Microbiology: a clinical approach

782 Pages·2010·83.149 MB·English

by  Strelkauskas, Jennifer, Moszyk-Strelkauskas, Danielle, Strelkauskas, Anthony J

Microbiology
a clinical approach
Anthony Strelkauskas
Jennifer Strelkauskas • Danielle Moszyk-Strelkauskas
000_Micro_Front_Matter.pdf 1 22/10/2009 15:39

Prelims iii
Microbiology
a clinical approach
Anthony Strelkauskas
Jennifer Strelkauskas • Danielle Moszyk-Strelkauskas
000_Micro_Front_Matter.pdf 3 22/10/2009 15:39
Garland Science Front cover image shows the
spirochete Treponema pallidum
Vice President: Denise Schanck
corkscrewing into tissue.
Editor: Elizabeth Owen
Image from Science Source/
Assistant Editor: Sarah Holland
Science Photo Library.
Senior Media Editor: Michael Morales
Assistant Media Editor: Monica Toledo
Production Editors: Georgina Lucas and Simon Hill
Design and Typesetting: Matthew McClements, Blink Studio Ltd.
Illustrator: Matthew McClements, Blink Studio Ltd.
Copyeditor: Bruce Goatly
Proofreader: Susan Wood
Indexer: Liza Furnival
©2010 by Garland Science, Taylor & Francis Group, LLC
This book contains information obtained from authentic and highly regarded sources. Reprinted material
is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable
efforts have been made to publish reliable data and information, but the author and the publisher cannot
assume responsibility for the validity of all materials or for the consequences of their use. All rights
reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted
in any form or by any means—graphic, electronic, or mechanical, including photocopying, recording,
taping, or information storage and retrieval systems—without permission of the copyright holder.
The publisher makes no representation, express or implied, that the drug doses in this book are correct.
Readers must check up-to-date product information and clinical procedures with the manufacturers,
current codes of conduct, and current safety regulations.
The views expressed in this publication are those of the authors and do not reflect the official policy or
position of the Department of the Navy, Department of Defense, or the United States Government.
ISBN 978-0-815-36514-3
Library of Congress Cataloging-in-Publication Data
Strelkauskas, Anthony J., 1944-
Microbiology : a clinical approach / Anthony Strelkauskas,
Jennifer Strelkauskas, Danielle Moszyk-Strelkauskas.
p.; cm.
Includes index.
ISBN 978-0-8153-6514-3
1. Medical microbiology--Textbooks. I. Strelkauskas, Jennifer. II. Moszyk-
Strelkauskas, Danielle. III. Title.
[DNLM: 1. Communicable Diseases--microbiology. 2. Infection--microbiology.
3. Microbiological Phenomena. QW 700 S915m 2010]
QR46.S87 2010
616.9’041--dc22
2009041852
Published by Garland Science, Taylor & Francis Group, LLC, an informa business,
270 Madison Avenue, New York NY 10016, USA, and
2 Park Square, Milton Park, Abingdon, OX14 4RN, UK.
Printed in the United States of America
15 14 13 12 11 10 9 8 7 6 5 4 3 2 1
Visit our web site at http://www.garlandscience.com
Preface
Microbiology affects our lives every day. We are surrounded by microorganisms—
they live in our bodies, on our bodies, in the air we breathe, in the ground we
walk on, in the water we drink, and in the food we eat. Health care professionals
see evidence of this every day. Sometimes, the presence of microorganisms is
benefi cial or even essential to good heath; but in many cases microorganisms
can be harmful or even deadly. By understanding the fundamental principles of
microbiology, health care professionals can help manage the problems caused
by these organisms.
The study of microbiology began in the late nineteenth century with the investigation
of the causes of disease. Since then there has been a vast increase in knowledge
about the structure, physiology, and genetics of microbes, and microbiology now
encompasses environmental microbiology, insect control, and biotechnology. To do
justice to the whole of microbiology would take a book much longer than this one.
Therefore, our focus is on the relationships between microbes and infectious disease,
since this is the area most relevant to human health. This book is the result of many
years of teaching microbiology to students interested in the health care professions,
in particular the nursing fi eld, and it is specifi cally designed for this audience. Thus,
from start to fi nish, the book provides a clinical approach to microbiology through
its emphasis on the roles microbes play in disease and infection.
The book contains several unique features that make it an effective tool for
teaching microbiology to a clinically oriented audience. The text begins with
a special Learning Skills section, written by Dr. Peter Susan, which introduces
students to practical strategies for improving reading comprehension and
retention of information. Clinical themes are interwoven throughout the
individual chapters, and the book as a whole, by emphasis and repetition of key
clinical concepts. In particular, we emphasize what we call the big fi ve, which
are the fi ve requirements for infection: namely, “get in,” “stay in,” “defeat the host
defenses,” “damage the host,” and “be transmissible.” These requirements are
introduced in the fi rst chapter and revisited throughout the text. The fi rst chapter
also presents a series of case studies designed to grab the readers’ attention and
demonstrate the vital importance of studying microbiology.
All chapters start by addressing the two questions most often asked by students:
“Why do I need to know this?” and “What do I need to know?” Short summaries
of individual sections of each chapter, called Keep in Mind, are interspersed
throughout, in order to help students digest important facts and concepts before
moving on to the next section.
There are three types of end-of-chapter questions. Self Evaluation and Chapter
Confi dence questions test basic comprehension. Depth of Understanding questions
require the student to integrate important concepts in a more challenging way.
And Clinical Corner questions ask students to apply what they have just learned
to a specifi c clinical setting or problem. Answers and explanations for why they
are correct are available on the Student Resource Website.
In addition to these pedagogical features, chapters are fi lled with carefully selected
images to facilitate understanding. Photographs and micrographs have been
selected for both their beauty and their ability to illustrate important concepts.
Glimpses of the wonder of the microscopic and molecular worlds are also found
in the MicroMovies which were developed to make some of the challenging
topics more accessible to students. Icons in the margin of the book indicate when
a movie that corresponds to a particular section or fi gure is available.
This book is a communal effort; many people have helped us and they are credited
in the Acknowledgments that follow. We would like to thank you for choosing our
book. It is important to us that the book is accurate, authoritative, and interesting.
Despite our best efforts, it is inevitable that there will be errors. We encourage
readers who fi nd errors to email us at [email protected] in order that we may
continue to refi ne the text in subsequent printings and editions. Your input is very
important to us and we thank you in advance for your comments and questions.
Tony Strelkauskas
Jennifer Strelkauskas
Danielle Moszyk-Strelkauskas
Acknowledgments
The inspiration for this book came from the hundreds of students we have
known, studied with, and taught. We owe them a great deal, and hope this book
will benefi t future students who want to enter the health care professions. The
inspiration provided by the students came to life through the efforts of many
people, and we would like to acknowledge their contributions. We thank Garland
Science, our publisher, for believing in the project. Special thanks go to Matt
McClements, whose incredible artwork and design made this book easy to read
and understand. Bruce Goatly copy-edited the manuscript and we are grateful
for his editing skills and command of the English language. Mike Morales and
Monica Toledo edited and produced the animations and multimedia. Thanks also
go to Sarah Holland for her patience with authors and her universal good cheer,
and to Georgina Lucas and Simon Hill for all their help in production of the book.
We are grateful to Sherry Fuller-Espie (Cabrini College, Pennsylvania) for writing
the Question Bank, and Joanne Dobbins (Bellarmine University, Kentucky) for
reviewing all the questions. We have saved the best for last: the person who
held us all together, who encouraged, cajoled, pushed, and pulled, but always
kept things running smoothly. Though she could be a psychiatrist, she is the
best editor there could ever be. We have no way to thank Liz Owen enough for
making our work so enjoyable. Thanks, Liz.
The authors also want to thank special people involved in the project:
AJS — I want to thank my beloved wife, Jennifer, for so many years of love and
encouragement, and my daughter (and co-author) JES and my son Daniel for
being the best children a father could have. The successful completion of this
book is because of them.
JES — I’d like to thank my dad (and coauthor), AJS, for being everything anyone
could ask for in a dad. You are my inspiration. You made being smart synonymous
with being cool and I can never thank you enough. Thanks also to my mom for
sharing with me her unshakable faith that we can “make it all work” because she
could and did.
DM-S — I want to thank my husband, Danny, for being a constant through all the
changes. Thanks also to my parents and my sister for all the support and words
of encouragement.
In writing this book the authors and publishers have benefited greatly from the
advice of many microbiologists, immunologists, and instructors. We would like
to thank the following for their suggestions in preparing this edition.
Waseem Ahmed (Community College of Allegheny County); Ralph Alcendor (City
Technology College, CUNY); Mary Allen (Hartwick College); Mordechay Anafi (York
University); Josef Anné (University of Leuven); Silvio Arango-Jaramillo (Palm Beach
State College); Janice Barney (Mount Wachusett Community College); Preena
Bhalla (Maulana Azad Medical College); S. A. Bhatt (North Gujarat University);
Christine Bezotte (Elmira College); Laurie Bradley (Hudson Valley Community
College); Kathleen Boyle (Southeast Arkansas College); Carol E. Carr (John Tyler
Community College); Yasemin Congleton (Bluegrass Community and Technical
College); Paul Cos (University of Antwerp); Chester R. Cooper (Youngstown State
University); Christina Costa (Mercy College); Don C. Dailey (Austin Peay State
University); Anjana J. Desai (University of Baroda); Beverly Ann Dixon (California
State University, East Bay); Kristiann Dougherty (Valencia Community College);
Khrys Duddleston (University of Alaska); Hussein El Ebiary (South Puget Sound
Community College); Hanan El-Mayas (Georgia State University); Pamela
Fouche (Walters State Community College); Wim Gaastra (University of Utrecht);
Eric T. Gillock (Fort Hays State University); Louise M. Hafner (Queensland
University of Technology); Jenny Hardison Clark (Saddleback College); Janelle
Hare (Morehead State University); Diane Hartman (Baylor University); Pamela
K. Hathorn (Oklahoma State University); George A. Jacob (Xavier University);
Amy Jessen-Marshall (Otterbein College); Jeanne Kagle (Mansfield University);
Judy Kaufman (Monroe Community College); Dubear Kroenig (University of
Wisconsin); John M. Lammert (Gustavus Adolphus College); Sue Lang (Glasgow
Caledonian University); Carol R. Lauzon (California State University, East Bay);
Steven Leidich (Cuyahoga Community College); Jared Q. LeMaster (Cuyahoga
Community College); Roger Lightner (Nashville State Community College); Holger
Hill (Free University, Amsterdam); Anne Mason (Mesa Community College); Ethel
M. Matthews (Midland College); Janie Milner (Santa Fe Community College);
Richard Myers (Missouri State University); Edwin Noboa (GateWay Community
College); Lourdes Norman-McKay (Florida Community College); Gordon Plague
(Fordham University); Madhura Pradhan (Ohio State University); Nadia Rajsz
(Orange County Community College); Clifford M. Renk (Florida Gulf Coast
University); Jackie Reynolds (Richland College); Beverley Roe (Erie Community
College); Sarah Richart (Asuza Pacific University); ValJean Rossman (Community
College of Allegheny County); David Jesse Sanchez (Los Angeles City College);
Susan Salter (University of Tasmania); Lisa Sedger (University of Technology,
Sydney); Heather Seitz (Johnson County Community College); Prafull C. Shah
(Valdosta State University); S. P. Singh (Saurashtra University); Theresa Stanley
(Gordon College); Terry A. Tattar (Edison State College); Lewis Linton Tomalty
(Queen’s University); Olga E. Vazquez (Valencia Community College); Ernesto
Lasso de la Vega (Edison State College); Helen Walter (Mills College); Wan Wei
(Texas A&M University); Janice Yoder Smith (Tarrant County College); Malcolm
Zellars (Georgia State University).
About the Authors
Anthony J. Strelkauskas, PhD
After earning a PhD from the University of Illinois Medical Center, Chicago,
Tony Strelkauskas completed postdoctoral research at the Sidney Farber Cancer
Institute, Harvard Medical School, before becoming a professor at the Medical
University of South Carolina, where he taught immunology and microbiology to
medical students. He is now the lead instructor for the microbiology course at
Trident Technical College, Charleston, South Carolina, where his students have
repeatedly nominated him for Who’s Who Among American Teachers.
Jennifer E. Strelkauskas, DVM
Jennifer Strelkauskas is pictured here with a 6-day old baby alpaca (called a cria)
after giving the newborn its fi rst examination. She earned her DVM from Auburn
University, Alabama, and is currently practicing veterinary medicine in Hood
River, Oregon.
Danielle Moszyk-Strelkauskas, MD
Danielle Strelkauskas earned her MD from the Uniform Services University of
the Health Sciences and then completed an internal medicine internship at the
Naval Medical Center, San Diego, California. She is currently the Chief Academic
Resident in Emergency Medicine at the Naval Medical Center, San Diego,
California.
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A Letter to Our Students
Welcome to microbiology. This is one of the most important courses you will take
as you prepare for a career as a health care professional. It can be a complex
course and you may be anxious about it, but you’re not on your own.
We have spent our careers in health care as a clinical researcher, a veterinarian,
and a medical doctor. So we know the diffi culties and rewards of your studies,
since each of us also traveled a similar road. We have written this book to help you
succeed in your studies and your career. We hope you enjoy learning microbiology
with this book, and put the knowledge to good use. There are two important things
you should know:
1. This book was specifi cally designed and written for you: that is, students
preparing for careers in health care.
2. Drawing from our professional experience, we focus on the things most
important to know, and have tried to make them as accessible as possible.
In the next section, we explain how the book is geared specifi cally for students
preparing for careers in health care. We also review the variety of interactive
activities designed for this book that are available on the Student Resource
Website, located at www.garlandscience.com/micro.
We hope you take advantage of the help this book and the Student Resource Website
provide. We know if you use these resources, you will be better prepared for both
this course and your career. We wish you the best of luck and all success.
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