The Short Textbook of Medical Microbiology (Including Parasitology) The Short Textbook of Medical Microbiology (Including Parasitology) Tenth Edition Satish Gupte MD Professor and Head Department of Microbiology Gian Sagar Medical College and Hospital Ramnagar (Banur), Distt. Patiala. (Punjab) Ex-Professor and Head Department of Microbiology Adesh Institute of Medical Sciences and Research Centre Bathinda (Punjab) and Govt. Medical College and Associated Hospitals Jammu 180001, J & K, India ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • St Louis (USA) (cid:129) Panama City (Panama) (cid:129) Ahmedabad (cid:129) Bengaluru Chennai (cid:129) Hyderabad (cid:129) Kochi (cid:129)Kolkata (cid:129)Lucknow (cid:129)Mumbai (cid:129) Nagpur Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd Corporate Office 4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, Phone: +91-11-43574357 Fax: +91-11-43574314 Registered Office B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi - 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021 +91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected], Website: www.jaypeebrothers.com Offices in India Ahmedabad, Phone: Rel: +91-79-32988717, e-mail: [email protected] Bengaluru, Phone: Rel: +91-80-32714073, e-mail: [email protected] Chennai, Phone: Rel: +91-44-32972089, e-mail: [email protected] Hyderabad, Phone: Rel:+91-40-32940929, e-mail: [email protected] Kochi, Phone: +91-484-2395740, e-mail: [email protected] Kolkata, Phone: +91-33-22276415, e-mail: [email protected] Lucknow, Phone: +91-522-3040554, e-mail: [email protected] Mumbai, Phone: Rel: +91-22-32926896, e-mail: [email protected] Nagpur, Phone: Rel: +91-712-3245220, e-mail: [email protected] Overseas Offices North America Office, USA, Ph: 001-636-6279734, e-mail: [email protected], [email protected] Central America Office, Panama City, Panama, Ph: 001-507-317-0160 e-mail: [email protected] Website: www.jphmedical.com The Short Textbook of Medical Microbiology (Including Parasitology) © 2010, Mrs Jyotsna Gupte All rights reserved. No part of this publication should 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 written permission of the author and the publisher. This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only. First Edition : 1982 Second Edition: 1984 Third Edition: 1986 Fourth Edition: 1989 Fifth Edition: 1993 Indonesian Edition: 1990 Sixth Edition: 1995 Seventh Edition: 1999 Eighth Edition: 2002 Ninth Edition: 2006 Tenth Edition : 2010 ISBN : 978-81-8448-840-1 Typeset at : JPBMP typesetting unit Printed at : GIAN SAGAR MEDICAL COLLEGE & HOSPITAL Ram Nagar (Banur), Distt. Patiala, Punjab-140601 (India) Mobile : 9876900006, Telefax : 01762-507759 Foreword Dr Satish Gupte has done wonderful job in updating his book to tenth edition. The simplicity of language and scholarly work done in the book shows the effort of author for updating the book. I wish more undergraduate and postgraduate students will read this book for updating their knowledge and skills. I wish the book to be a landmark in subject of Microbiology. Dr AS Sekhon MD Principal Gian Sagar Medical College and Hospital Ram Nagar (Banur) Distt. Patiala, Punjab India Preface to the Tenth Edition Over 27 years back first edition of The Short Textbook of Medical Microbiology was brought out in 1982. Since then the volume is galloping while passing through silver jubilee year landing right into revised, enlarged and updated tenth edition decorated elegantly and colorfully with entirely fresh and new get up. Indonesian edition of this volume was published in 1990 with collaboration of Binarupa Aksara under the title MICROBIOLOGI DASAR earning fame and name in that region. It has been kept in mind to condense and include the latest major meaningful advances in medical microbiology in this volume. Distinct feature of this volume is inclusion of updated Medical Parasitology with Entomology. All the chapters are thoroughly revised and updated as highlighted by esteemed readers from time to time. New chapters are included namely; microbiology in the service of human being, molecular techniques in microbiology, emerging and re-emerging infections and laboratory and hospital wastes. Also included in this volume: Biofilm, new methods of disinfection and sterilization, super antigen, Ogawa medium, adenosine deaminase activity, immunological investigations of Mycobacterium tuberculosis, Napah virus, pandemic of swine flu (HN) breakthrough 2009, laboratory 1 1 diagnosis of septicemia/bacteremia and infective endocarditis and Nobel prize in Medicine etc. The challenge was to keep the volume comprehensive, profusely colored, beautifully illustrated and still handy maintaining emphasis on the needs of MBBS and BDS students. Several colored figures and photographs, tables and colored illustrations (adjusted appropriately between texts) are included to enhance and intensify the utility of this volume. The chapters pertaining to clinical microbiology are especially addressed to budding doctors (interns and house surgeons/physicians) who usually face problems in collection and transportation of clinical samples for laboratory investigations. It is the privilege to offer my sincere gratitude to my respected teachers: Professor TD Chugh, Professor Uma Sabharwal, Professor RK Arya and Professor DR Arora for their blessings, encouragement, inspiration and good will. My special thanks to Professor Aruna Aggarwal, Professor BL Sherwal, Professor Jagdish Chander, Professor Prem Narwan, Professor Raj Kumar, Professor Anjum, Professor Bella Mahajan and many others for their best wishes and valuable suggestions in upbringing the current edition of this volume. I am thankful to Dr GM Warke of Hi Media Laboratory, Mumbai, for kind permission to use some photographs. I acknowledge the help rendered by faculty of Department of Microbiology, Gian Sagar Medical College and Hospital, (Banur), Patiala in the preparation of this edition. Thanks to Mr Gurpreet Singh for taking responsibility of secretarial work of this volume. Professor AS Sekhon, Dean and Principal, Gian Sagar Medical College, (Banur), Patiala has encouraged me and enriched me with his good wishes to accomplish the commitment of bringing up this edition to the contentment and expectations of readers. From the core of my heart, I am grateful to him indeed. My sincere thanks to Shri Jitendar P Vij (Chairman and Managing Director), Jaypee Brothers Medical Publishers (P) Ltd., New Delhi and his dedicated and dynamic team for publishing this book elegantly and speedily. In true sense I derived much inspiration and blessings from my mother, respected Late Smt. Kaushalya Gupte and respected father Late Shri Charanjit Gupte. Also, I take opportunity to express my thanks to all my family members especially to my wife Mrs Jyotsna Gupte and dear son Anubhav Gupte who actually helped me sincerely while I was simply engrossed in preparing and also during finalizing this manuscript. Comments, suggestions and constructive criticisms towards improvements of future editions of this volume are very much welcomed. In fact, they underline the shortcomings which are looked into and rectified in the interest of our esteemed readers. “Gupte House” Satish Gupte 60, Lower Gumat, Jammu 180016 September, 2009 Preface to the First Edition In India as also in other countries of the Third World, despite advances in the field of microbiology, there has been an acute dearth of well-written textbooks on the subject for the undergraduate medical students. The Short Textbook of Medical Microbiology attempts to fill that long-left gap. In spite of great deal of expansion in all branches of microbiology, I have tried to make it concise yet comprehensive, handy and up-to-date. The stress has been on contemporary medical microbiology’s relevance for today’s needs in our set-up. A large number of line diagrams and tables are included to simplify the points. Also, the language has been simple, easy and straightforward. In line with our requirements more emphasis has been laid on practical aspects. A strong point of the digest is a special stress on the mechanism of production of disease by the microbes and laboratory diagnosis. In writing this volume, I have considerably counted on the superb teaching of my teachers, namely Prof TD Chugh, Prof RK Arya and Prof (Mrs) Uma Sabharwal. The goodwill and wise counsels of Dr DR Arora, Dr Ashok Malik, Dr (Mrs.) Santhosh Saini, Dr Satish Walia, Dr RL Kaul, Dr (Mrs) Sudershan Kumari Gupta and Dr Satish Sharma proved a source of much stimulation. Lastly, I express my appreciation for the various favors extended by the family folk at various stages of publication. With this, let me hope that this little book makes its modest contribution by presenting the subject of medical microbiology in an easy, simple and straightforward form helping the undergraduates to imbibe basic and applied things on the subject. “Gupte House” Satish Gupte 60, Lower Gumat, Jammu July 1982 Contents Part I General Bacteriology 1. Glossary of Microbiology ....................................................................................................3 2. History and Scope................................................................................................................10 3. Morphology of Bacteria......................................................................................................16 4. Nutritional Requirements of Bacteria..............................................................................30 5. Bacterial Metabolism ..........................................................................................................35 6. Media for Bacterial Growth...............................................................................................37 7. Classification and Identification of Bacteria..................................................................44 8. Sterilization and Disinfection...........................................................................................50 9. Infection.................................................................................................................................57 10. Antimicrobial Therapy .......................................................................................................60 Part II Bacterial Genetics 11. Bacterial Genetics ................................................................................................................67 Part III Immunology 12. Immunity...............................................................................................................................83 13. Antigen ..................................................................................................................................92 14. Antibodies—Immunoglobulins........................................................................................95 15. Antigen and Antibody Reaction .....................................................................................101 16. The Complement System.................................................................................................107 17. Structure and Functions of Immune System ................................................................111 18. The Immune Response.....................................................................................................117 19. Hypersensitivity.................................................................................................................122 20. Immunohematology..........................................................................................................129 21. Miscellaneous.....................................................................................................................132 Part IV Systematic Bacteriology 22. Staphylococcus ...................................................................................................................145 23. Streptococcus ......................................................................................................................154 24. Pneumococcus.....................................................................................................................162 25. Neisseria ..............................................................................................................................166 26. Corynebacterium.................................................................................................................171 27. Mycobacteria.......................................................................................................................176 28. Bacillus ................................................................................................................................190 x The Short Textbook of Medical Microbiology (Including Parasitology) 29. Clostridium..........................................................................................................................194 30. Enterobacteriaceae.............................................................................................................202 31. Pseudomonas ......................................................................................................................216 32. Vibrio....................................................................................................................................218 33. Campylobacter....................................................................................................................222 34. Helicobacter Pyloridis.......................................................................................................225 35. Brucella................................................................................................................................227 36. Pasteurella, Yersinia and Francisella..............................................................................230 37. Hemophilus..........................................................................................................................234 38. Bordetella ............................................................................................................................237 39. Spirochaetes........................................................................................................................239 40. Miscellaneous Bacteria.....................................................................................................246 41. Rickettsiae...........................................................................................................................253 42. Chlamydiae.........................................................................................................................258 43. Newer Bacteria ...................................................................................................................263 44. Microbiology of Oral Cavity ...........................................................................................267 Part V Virology 45. General Characteristics of Viruses.................................................................................271 46. Chemotherapy of Viral Diseases....................................................................................280 47. Classification of Viruses ..................................................................................................286 48. Oncogenic Viruses.............................................................................................................289 49. DNA Viruses.......................................................................................................................295 50. RNA Viruses.......................................................................................................................302 51. Severe Acute Respiratory Syndrome (SARS)...............................................................311 52. Avian Influenza (Bird Flu)...............................................................................................313 53. Acquired Immune Deficiency Syndrome (AIDS) .......................................................314 54. Miscellaneous Viruses......................................................................................................320 Part VI Mycology 55. Mycology.............................................................................................................................331 Part VII Parasitology 56. Introduction........................................................................................................................353 57. Protozoa...............................................................................................................................357 58. Helminths............................................................................................................................383 59. Medical Entomology.........................................................................................................399 Part VIII Clinical Microbiology 60. The Normal Flora...............................................................................................................409 61. Collection and Transport of Clinical Specimens.........................................................411 62. Collection and Preliminary Processing of Specimens................................................413 Contents xi 63. Diagnostic Microbiology—An Approach to Laboratory Diagnosis........................415 64. Rapid and Automation Methods in Diagnostic Microbiology .................................427 65. Molecular Techniques in Microbiology........................................................................429 66. Serological and Skin Tests...............................................................................................431 67. Microbiology in the Service of Human being..............................................................434 68. Community Microbiology ...............................................................................................436 69. Emerging and Re-emerging Microbial Diseases .........................................................438 70. Nosocomial Infections......................................................................................................441 71. Hospital and Laboratory Waste.......................................................................................444 72. Diagnostic Virology..........................................................................................................447 73. Emergency Microbiology.................................................................................................449 74. Bacteriology of Milk, Air and Water..............................................................................451 Part IX Appendices Appendices 1-15...................................................................................................................459 Index........................................................................................................................................467