Medical Microbiology and Infection at a Glance
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Stephen H. Gillespie. Medical Microbiology and Infection at a Glance
Table of Contents
Guide
Pages
Medical Microbiology and Infection at a Glance
Biographies
Preface to the fifth edition
About the companion website
Part 1 Concepts. Chapters
1 Microbial pathogens, classification and concepts
Characteristics of bacteria
Bacterial structural components
Bacterial classification
Medically important groups of bacteria
2 Innate and acquired immunity
Phagocytes
Complement and other plasma proteins
The adaptive (specific) immune response
Damaging immunity
3 The ‘normal’ flora in health and disease
Normal flora
Physical and chemical barriers
Mechanisms and consequences of deficiency
4 Pathogenicity and pathogenesis of infectious disease
Definitions
Types of pathogen
Mechanisms of pathogenicity
Access to the host: transmission
Attachment to the host
Invasion
Motility
Immune evasion
Damaging the host. Toxins. Endotoxins
Exotoxins
5 Making a microbiological diagnosis of infection
Specimens
Laboratory examination
Culture
Identification
Susceptibility testing
Serology
Molecular techniques. Southern blotting and nucleic acid hybridization
Nucleic acid amplification tests
Whole genome sequencing
6 Antimicrobial therapy – principals and concepts
Adverse events. Gastrointestinal tract
Skin
Haemopoietic system
Renal system
Liver
Acute allergy and intolerance
Targeting treatment
Monitoring therapy
7 Antibacterial agents – pharmacology and modes of action
Beta‐lactam antibiotics
Penicillins
Cephalosporins
Monobactams
Carbapenems
Aminoglycosides
Glycopeptides
Daptomycin
Quinolones
Macrolides
Streptogramins
Oxazolidinones
Metronidazole
Tetracyclines
Sulphonamides and trimethoprim
8 Antimicrobial use and stewardship
A holistic approach in antibiotic therapy
Antibiotic prescribing policies
Choice of therapy
Routes of administration
Choosing an antibiotic
9 Emergence and detection of resistance
Transmission of resistance determinants between bacteria. Transformation
Conjugation
Transposons and integrons
Multiple resistance
Mechanisms of resistance. Antibiotic modification. Enzyme inactivation
Enzyme addition
Impermeability
Efflux mechanisms
Alternative pathway
Alteration of the target site
Impact of prescribing
10 Sources and transmission of infection
Sources of infection
Endogenous infection
Exogenous infection
Survival and transmission
Airborne/respiratory
Faecal–oral
Parenteral/transcutaneous
Vector‐borne
Sexual transmission
11 Principles of infection control
Identifying an outbreak
Screening and diagnostics
Surveillance systems
Typing
Infection control
Isolation
Wound and enteric isolation
Respiratory isolation
Strict isolation
Protective isolation
12 Infection in the healthcare environment
The environment. Food supply
Air supply
Fomites
Water supply
The host
Medical activities. Intravenous access
Urinary catheters
Respiratory
Surgery
Antibiotic prophylaxis
Operation type
13 Immunization
Immunization
Passive immunization
Vaccination
Vaccine safety
Vaccination schedules
14 Emerging infections
New pathogens
15 High consequence infectious diseases and bioterrorism preparedness
Identification of threat
Assessing the threat
Detecting new infections
Integrated response by health protection bodies
Part 2 Bacteriology. Chapters
16 Staphylococcus
Staphylococcus aureus
Epidemiology
Pathogenesis
Clinical importance
Laboratory diagnosis
Antibiotic susceptibility
Prevention and control
Staphylococcus epidermidis
Clinical importance
Laboratory diagnosis
Antibiotic susceptibility
Staphylococcus haemolyticus
Staphylococcus saprophyticus
Emerging issues
17 Haemolytic streptococcal infections
Microbiological summary
Streptococcus pyogenes
Pathogenesis
Clinical presentation
Prevention and control
Streptococcus agalactiae
Clinical features and diagnosis
Treatment and prevention
Group C and G haemolytic streptococci
18 Other Gram‐positive cocci and the alpha‐haemolytic streptococci
Spectrum of disease
Infective endocarditis
Metastatic abscesses
Bacteraemia and colon cancer
Dental caries
Other Gram‐positive cocci
Alloiococcus otitidis
Streptococcus pseudopneumoniae
Enterococcus spp. Description of the species
Role in human disease
Emergence of resistance and antibiotic choice
Diagnosis
19 Streptococcus pneumoniae
Streptococcus pneumoniae
Pathogenesis
Epidemiology
Diagnosis
Clinical features
Antibiotic susceptibility and treatment
Prevention and control
20 Listeria, bacillus, non‐diphtheria corynebacterium
Listeria
Epidemiology
Clinical features
Laboratory diagnosis
Management
Prevention and control
Corynebacterium spp. Corynebacterium jeikeium
Other corynebacteria and related organisms
Bacillus
Bacillus anthracis
Bacillus cereus
21 Diphtheria, tetanus and pertussis
Corynebacterium diphtheriae. Pathogenesis
Clinical features and management
Laboratory diagnosis
Prevention and control
Tetanus. Epidemiology and pathogenesis
Clinical features
Treatment and prevention
Bordetella spp
Pathogenesis
Clinical features
Laboratory diagnosis
Treatment
Prevention and control
22 Mycobacterium tuberculosis
Mycobacterium tuberculosis. Epidemiology and pathogenesis
Clinical features
Laboratory diagnosis
Treatment
Prevention and control
23 Non‐tuberculous mycobacteria and leprosy
Mycobacterium leprae
Non‐tuberculous mycobacteria (NTM)
Mycobacterium avium–intracellulare complex
Mycobacterium kansasi, Mycobacterium malmoense and Mycobacterium xenopi
Diagnosis
Treatment
24 Clostridium
Clostridium difficile
Epidemiology and pathogenesis
Clinical features
Diagnosis
Treatment and prevention
Botulism
Epidemiology and pathogenesis
Clinical features
Treatment and prevention
Clostridium perfringens
Epidemiology and pathogenesis
Clinical features
Diagnosis
Treatment and prevention
Other Clostridium perfringens syndromes
25 Non‐sporing anaerobic infections
Anaerobic sepsis. Pathogenesis
Clinical syndromes due to non‐sporing anaerobes
Laboratory diagnosis
Antibiotic susceptibility
Management
Prevention and control
Pathogens of anaerobic sepsis
26 Neisseria and Moraxella
Neisseria gonorrhoeae. Epidemiology and pathogenesis
Clinical features
Diagnosis
Treatment and prevention
Neisseria meningitidis
Epidemiology
Pathogenesis and clinical features
Diagnosis and treatment
Prevention
Moraxella catarrhalis
27 Small Gram‐negative coccobacilli: Haemophilus, Brucella, Francisella, Yersinia and Bartonella
Haemophilus
Haemophilus influenzae
Clinical features
Laboratory diagnosis
Treatment and prevention
Haemophilus ducreyi
Brucella spp
Pathogenesis
Clinical features
Laboratory diagnosis
Treatment and prevention
Francisella tularensis
Yersinia. Yersinia enterocolitica
Yersinia pseudotuberculosis
Yersinia pestis
Bartonella spp
28 Pathogenicity of enteric Gram‐negative bacteria
Habitat and transmission
Pathogenicity. Capsules
Lipopolysaccharide
Urease
Fimbriae
Toxins. Enterotoxigenic E. coli
Enteroaggregative E. coli
Enteropathogenic E. coli
Enterohaemorrhagic E. coli
Genetic exchange
29 Enterobacteriaceae clinical syndromes
Salmonella
Salmonellosis
Enteric fever
Other infections. Urinary tract infection and pyelonephritis
Meningitis and brain abscess
Osteomyelitis and septic arthritis
Klebsiella infections
Enterobacter, Serratia and Citrobacter infections
Diagnosis
Treatment and prevention
30 Vibrio, Campylobacter and Helicobacter
Vibrio spp
Vibrio cholerae
Epidemiology
Clinical features
Diagnosis
Treatment
Prevention and control
Campylobacter spp
Pathogenicity
Clinical features
Diagnosis
Treatment
Prevention and control
Helicobacter pylori
Pathogenesis
Clinical features
Diagnosis
Treatment
31 Environmental pathogens: Pseudomonas, Burkholderia, Legionella and Acinetobacter
Pseudomonas spp
Pseudomonas aeruginosa
Pathogenesis
Clinical syndromes
Laboratory diagnosis
Treatment
Prevention and control
Burkholderia spp. Burkholderia cepacia
Burkholderia pseudomallei
Stenotrophomonas maltophilia and Acinetobacter spp
Legionella spp
Pathogenesis
Clinical features
Laboratory diagnosis
Treatment and prevention
32 Chlamydia, Mycoplasma and Rickettsia
Chlamydia
Pathogenicity
Chlamydia pneumoniae
Chlamydia trachomatis
Chlamydia psittaci
Laboratory diagnosis
Mycoplasma and Ureaplasma
Pathogenicity
Clinical features
Laboratory diagnosis
Treatment
Rickettsia
Coxiella burnetii
33 Spiral bacteria
Leptospira
Epidemiology
Pathogenesis and clinical features
Borrelia
Relapsing fever
Lyme disease
Oral spirochaetes
Treponema pallidum
Clinical features
Diagnosis
Treatment
Part 3 Virology. Chapters
34 Virus structure and classification
Viral classification
Genetic material and replication. DNA viruses
RNA viruses
Capsid symmetry
Envelope
Viral diagnosis
Viral pathogenesis
Critical steps in viral pathogenesis
35 Antiviral therapy
Antiviral therapy
Uncoating
Reverse transcriptase inhibition
Nucleoside analogues
Aciclovir
Nucleoside reverse transcriptase inhibitors
Non‐nucleoside reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors
Fusion inhibitors
HIV regimens
Release inhibitors
Immune modulators
36 Herpesviruses I
Classification
Cytomegalovirus. Epidemiology and pathogenesis
Clinical features
Diagnosis
Treatment and prevention
Epstein–Barr virus. Epidemiology and pathogenesis
Clinical features
Diagnosis
Human herpesviruses 6 and 7
Human Kaposi sarcomavirus or human herpesvirus 8
37 Herpesviruses II
Herpes simplex
Pathogenesis and epidemiology
Clinical features
Diagnosis
Treatment
Varicella zoster virus
Pathogenesis and epidemiology
Clinical features
Diagnosis
Treatment and prevention
38 DNA viruses: adenovirus, parvovirus and poxvirus
Adenovirus
Epidemiology and clinical features
Diagnosis
Prevention and control
Parvovirus
Epidemiology
Pathogenesis and clinical features
Diagnosis
Prevention and control
Papillomavirus
Poxvirus
Smallpox
Monkeypox
Orf
Molluscum contagiosum
Tanapox
39 Measles, mumps and rubella
Measles
Pathogenesis and epidemiology
Clinical features
Diagnosis
Mumps
Epidemiology
Clinical features
Diagnosis
Management
Rubella
Epidemiology
Clinical features
Diagnosis
Prevention of measles, mumps and rubella
40 Influenza viruses
Influenza virus. Virology and epidemiology
Epidemic/pandemic ’flu
Avian ’flu
Clinical features
Diagnosis
Treatment, prevention and control
41 Parainfluenza and other respiratory viruses
Parainfluenza virus
Pathogenesis and epidemiology
Clinical features
Diagnosis and treatment
Respiratory syncytial virus
Epidemiology
Clinical features
Diagnosis and treatment
Prevention
Coronavirus
Metapneumovirus
42 Enterovirus and viruses that infect the gastrointestinal tract
Enterovirus
Pathogenesis
Epidemiology
Clinical features
Diagnosis and treatment
Prevention
Rhinovirus
Rotavirus
Pathogenesis
Epidemiology
Diagnosis
Treatment and prevention
Norovirus and astrovirus
43 Hepatitis viruses
Hepatitis A
Diagnosis
Treatment and prevention
Hepatitis B
Clinical features
Diagnosis
Treatment and prevention
Hepatitis D
Hepatitis C
Clinical features
Diagnosis
Treatment and prevention
Hepatitis E
44 Tropical, exotic or arbovirus infections
Rabies
Yellow fever
Clinical features
Dengue
Zika virus
Japanese B encephalitis
West Nile virus
Lassa fever
Ebola virus
Hantavirus
Nipah and Hendra virus
Part 4 Mycology. Chapters
45 Yeast infections
Candida spp
Pathogenesis
Clinical features
Laboratory diagnosis
Antifungal susceptibility
Cryptococcus neoformans
Pathogenesis
Clinical features
Laboratory diagnosis
Treatment
Pityriasis versicolor
Systemic yeast infections
Laboratory diagnosis
Treatment
Antifungal compounds. Azoles
Itraconazole
Voriconazole, posoconazole and isavuconazole
Flucytosine
Echinocandins
Polyenes
46 Filamentous fungi
Aspergillus spp
Pathology and clinical features
Laboratory diagnosis
Treatment and prevention
Other filamentous fungal infections
Dermatophytes
Clinical features
Laboratory diagnosis
Treatment
47 Antifungal drugs and antifungal therapy
Fungal cell targets
Antifungal compounds. Terbinafine
Griseofulvin
Polyenes
Echinocandins
The azoles
Antifungal stewardship
Candidiasis and yeast infections
Aspergillus infections
Cryptococcus infection
Histoplasmosis
Mucormycosis
Prophylaxis
Adjuvant therapy
Part 5 Parasitology. Chapters
48 Intestinal protozoa
Entamoeba histolytica
Clinical features
Diagnosis
Treatment
Prevention and control
Giardia lamblia
Pathogenesis
Clinical features
Laboratory diagnosis
Treatment
Cryptosporidium
Clinical features
Diagnosis and treatment
Cyclospora cayetanensis
Pathogenesis
Clinical features
Diagnosis and treatment
Isospora belli
Microsporidia
Pathogenesis
Diagnosis and treatment
49 Malaria, leishmaniasis and trypanosomiasis
Malaria
Life cycle
Epidemiology
Clinical features
Diagnosis
Treatment
Prevention and control
Leishmaniasis
Clinical features
Diagnosis and treatment
Trypanosomiasis. African trypanosomiasis
Diagnosis and treatment
South American trypanosomiasis
Diagnosis
Treatment
50 Intestinal helminths
Roundworms and hookworms
Epidemiology
Pathogenesis
Clinical features
Diagnosis
Treatment
Threadworms
Strongyloides stercoralis
Clinical features
Diagnosis
Treatment
Prevention
Tapeworms. Taenia spp
Pathogenesis and clinical features
Diagnosis
Treatment and prevention
Diphyllobothrium latum
Hymenolepis nana
51 Tissue helminths
Schistosomiasis
Pathogenesis and clinical features
Diagnosis
Prevention and control
Filariasis
Clinical features
Diagnosis
Treatment
Prevention and control
Hydatid disease
Clonorchis sinensis (Opisthorchis sinensis)
Fasciola hepatica
Paragonimus spp
Part 6 Systemic infection. Chapters
52 Congenital and perinatal infections
Congenital rubella
Cytomegalovirus
Congenital and intrapartum herpes simplex infections
Varicella
Listeriosis
Syphilis
Toxoplasmosis
Zika
Parvovirus
Vaccination
53 HIV infection and AIDS
Human immunodeficiency virus
Epidemiology
Pathogenesis
Clinical features
Diagnostic testing
Treatment
Prevention
54 Pyrexia of unknown origin and puerperal sepsis
Pyrexia of unknown origin. Definition
Aetiology
Investigation
Management
Puerperal fever. Definition
Epidemiology
Clinical features and diagnosis
55 Sepsis
Definition
Aetiology (clinical predisposition and key organisms)
Clinical features
Pathogenesis
Diagnosis
Management
Prevention
56 Endocarditis, myocarditis and pericarditis
Endocarditis
Clinical features
Diagnosis
Complications
Investigation
Management
Prevention
Myocarditis
Pericarditis
57 Infections of the central nervous system
Bacterial meningitis
Clinical features
Complications
Diagnosis
Management
Prevention
Brain abscess
Clinical features
Diagnosis and treatment
Viral meningitis
Viral encephalitis
Postinfectious encephalitis
Spongiform encephalopathies
58 Acute respiratory tract infections
Upper respiratory tract infections. Pharyngitis
Management
Otitis media and sinusitis
Acute epiglottitis
Lower respiratory tract infections. Epidemiology
Clinical features
Complications
Diagnosis
Management and prevention
59 Chronic infections of the lung and hospital acquired pneumonia
Cystic fibrosis
Bronchiectasis
Chronic obstructive pulmonary disease
Empyaema
Hospital acquired pneumoniae (HAP) HAP and ventilator associated pneumonia
60 Urinary and genital infections
Urinary tract infection. Anatomical considerations
Epidemiology and pathogenesis
Clinical features
Laboratory diagnosis
Treatment and prevention
Genital infection
Diagnosis
Treatment
Prevention
Trichomonas vaginalis
Non‐specific vaginosis
Epididymo‐orchitis
61 Infections of the bones and joints
Osteomyelitis
Clinical features
Diagnosis
Treatment
Chronic osteomyelitis
Suppurative arthritis
Clinical features
Prosthetic joint infections
Reactive arthritis
Viral arthritis
Diabetic foot infections
62 Bacterial diarrhoeal disease
Epidemiology
Pathogenesis
Clinical features
Diagnosis
Management
Prevention
63 Zoonoses
Viral zoonoses
Rat‐bite fever
Anthrax
Plague
Borreliosis
Toxoplasmosis
Dermatophytes
Toxocariasis
Cat‐scratch disease
Hydatid disease
Pathogenesis and clinical features
Diagnosis
Treatment
64 Infections in immunocompromised patients
Neutropenia
Treatment of fever in neutropenic patients
Prevention of infection
T‐cell deficiency
Pathogens
Diagnosis
Hypogammaglobulinaemia
Complement deficiency
Mannose‐binding lectin
Postsplenectomy infection
Prevention
Pneumocystis jiroveci
Clinical presentation
Diagnosis
Treatment
Toxoplasma gondii
65 Ocular infections
Bacterial conjunctivitis
Bacterial keratitis
Viral conjunctivitis
Varicella zoster virus
Herpes simplex
Trachoma
Endophthalmitis
Ocular manifestations of HIV
66 Infections of the skin and soft tissue
Bacterial
Disease patterns. Cellulitis
Necrotizing fasciitis
Erythrasma
Erysipelas
Erysipeloid
Burns
Paronychia
Manifestations of systemic infections
Warts
Index
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Fifth Edition
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Gram‐negative bacilli (including the family Enterobacteriaceae) can be part of the normal flora of humans and animals, and in the environment. They include many pathogenic genera: Salmonella, Shigella, Escherichia, Proteus and Yersinia (see Chapters 28 and 29). Pseudomonas and Burkholderia are environmental saprophytes that are naturally resistant to antibiotics and are important healthcare associated pathogens (see Chapter 31). Legionella lives in the environment in water but can cause human infection if conditions in the built environment allow it to gain a foothold (see Chapter 31).
Spiral bacteria include the small gastrointestinal Helicobacter that colonizes the stomach, and may lead to gastric ulcers, duodenal ulcers and gastric cancer. Campylobacter spp. can cause acute diarrhoea (see Chapter 33). The Borrelia may cause a chronic disease of the skin joints and central nervous system, Lyme disease (Borrelia burgdorferi), or rarely relapsing fever (Borrelia duttoni and Borrelia recurrentis). The Leptospira are zoonotic agents that cause an acute meningitis syndrome that may be accompanied by renal failure and hepatitis. The Treponema include the causative agent of syphilis (Treponema pallidum) (Chapter 33).
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