ..................... ................ ... ..... ... ... ... ...... .. . 3..3 .6.. ... HELMINTHS. ..... 32 ........... ...... .... ............... .. ................. .. .. ......... .................. .. ............. . ............ . ...... ....................... ....... .. ..... ... ..... . ..... 3..6. 2. PART5 . VERSYT RANGE CRITTERS ................................3.8.2. ....................................................... PRION(Sc ontribauuttihnoHgra :n sH enriLka rseMn.,D ..J.. ....... . ... ..... ................. 33 . ..................................................................3...8..2. PART 6.T HE END ..................................................................................................................................... 387 ANTIMICROBIAL RESISTANCEO:NE STEPT OWARD THE POST-ANTIBIOETRIAC? 34 (contribauuttihnoEgra :r neAlsetx andePrh,a rm.D..... .................... ................ .. l ...... ....................................................................... 387 THEA GENTOSF B IOTERRORISM 35 (contriabuutthionLrgus c:i ana BMoDra inod, ClarLeanmc.)e. ..........................3.9.2. ........................................................................ BIOTERRORISDME FENSEU PDATES: http://www.medmaster.net/BioterrorismDefense.html ATLASO FM ICROBIOLOGY http://www.med(mfraesdeto ewrn.lnoeatd ) INDEX ................................................................................................................................................................3..9.. 9 vii PART1 . BACTERIA CHAPTER 1. BACTERIAL TAXONOMY Allo ragnishmasva en amceo snistoiftn wgpo ar t:ts he DISACCHARIDE genfoulsl obwyet dhs ep ec(iieH.soe m.so,pa ein)sB.a c­ terhiaavb ee egnru opeadn nda mepdr iamriolnty h eir morphologbiicoaclh Veammneidtco aalbidciff erse.n ce Howevbeacrt,e arrineao wa lbseoi cnlga ssaicficeodr d­ intgo t heir immaunndgo elnoegctihicac r aicscttsei.r Thicsh apfotceurs oenst heGr ams taibanc,te rial morphoalnomdgye ,t abcohlaircai csttaeilrcolsfw , h ich enabtlhceel intiocr iaapnid deltye rtmhioenr eg anism causaip natgi einntfe'icso.t n GRAM STAIN 0 Becabuascet aerrceio al oarnludes susa ilnlvyi tsoi ble I ligmhitc rosccoolposyrt,fua lhi anvsbe e edne voepletdo -CH3 c visuatlhie.zTm eh em osuts efuilst hGer ams tna,i whiscehrp aatoersng iasimns2t g oor upsg:ar m-piovsei t bugasn gdr anme-gabtuigv.Tse h isst aina lalltoshwoes I clintiodc eitaenr wmhienteth heoerr ganiiss mro oru nd aa rod-shaped. Foarn syt ayionmu u sfitr sstm etahrse u bsttaon ce aa ACIDS bes tai(npseuudtm p,u esct,.o )nt aso l iadnetd h ehne at AMINO aa itto tfihxbe a ctoenrt ihsael i.d e Thearre4e s tetpots h e Gsrtiaanm: aa 1)P ouornc rysvtoiallse tta (iabn l udeye )an wda itF igure1 -1 60s eco.n ds 2) Woaffsw hi twha taenrd flooido dwisinotelh u ­ toinW.a i6t0s econds. Botghar m-spiotainvdeg ra-mnaetgiovgrea nisms 3)W asohff w ith waanttdeh re" nd ecolwoiritzheh "a vmeo rteh a1nl y aeprr otetchteicinyorgtp laasnmd 95%a lcoolh. nuclfreoumst heex traacree lnlvouinlrmenutn,l ike 4)F inacloluyn,st tearwi-ints ha fran(iarn e ddy )e. animcaellls w,h ichhav eo nlay s ingclypetl oasmic Wai3t0s ecoanndwdsa sohffw itwha ter. membracnoem poosfae pdh osphobliilpaiyde r. The layjesurot utstihdbeea t cearlcit yoplamsemmibcr ane Whent hsel iidsse t udmiieocdsr copiccealtllhlsay t,i sth pee ptidogllayyocercar en wl al.l I lti sp resent absbot rhcer ysvtoiallea tn dh olodn tiotw ilalp peairnb otghar m-piovsaein tgdr ma-naetgiovreg samnsi. bl.uT eheasrece a lglreadm -poosrigtsaimnv.siHe o w­ eveirtf,h cer ysvtiaolil swe ats hoeffdb yt hael co,h oFlig1.- 1T.h ep eptidogllayycoearrc n e wlall ils thecseel wlisla lb sbo trhsefra aniann da pperader. compoosfreedap teidnigsc ahcarwiidte4ahs m iancoi ds Theasrece a lglreadm -negoargtsaimnvsie. inas icdhea eixnt enfrdoimen agc dhi cscahiadre. Fig1.- 2T.h eam ino-cahcaiiodnft s hp eep tidoglycan Gram-posBiLtUEi ve = covalbeinnttdloo y t haemri naoc ifrdosmn eighboring I'pmo sitBiLUvEeo lvyey rou !! chianTsh.i rse suilnat s st acbrloe skse-sdlt irunct.u re Gram-negaRtEiD ve Theen ymze thacta taltyhfozerme ast iooftn h linisk age = No( nega)t iRvcEeoDm em!si! isc altlerda nspepatnidid slac osaeti endt hien ner cytoplamsemmibcr .aT nhaeen tibpieontiicbcii lntldois n Thdei ffersetnaatir nes r tehseou dfli tff erientnhc ee sa nidn bhiitthsei nsmz eyF.o trh riesa stohenenz ymies cewlall olfgsa r m-piotsiavnegd r ma-naetgibvaec itae.ra lcsaol pleendi cbiilnldipinrn ogt (eesiepn a g1e6 0). 1

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Clinical Microbiology Made Ridiculously Simple PDF

416 Pages·2015·10.848 MB·English
by  Mark Gladwin, William Trattler, C.Scott Mahan
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CLINICAL MICROBIOLOGY tnade ridiculously sitnple™ Edition 6 MarkG ladwin, MD WilliaTmr attlMeDr , C.S cotMta han,M D CLINICAL MICROBIOLOGY MADE RIDICULOUSLY SIMPLE MARK GLADWIN, M.D. WILLIAM TRATTLER, M.D. C.S COTT MAHAN, M.D. @ MedMast,eI rncM.i,a mi ClinMiiccarlo biMoaldRoeig dyi cuSliomupsallieyma stp rovidingp rgiennceoirfmpa illce rso biology anidns o itn tenadsae w do rkignugit dope a tidernuatgd ministPrlaetariseoefent r.ot he maunfactupraecrk'iasnge serfo trr ecommednrdudegod s augned,e sierffeacbtclsoe,n tnrdaiications anddr uign teiroancst. Copyri2g0ht12©40 ,1 230,1 210,0 290,0 8, 2200002607,0, 24 0,0 230,10 1,9 91999,7 1,9 9b5yM edaMstIenrc,. SecoPnrdi nt1i9n9gT5,h; i Prrdi nt1i9n9gF6,o; u rPtrhi nt1i9n9gF7,i; f Ptrhi nt1i9n9g8,; SxitPhr int1i9n9Sg9e,;nv tePhr int2i0n0Eg0i,;g hPtrhi nt2i01n0N;gi ,n Ptrhi nt2i0n0g2,; TenPtrhni ti2n0g0,E2 el;v enPtrnhit i2n0g0,T3 we;lt fhP rint2i0n0Tg4h,;i rtPereinntth2i 0n0;g4 , FourtePernintnght2, i0 0F6i;ftn etePhr int2i00n7Sg,i, x tePernitnht2 i0n0;Sg 7e,v entPerienntti2hn0 g0,8 ; EightePreinntth2i 0n0;gT8 ,w entPireitnht2 i0n0Tg9w,;e ntyP-rifinrtsi2tn0 g0T,9w; e nsteyc-oPnrdi nt2i0n0g9,; Twenty-Ptrhiinrt2di0 n1gT0,w; e nty-Pforuirntth2i 01n1gT;,w enttyh-P firfint2i0n1;gT 2,w enty-Psriixntt2hi0 n1g3,. Alrli ghrtessv eedr.T hibso oiksp rotebcyct oepdy rNiogp hatro.tfi mt ayb er eprodsutcoeriden,ad reetrviaslye smto,rt ransmiinat ntye dfoo rrbm y amneyna se,l teorcnimce,c ha,np ihcoatlocopying, recorodroi tnhges reww,ii thworuitt pteernm ifrsosmit ohcnepo yriogwhnte r. SBN# 97-8-193506--6165 CovbeyrR ichMaarrdc h Madei nt heU nited StoaftAm eesr ica Pubslhiebdy MedMsateIrn,c . P0.. B ox6 40028 MiamFiL,3 3 164 SpeciTahla nktso : Conitubrtgi CnhaptAeurt hors Prions HanHse nircLka sreMnD,( hCatpe3r3 ) One STtoewpa trdhP eo st-AntEirbai?o tic DevelopamnedSn ptr eoafAd n timicrRoebsiiaslt ance EarneAlsetx anPdhearmr,.. D TheAg entosfB ioterrorism LuciBaonraMi Doa ,n Cdal renLcaem Resotft hReN AV iruses AmyG uilAlgaerwta ,Ml Da nJdo hBne ei!gM,D Herpesviridae JohBne eilgM,D TheI lltursators MarGkl aidnwM,. D. RiCnar roll SiobAhrnaonl d GaiGle rlach Steve GoMl.dDb.e rg, JennGirfeare ber ElibzeatMha han TheBo oRke viewers StepGhoelnd bMe.rDg., PhlylGiosl degn ber OtheCro nteEndti tors JameHsw e EarneAsletx andPehram,r. D. HenyMr asuMrD, AmyG uilAlgerwtaa lM,D JohBne ei!gM,D MnemonaincdsO theCro ntbruiitons DaviFdl uMm.,D . MikSet eenvMs.,D . GregSocrhyr ank SundGereapn dhe Famyi l ChrisGtlianidanwP ,h. D. HugGhl aidnwP,h. D. MarcTiraa ttler HenyTr raetrtM,l. D. MeerdiTtrha etrt l JiTlrla ttler AliJ,e reamnyJd,o shTuraa ttler And Flo.r.a . PREFACE A weldle-velkonpoewdl eodfc glei nmiiccarlog byi olTohe hteabxset e unp dtaetdoi nclcuudrer iennfotr ­ isc ritifocrat lhp er actpihcyisnigic ni aamnne yd icamla tioonrn a piddelvye ltooppi,ins cgus cahsH IV and field.e riBavia,rucs teasn,pd r ooztoahnasv er ensop eAcItD S( avccienffeor atnsad l tlh neew anti-mHeIdV­ fort hdei isntctbieotnw eopehnt mhoallopgye,ad ticris,i catsi)Ao,van inI nflueHn5zNalS ,AR S Coornauvsi,r trausmuar goerrg ye,r iamteirdcniiceA .s a p hysicEiabnov liaurs H,an tavsiE,r. u couotlabikr ,seM ad Cow yowui bllefa cedda iwliytt hh ceo nceopfmt isc robDiiasl e,ab sreand-annetwi micarnotbiiibac,ilsa o ntd diseaansaden timictrhoebriMaaiplcy r.o obgiiysoo n le agents of bioterrorism oft hfeew c ourwsheesmr uec ohft h"em inuitrsie ag"u ­Them nemonaincdcs at roonisn t hibso odko n ot lraluys ebdyt hper actpihcyiisnaignc . intend dfoirsa rneys tppieaccruptla atrip eonpatut lion This abtotoekm tpotfa sci itlattheel a ernionfg orr acoirae lt hngriocu bpu atr seo lely parse sented microobgbiyy op lresentthiein nfogr maitnai c olne amre moyd reivcteosa ssiints htle e ranionfagc omplex anedn tertmaainnnibenrrgi mminmge mwoiratydih s . anidm ptoarnmte discuajbclet . Ouarp prohaabcshe etno : Wew elcosmueg gesfotri ofuntseu driieot nDse.si pte oubre setff ortpsr oofraenaeddd it, moiftesnst laikpe s 1)W riitnaec onverssattyfoilrroe an paailsd s imilation. to byW.e w elcocmoerr ectainodnn eswm nemoindieca s 2)I nclnuudmee rfioguusrs eesrvi nags" vismueaml­ froms tudewnhtors e atdh bioso (klp eaesmea igll ad ortyo oalnssdum"m aryc haarttst h een odef a cchh aptewri.n [email protected] wfe p ublyiosurhro c'km intone monic Thecsaebn e u sefodr" crsaemss ioanftse"tr h ceo ncepts (hsorrtymh esp,h rsaeosro, t hmeerm otrye chniques that havbee esnt udiinte hdte e xt. make itnhfoer maetaisotinoae ssri maitalen mde miorze) 3)C oncreantmteo roenc linaincida nlcfe tidoiuss­ wew irlelc ogynoiunzrae m wei tthhec ontirio!bn ut easies stuheasat rb eo tihn terestintgot haen d vital actuparla cotfmi ecdei c. ine 4)C reaatc eo ncuea,plo trganaipzpoeardc thot he MARK GLAD WIN, MD organsitsumdssi ote hdse t udreenltli eeossnsm emory WILAML ITRATILER, MD anmdo roenl oigcpaalt hoipohglyyos. C.S COTI MAHAN, MD v CONTENTS Prefa.c...e... .......................................................................................................................................................................................v.. ................ PART BACTERIA I. ..........................................................................................................................................................1... BACTERIATLAX ONOMY .... ......... ............................ ............... ..... ... 1 1 .................. ........................... ............. . ...... .. ........................ .......... CELLS TRUCTEUSRVI,R ULENCFEA CTROSa,n TdO XINS. ..................................................................... 2 . . .. . . . . . . ... . ........ ......... 9 BACTERIGAELN ETIC.S ... ..... ... .. .. ................................................2.1. .................. 3 ......................... .................................................. . ...... GRAM-POSITIBVAEC TERIA . .. . .... . 21 ................................................................................................................... STREPTOCOCCUS ............. .............. ......... ............................ ..... ......................................................................... ..........2. . 7... .. .... 4 ............ STAPHYLOC OCCUS ...................... .................. ....................... .. ......................... ......................... ... .. .... ................................4.... .0.... .... .. . 5 BACILLUaSnd C LOSTRIDI(USMP ORE-FORMRIONDGS ) .. .........................................................4..8. ..... 6 .................................. .. . . . CORYNEBACTERIaUnMd L ISTER(INAO N-SPORE-FORRMOIDNSG). . .......................................................................... 7 . .. . . . . .. . 58 GRAM-NEGATIVE BACTERIA .........................................64. ...................................................................... NEISSERIA .................. ...... ....... ... ...... ...... .... ............................... ................ ........ ............. ... . ..... ........ . .... .. .... ........ .........6 . .4 . .... 8 ................. .... ........... .. ...... ........... ..... ................................ .... . ...... ................... .... ...... ..... . ... . ... . .. ...7..2.. ... ... .. ... ... ... ... .. ... ... ... ... 9 THEE NTERIC..S.. ...... HOSPITAL-ACQUIGRRAME D NEGATIVES .. . .................................... 10 .............................................................................. . . . ..... . .. 9. 1 HAEMOPHILUBSO,R DETELLaAn,dL EGIONELLA ..... ..... .. . . ... ...............9.6. ................. 11 ............. .................................................... . YERSINIAF,R ANCISELBLRAU,C ELLaAn,dP ASTEURELLA .. ...................................................................... 12 ................. . . . . ... . . . 104 CHLAMYDIA, RICKETTSIAa,n dF RIEND.S. ......................... ........................................................ 13 ..... . .. . ........... ..... ........ ..... . . .. . ..... 110 SPIROCHETE.S . . ......... .. ........................ ..........................1.2.8. .. 14 ................................................................................ ... ...... . ........ ......... . . . ACID-FBAASCTT ERIA .........................................................................................1. 4.2. .................. .. . .. . . .. ... . . .. .. . MYCOBACTERIUM . . .... .. . ...142 15 ................................................................................................................................................................. BACTERIWAI THOUTC ELL WALLS ........................................1.5.6. ................................................ . MY PLASMA . . . . . ... ........... .........................1..5 .6 16 CO ......................................................................................................... . ..................... . . ... ANTI-BACTERIAL MEDICATIONS ...................................................... .1..6..0.. ................................. . . . . PENICILLFIANM ILAYN TIBIOTICS .. . . .. .. . . .. 160 17 .................................................................................................................................. ANTI-RIBOSOMANATLI BIOTIC.S. ...............................................................................................................1..7..4.. ............................... 18 ANTI-TaBn dA NTI-PLEROS ANTIBIOTIC.S . .... .. . .... ..............................1..8..6.. ...... 19 Y ................. ..................................................... .. . MISCELLANEOUANST IBIOTIC.S. ..........................................................................................................................1..9..4.. ................. 20 PART FUNGI 2. ....................................................................................................2..0 .2. ............................................. THEF UNGI . ..... . . ........... ............................2..0..2 21 .............. .................................................................................................... ................. . . . ANTI-FUNGMAELD ICATIONS . ... ........... .... .. ..........................2.1.6. ................. 22 ................................. ......... ...................................... . ... PART3 .V IRUSES ................................................................2.2.6. ........................................................................... VIRAL REPLICATIaOnNdT AXONOMY . . . . ... ... ...........................2.2.6. 23 .............................................................................................. . . . ORTHOMYXOa ndP ARAMYXOVIRIDAE . . .... . . . .....................2..4. 0. 24 ............................................................................................... . ... . . HEPTITSIV IRIDAE ... .. ...........................2..5..4.. ...... . 25 A .......................................................................................................................... . RETROVIRIDHAIEVa,,n dA IDS ......................... . . ..................2.6.6. .............. 26 ......................................... .... ..... ..................................... HERPESVIRI(DcAoEn triabuutthiJonrgo: h Bne igMeDl), . ..... ..........................................2.8.1. .................. 27 ...................... .. ... ...... . .. RESTO FT HED NAV IRUSES .. . . .........................................2.9.0. ... 28 ..................................................................................... .......... .... . . .. RESTO FT HE RNAVI RUSES( contriabuutthionArgms y:G uillet MADgar naJdwo ahlBn,e igMeD!),. ..............2..9..6.. ... 29 .. . ANTI-VIRAL MEDICATIONS . ..... .. ............. . 314 30 ..................................................................................................................... .. .............. PART PARASITES 4. ....................................................................................................................................... 336 PROTOZOAN.S. 31 .. ................ .............. ......................... .. .... ... ................... ... ............... .... ..................... ................ ... ..... ... ... ... ...... .. . 3..3 .6.. ... HELMINTHS. ..... 32 ........... ...... .... ............... .. ................. .. .. ......... .................. .. ............. . ............ . ...... ....................... ....... .. ..... ... ..... . ..... 3..6. 2. PART5 . VERSYT RANGE CRITTERS ................................3.8.2. ....................................................... PRION(Sc ontribauuttihnoHgra :n sH enriLka rseMn.,D ..J.. ....... . ... ..... ................. 33 . ..................................................................3...8..2. PART 6.T HE END ..................................................................................................................................... 387 ANTIMICROBIAL RESISTANCEO:NE STEPT OWARD THE POST-ANTIBIOETRIAC? 34 (contribauuttihnoEgra :r neAlsetx andePrh,a rm.D..... .................... ................ .. l ...... ....................................................................... 387 THEA GENTOSF B IOTERRORISM 35 (contriabuutthionLrgus c:i ana BMoDra inod, ClarLeanmc.)e. ..........................3.9.2. ........................................................................ BIOTERRORISDME FENSEU PDATES: http://www.medmaster.net/BioterrorismDefense.html ATLASO FM ICROBIOLOGY http://www.med(mfraesdeto ewrn.lnoeatd ) INDEX ................................................................................................................................................................3..9.. 9 vii PART1 . BACTERIA CHAPTER 1. BACTERIAL TAXONOMY Allo ragnishmasva en amceo snistoiftn wgpo ar t:ts he DISACCHARIDE genfoulsl obwyet dhs ep ec(iieH.soe m.so,pa ein)sB.a c­ terhiaavb ee egnru opeadn nda mepdr iamriolnty h eir morphologbiicoaclh Veammneidtco aalbidciff erse.n ce Howevbeacrt,e arrineao wa lbseoi cnlga ssaicficeodr d­ intgo t heir immaunndgo elnoegctihicac r aicscttsei.r Thicsh apfotceurs oenst heGr ams taibanc,te rial morphoalnomdgye ,t abcohlaircai csttaeilrcolsfw , h ich enabtlhceel intiocr iaapnid deltye rtmhioenr eg anism causaip natgi einntfe'icso.t n GRAM STAIN 0 Becabuascet aerrceio al oarnludes susa ilnlvyi tsoi ble I ligmhitc rosccoolposyrt,fua lhi anvsbe e edne voepletdo -CH3 c visuatlhie.zTm eh em osuts efuilst hGer ams tna,i whiscehrp aatoersng iasimns2t g oor upsg:ar m-piovsei t bugasn gdr anme-gabtuigv.Tse h isst aina lalltoshwoes I clintiodc eitaenr wmhienteth heoerr ganiiss mro oru nd aa rod-shaped. Foarn syt ayionmu u sfitr sstm etahrse u bsttaon ce aa ACIDS bes tai(npseuudtm p,u esct,.o )nt aso l iadnetd h ehne at AMINO aa itto tfihxbe a ctoenrt ihsael i.d e Thearre4e s tetpots h e Gsrtiaanm: aa 1)P ouornc rysvtoiallse tta (iabn l udeye )an wda itF igure1 -1 60s eco.n ds 2) Woaffsw hi twha taenrd flooido dwisinotelh u ­ toinW.a i6t0s econds. Botghar m-spiotainvdeg ra-mnaetgiovgrea nisms 3)W asohff w ith waanttdeh re" nd ecolwoiritzheh "a vmeo rteh a1nl y aeprr otetchteicinyorgtp laasnmd 95%a lcoolh. nuclfreoumst heex traacree lnlvouinlrmenutn,l ike 4)F inacloluyn,st tearwi-ints ha fran(iarn e ddy )e. animcaellls w,h ichhav eo nlay s ingclypetl oasmic Wai3t0s ecoanndwdsa sohffw itwha ter. membracnoem poosfae pdh osphobliilpaiyde r. The layjesurot utstihdbeea t cearlcit yoplamsemmibcr ane Whent hsel iidsse t udmiieocdsr copiccealtllhlsay t,i sth pee ptidogllayyocercar en wl al.l I lti sp resent absbot rhcer ysvtoiallea tn dh olodn tiotw ilalp peairnb otghar m-piovsaein tgdr ma-naetgiovreg samnsi. bl.uT eheasrece a lglreadm -poosrigtsaimnv.siHe o w­ eveirtf,h cer ysvtiaolil swe ats hoeffdb yt hael co,h oFlig1.- 1T.h ep eptidogllayycoearrc n e wlall ils thecseel wlisla lb sbo trhsefra aniann da pperader. compoosfreedap teidnigsc ahcarwiidte4ahs m iancoi ds Theasrece a lglreadm -negoargtsaimnvsie. inas icdhea eixnt enfrdoimen agc dhi cscahiadre. Fig1.- 2T.h eam ino-cahcaiiodnft s hp eep tidoglycan Gram-posBiLtUEi ve = covalbeinnttdloo y t haemri naoc ifrdosmn eighboring I'pmo sitBiLUvEeo lvyey rou !! chianTsh.i rse suilnat s st acbrloe skse-sdlt irunct.u re Gram-negaRtEiD ve Theen ymze thacta taltyhfozerme ast iooftn h linisk age = No( nega)t iRvcEeoDm em!si! isc altlerda nspepatnidid slac osaeti endt hien ner cytoplamsemmibcr .aT nhaeen tibpieontiicbcii lntldois n Thdei ffersetnaatir nes r tehseou dfli tff erientnhc ee sa nidn bhiitthsei nsmz eyF.o trh riesa stohenenz ymies cewlall olfgsa r m-piotsiavnegd r ma-naetgibvaec itae.ra lcsaol pleendi cbiilnldipinrn ogt (eesiepn a g1e6 0). 1

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