PPrreelliimmss..iinndddd ii 55//1155//22001122 1100::2200::0011 AAMM Textbook of Microbiology and Immunology PPrreelliimmss..iinndddd ii 55//1155//22001122 1100::2200::0011 AAMM “This page intentionally left blank" PPrreelliimmss..iinndddd iiii 55//1155//22001122 1100::2200::0022 AAMM Textbook of Microbiology and Immunology 2nd Edition Subhash Chandra Parija MBBS, MD, PhD, DSc, FRCPath FAMS, FICPath, FICAI, FABMS, FISCD, FIAVP, FIATP, FIMSA Professor and Head Department of Microbiology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry, India ELSEVIER A division of Reed Elsevier India Private Limited PPrreelliimmss..iinndddd iiiiii 55//1155//22001122 1100::2200::0022 AAMM Textbook of Microbiology and Immunology, 2/e Parija ELSEVIER A division of Reed Elsevier India Private Limited Mosby, Saunders, Churchill Livingstone, Butterworth-Heinemann and Hanley & Belfus are the Health Science imprints of Elsevier. © 2012 Elsevier First Edition 2009 Second Edition 2012 All rights are reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of the publisher. ISBN: 978-81-312-2810-4 Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The author, editors, contributors and the publisher have, as far as it is possible, taken care to ensure that the information given in this text is accurate and up-to-date. However, readers are strongly advised to confirm that the information, especially with regard to drug dose/usage, complies with current legislation and standards of practice. Please consult full prescribing information before issuing prescriptions for any product mentioned in this publication. Published by Elsevier, a division of Reed Elsevier India Private Limited. Registered Office: 305, Rohit House, 3 Tolstoy Marg, New Delhi-110 001. Corporate Office: 14th Floor, Building No. 10B, DLF Cyber City, Phase II, Gurgaon–122 002, Haryana, India. Sr. Commissioning Editor: Shukti Mukherjee Bhattacharya Managing Editor (Development): Shabina Nasim Development Editor: Shravan Kumar Copy Editor: Shrayosee Dutta Manager Publishing Operations: Sunil Kumar Manager Production: NC Pant Typeset by Mukesh Technologies Pvt. Ltd., Pudhucherry, India. Printed and bound at EIH Unit Ltd. Press, Manesar. PPrreelliimmss..iinndddd iivv 55//1155//22001122 1100::2200::0033 AAMM To my father Late Shri Managovinda Parija and mother Late Smt Nishamani Parija PPrreelliimmss..iinndddd vv 55//1155//22001122 1100::2200::0033 AAMM “This page intentionally left blank" PPrreelliimmss..iinndddd vvii 55//1155//22001122 1100::2200::0033 AAMM Preface to the Second Edition Like the first edition, the second edition of Textbook of Microbiology and Immunology consists of six sections. Section I and II deal with general micro biology and immunology, respectively. Section III, IV, and V deal with bacteriology, virology, and mycology, respec- tively. Lastly, Section VI deals with applied microbiology and includes epidemiology and control of community infections, hospital infections, antimicrobial chemotherapy, water analysis, and immunization. Medical microbiology is a rapidly changing and evolving field. The threat of emerging and reemerging pathogens and the changing epidemiology of known pathogens have made it imperative that we keep abreast of the changes and developments in the field if we are to efficiently deal with them. The second edition of the Textbook of Microbiology and Immunology has been revised thoroughly and revamped to include the latest information in the field of medical microbiology. Special emphasis has been placed on molecular methods of diagnosis, which have revolutionized the diagnosis of infectious diseases and have made it possible to detect hitherto unknown and unculti- vable pathogens from clinical specimens. The problem of antimicrobial resistance with respect to emerging mechanisms, changing epidemiology, and newer ways of detection has been dealt with in detail. This text aims at not only providing basic information about microbiology and immunology, but also deals with the clinical appli- cations of microbiology in the study of infectious diseases. In each chapter, key points are highlighted. Clinical case studies have been included so that students can evaluate their understanding of the various microbes. Photographs and pertinent line diagrams have been included to aid the learning process. The book has been trimmed down so as to include the necessary information with- out overburdening the students. This textbook aims at providing comprehensive information about microbiology and it’s applications for medical students, para- medical students and workers in the field of infectious diseases. I sincerely hope the book serves this purpose and also helps in creating interest towards the subject among students. Readers’ views and suggestions for further improving the book in the coming years are welcome. Suggestions may kindly be e-mailed at [email protected]. Subhash Chandra Parija PPrreelliimmss..iinndddd vviiii 55//1155//22001122 1100::2200::0033 AAMM PPrreelliimmss..iinndddd vviiiiii 55//1155//22001122 1100::2200::0033 AAMM Preface to the First Edition The intent of the book is to provide an up-to-date information on microbial diseases which are emerging as an important health problem world wide. This book has been written to provide a comprehensive coverage of basic and clinical microbiology, including immunology, bacteriology, virology, and mycology, in a clear and succinct manner. The book also intends to provide an accurate presentation of clinically relevant information to the learners of medical microbiology. Textbook of Microbiology and Immunology consists of six sections. Section I and II deals with general micro biology and immunology, respectively. Section III, IV, and V deals with bacteriology, virology, and mycology, respectively. Lastly, Section VI deals with applied microbiology and includes epidemiology and control of community infections, hospital infections, antimicrobial chemotherapy, water analysis, and immunization. Emphasis, throughout the text, is made on the clinical applications of microbiology to study infectious diseases. Cultivation and identification of each organism along with pathogenesis of diseases, clinical manifestations, diagnostic laboratory tests, treatment, and prevention and control of resulting infections are thoroughly updated to include most recent advances in the field. Details are summarized in the tabular format. Clinical cases are provided in most of the chapters. The book is profusely illustrated with line diagrams and photomicrographs both black & white and color. I believe this book will be a useful source of comprehensive information for students mainly the undergraduate students of medicine, allied sciences, and others who are interested in medical microbiology. I welcome reader’s views and suggestions for further improvement of the book in the future edition. Suggestions may kindly be e-mailed at [email protected] or at [email protected]. Subhash Chandra Parija PPrreelliimmss..iinndddd iixx 55//1155//22001122 1100::2200::0033 AAMM