Front Cover 1
Medical Microbiology Illustrated 4
Copyright Page 5
Table of Contents 6
Dedication 3
Preface 8
Acknowledgements 10
Chapter 1. Introduction to clinical microbiology 12
Introduction 12
The process of microbiological diagnosis 12
Specimens 12
Sensitivity testing 18
Serology and antigen detection 19
Reporting 19
Typing 21
Computerized records 22
Chapter 2. Gram-positive cocci 23
Introduction 23
Staphylococcus 23
Streptococcus 31
Chapter 3. Gram-positive bacilli 41
Introduction 41
Listeria 47
Chapter 4. Mycobacterial infection 55
Introduction 55
Classification 55
Pathogenesis 55
Clinical importance 56
Laboratory diagnosis 58
Identification techniques 63
Susceptibility testing 66
Chapter 5. Gram-negative cocci (the Neisseriaceae) 69
Classification 69
Classification and clinical importance 69
Neisseria 70
Chapter 6. Gram-negative coccobacilli 79
Introduction 79
Other rare Gram-negative coccobacilli 92
Chapter 7. Gram-negative bacilli 93
Introduction 93
Enterobacteriaceae 93
Chapter 8. Anaerobes 103
Introduction 103
Pathogenesis 104
Laboratory diagnosis 104
Generation of anaerobic atmosphere 107
Identification of anaerobic species 109
Gram-negative non-sporing anaerobes 112
Chapter 9. Spiral bacteria 119
Introduction 119
Borrelia 121
Spirillum minor 123
Chapter 10. Medical mycology 124
Introduction 124
Definitions 124
Classification 125
Opportunistic fungal infections 126
Systemic fungal infections 130
Superficial mycoses 131
Chapter 11. Parasitology 136
Introduction 136
Parasitic infections which present with fever 136
Intestinal parasites 146
Intestinal protozoa 147
Intestinal helminths 150
Chapter 12. The microbiology laboratory: organization and quality assurance 157
Microbiology staff 157
Accreditation 158
Medical audit 159
Laboratory controls 159
Chapter 13. Safety in the laboratory 162
Introduction 162
Control of substances hazardous to health (COSHH) 162
Developing a safety policy 163
Chapter 14. Collection of blood for culture 171
Introduction 171
Principles of blood culture 171
Laboratory examination of blood culture 174
Contamination of blood cultures 176
Concentration techniques 177
Removal of antibiotics in blood 177
Investigation of pyrexia of uncertain origin 177
Chapter 15. Examination of specimens from the central nervous system 182
Acute meningitis 182
Brain abscess 188
Chapter 16. Infections of the respiratory tract 190
Introduction 190
Classification of lower respiratory tract infections 190
Sputum 190
Nasopharyngeal aspiration 192
Lung puncture 193
Throat and nasal swabs 194
Mycoplasma and ureaplasma 195
Chlamydia causing respiratory infection 200
Chapter 17. Examination of faeces for bacterial pathogens 203
Introduction 203
Direct examination 204
Bacteriological culture 204
Chapter 18. Examination of urine and pus 222
Urine 222
Examination of pus 227
Skin 229
Diagnosis of ocular infection 231
Chapter 19. Investigation of specimens from the genital tract and diagnosis of sexually transmitted diseases (STDs) 233
Syphilis 233
Genital mycoplasmas 240
Donovanosis or granuloma inguinale 240
Chancroid 240
Vaginal discharge 241
Chapter 20. Antimicrobial susceptibility 245
Introduction 245
Media 246
Disc diffusion tests 247
Breakpoints 251
Minimal inhibitory and bactericidal concentrations 253
Tests for synergy 255
Antibiotic assays 256
Serum bactericidal levels 258
Beta-lactamase testing 258
Chapter 21. Serological techniques 259
Introduction 259
Antigen–antibody interactions 259
Some indications for serological investigation 261
Precipitation and agglutination techniques 262
Immunofluorescence techniques 266
Radioimmunoassay (RIA) 268
Enzyme-linked immunosorbent assay (ELISA) 268
Detection levels of various techniques 273
Significance of positive results 273
Chapter 22. Bacteriological examination of water, food and air 274
Water 274
Milk 277
Food 278
Air 278
Further reading 281
Index 286