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Essentials of MEDICAL MICROBIOLOGY Essentials of MEDICAL MICROBIOLOGY Apurba Sankar Sastry MD DNB MNAMS PDCR Hos pita/Infection Control Officer Assistant Professor Department of Microbiology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMERJ Puducherry, India Sandhya Bhat KM D DNB MN AMS PDCR Associate Professor Department of Microbiology Pondicherry Institute of Medical Sciences (PIM S) (A Unit of Madras Medical Mission) Puducherry, India Co-Editor AnandJanagond Associate Professor Department of Microbiology Velammal Medical College Madurai, Tamil Nadu, India i dtln• The Health Sciences Publisher I I I New Delhi London Philadelphia Panama ., l; ., GBrD Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838124, Ansari Road, Daryaganj New Delhi 110002, India Phone: +91-11· 43574357 Fax: +91-11-43574314 Email: [email protected] Overseas Offices J.P. 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Jaypee Brothers Medical Publishers (P) Ltd The Bourse 17/l·B Babar Road, Block·B, Shaymali 111 South Independence Mall East Mohammadpur, Dhaka,1207 Suile 835, Philadelphia, PA 19106, USA Bangladesh Phone: +1267-519-9789 Mobile: +08801912003485 Email: [email protected] Email: [email protected] Jaypee Brothers Medical Publishers (P) Ltd Bhotahity, Kathmandu, Nepal Phone: +977·9741283608 Email: [email protected] Website: ww,•,.jaypeebrothers.com Website: www.jaypeedig~al.com @2016, Ja)l)e& Brothers Medical Publishers The views and opinions expressed in this book are solely those of tile original oootributor(s}fauthor(s) and do not necessarily represent those of e<frtor(s) of the book. All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers. All brand names and product names used in this book are trade names, service marks, trademarks or regis1ered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. Medical knowledge and practice change constantly. This book is designed to provide aocurate, authoritative information about the sub;ect matter in question. However, readers are advised to check the mos1 current information available on procedures included and check infonnation from the manufacturer of each product to be administered, to verify the reoommended dose, fonnula, method and duration of administration, adverse effects and oontraiodications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/ editor(s) assume any liability for any injury alld/or damage to persons or property arising from or related to use of material in this book. This book is sold on the understanding that the publisller is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought. Every effort has been made where necessary to contact holders of oopyright to obtain permission to reproduce oopyright material. If any have been inadvertentty over1ooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. Inquiries for bulk sales may be solicited at: [email protected] Essentials of Medical Microbiology First Edition: 2016 ISBN: 978·93·5152s987·3 Printed at Dedicated to Our Beloved Parents, Family Members And above all, the Almighty When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has been opened for us. - Helen Keller Fore\'Vord~~~~ ~ - Few decades back, there were hardly any books on Medical Microbiology written by Indian authors. With expansion of medical education in the country over the years, the undergraduate students' population has grown significantly and there is an intensely felt need for books to suite the students' choices with regards to style, presentation, language and content. It is in this backdrop that we have to visualize the birth of a good number of Indian books in the recent past. Most of these books are authored by teachers who have spent considerable time in teaching microbiology in medical colleges. However, here we have a couple of young enthusiastic passionate teachers of microbiology, who have taken pains to put their thoughts in the shape of a wonderful book. Though this book looks like another book in the field, but certain features, like the updated matter, lucid presentation style, useful pictures and clinical case-based discussions are unique to this book. I am sure that many students would relish to go through this book and get benefited. The information provided might become handy for postgraduate students as well, even though they cannot fully depend on this. I really appreciate the efforts made by my col league Dr Apurba Sankar Sastry and his wife Dr Sandhya Bhat K for this commendable work. Dr BN Harish MD Professor and Head Department of Microbiology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Puducherry, India E-mail: [email protected] Fore\'Vord~~~~ ~ - Essentials afM edical Micrabia/ogy by Dr Apurba Sankar Sastry and Dr Sandhya Bhat K comes at a time when several Microbiology books are being written and published in the country. We have come a long way from the time the students had to depend on one or two textbooks in microbiology which were published in India to the current time where the choice is varied, to pursue the course. This book has many advantages over other textbooks in microbiology in being a concise, easy-to-read book, which can be used both as a textbook for an undergraduate MBBS course as well as a handbook for easy reference for microbiology examinations. Chapters range from General Microbiology, which addresses the basic concepts in microbiology, to schematically , represented easily comprehensible immunology. New concepts in immunology and details of cells and cellular products have been lucidly explained with the help of diagrams. Bacteriology has been written with a clinical approach to make it relevant to a student in the clinical years. Several infections have been supported with clinical pictures and images. Virology also follows a similar trend with updated information on recent outbreaks, epidemics and emerging infections. The book will be useful for students preparing for examinations, both formative assessments and the final summative examination. An additional attraction is the orientation for postgraduate entrance examination. The students will find the book very handy. The authors must be congratulated on their continuous efforts to bring forth textbooks for students of microbiology. Reba Kanungo MD PhD Dean-Research and Professor and Head Department of Clinical Microbiology Pondicherry Institute of Medical Sciences (PIMS) Puducherry, India Past Presiden~ Indian Association of Medical Microbiologists Former Editor-in-Chief, Indian Journal of Medical Microbiology E-mail: [email protected]