Microbiology a systems approach 3rd ed cowan BBS part 2

Microbiology a systems approach 3rd ed cowan BBS part 2 Microbiology a systems approach 3rd ed cowan BBS part 2 Microbiology a systems approach 3rd ed cowan BBS part 2 Microbiology a systems approach 3rd ed cowan BBS part 2 Microbiology a systems approach 3rd ed cowan BBS part 2 Microbiology a systems approach 3rd ed cowan BBS part 2 Microbiology a systems approach 3rd ed cowan BBS part 2

13.2 The Progress of an Infection 367 Microbe X Virulence Percentage of optimal infectious dose Correct portal of entry High >100 Yes Low No Microbe passes through unnoticed Possible outcomes Host Genetic profile that resists Microbe X (Nonspecific defenses) Previous exposure to Microbe X (Specific immunity) General level of health; production of stress hormones Microbe becomes established without disease (colonization or infection) Microbe causes disease Yes No Figure 13.2 Will disease result from an encounter between a (human) host and a microorganism? In most cases, all of the slider bars must be in the correct ranges and the microbe’s toggle switch must be in the “yes” position while the host’s toggle switch must be in the “no” position in order for disease to occur developed virulence properties Examples of opportunistic pathogens include Pseudomonas species and Candida albicans Factors that greatly predispose a person to infections, both primary and opportunistic, are shown in table 13.4 The relative severity of the disease caused by a particular microorganism depends on the virulence of the microbe Although the terms pathogenicity and virulence are often used interchangeably, virulence is the accurate term for describing the degree of pathogenicity The virulence of a microbe is determined by its ability to establish itself in the host, and cause damage There is much involved in both of these steps To establish themselves in a host, microbes must enter the host, attach firmly to host tissues, and survive the host defenses To cause damage, microbes produce toxins or induce a host response that is actually injurious to the host Any characteristic or structure of the microbe that contributes to the preceding activities is called a virulence factor Virulence can be due to single or multiple factors In some microbes, the causes of virulence are clearly established, but in others they are not In the following section, we examine the effects of virulence fac- tors while simultaneously outlining the stages in the progress of an infection Note that different healthy individuals have widely varying responses to the same microorganism This is determined in part by genetic variation in the specific components of their defense systems That is why the same infectious agent can cause severe disease in one individual and mild or no disease in another Table 13.4 Factors That Weaken Host Defenses and Increase Susceptibility to Infection* • Old age and extreme youth (infancy, prematurity) • Genetic defects in immunity, and acquired defects in immunity (AIDS) • Surgery and organ transplants • Underlying disease: cancer, liver malfunction, diabetes • Chemotherapy/immunosuppressive drugs • Physical and mental stress • Other infections *These conditions compromise defense barriers or immune responses 368 Chapter 13 INSIGHT 13.1 Microbe-Human Interactions Life Without Microbiota For years, questions lingered about how essential the microbiota is to normal life and what functions various members of the biota might serve The need for animal models to further investigate these questions led eventually to development of laboratory strains of germ-free, or axenic, mammals and birds The techniques and facilities required for producing and maintaining a germ-free colony are exceptionally rigorous After the young mammals are taken from the mother aseptically by cesarean section, they are immediately transferred to a sterile isolator or incubator The newborns must be fed by hand through gloved ports in the isolator until they can eat on their own, and all materials entering their chamber must be sterile Rats, mice, rabbits, guinea pigs, monkeys, dogs, hamsters, and cats are some of the mammals raised in the germ-free state A dramatic characteristic of germ-free animals is that they live longer and have fewer diseases than normal controls, as long as they remain in a sterile environment From this standpoint, it is clear that the biota is not needed for survival in this rarefied environment At the same time, it is also clear that axenic life is highly impractical Studies have revealed important facts about the effect of the biota on various organs and systems For example, the biota contributes significantly to the development of the immune system When germ-free animals are placed in contact with normal control animals, they gradually develop a biota similar to that of the controls However, germ-free subjects are less tolerant of microorganisms and can die from infections Sterile enclosure for rearing and handling germ-free laboratory animals Why is there variation? In chapter 7, we described coevolution as changes in genetic composition by one species in response to changes in another Infectious agents evolve in response to their interaction with a host (as in the case of antibiotic resistance) Hosts evolve, too And although their pace of change is much slower than that of a microbe, eventually changes show up in human populations due to their past experiences with pathogens One striking example is sickle cell disease Persons who are carriers of a mutation Table 13.A Effects of the Germ-Free State Germ-Free Animals Display Suggesting That: Enlargement of the cecum; other degenerative diseases of the intestinal tract of rats, rabbits, chickens Microbes are needed for normal intestinal development Vitamin deficiency in rats Microbes are a significant nutritional source of vitamins Underdevelopment of immune system in most animals Microbes are needed to stimulate development of certain host defenses Higher rates of autoimmune disease Microbes are needed to “occupy” the immune system by relatively harmless species This susceptibility is due to the immature character of the immune system of germ-free animals Germ-free animals also have stunted intestinal tracts Table 13.A summarizes some major conclusions arising from studies with germ-free animals In 2008 researchers found that Bacteroides fragilis in the gut produce a molecule that fends off colonization by Helicobacter pylori When scientists isolated this molecule and fed it to mice, it protected them from colitis And normal biota in the mouth apparently are important contributors to taste, according to a recent study It seems that the thiols released from fruits and vegetables (and wines!), which give them their flavor, are released due to the action of oral bacteria Germ-free experiments have clarified the dynamics of several infectious diseases Perhaps the most striking discoveries were made in the case of oral diseases For years, the precise involvement of microbes in dental caries had been ambiguous Studies with germ-free rats, hamsters, and beagles confirmed that caries development is influenced by heredity, a diet high in sugars, and poor oral hygiene Even when all these predisposing factors are present, however, germ-free animals still remain free of caries unless they have been inoculated with specific bacteria Further discussion on dental diseases is found in chapter 22 in their hemoglobin gene (i.e., who inherited one mutated hemoglobin gene and one normal) have few or no sickle cell disease symptoms but are more resistant to malaria than people who have no mutations in their hemoglobin genes When a person inherits two alleles for the mutation (from both parents), that person enjoys some protection from malaria but will suffer from sickle cell disease People of West African descent are much more likely to have one or two sickle cell alleles Malaria is endemic in West 13.2 The Progress of an Infection Africa It seems the hemoglobin mutation is an adaptation of the human host to its long-standing relationship with the malaria protozoan In another example, AIDS researchers have found that people with a particular gene are less likely to be infected by HIV, and are slower to develop symptoms from it Conversely, possessing a different gene gives you weaker cellmediated immunity and that predisposes you to infections that others might not experience These are examples of the variability represented by the slider bar in the lower lefthand corner of figure 13.2 Scientists have also found that bacteria in the human body respond to human stress hormones, such as norepinephrine For example, when nerve cells in the gut produce this hormone, E coli were found to increase their numbers up to ten-thousandfold Other studies have found that some stress hormones can induce bacteria to adhere to hard surfaces, raising the possibility of biofilm formation, and that bacteria increase the expression of pathogenic genes in these hormones These phenomena (depicted with the lower right slider bar in figure 13.2), suggest an intriguing new area of research into the prevention of microbial disease Even though human factors are important, the Centers for Disease Control and Prevention has adopted a system of biosafety categories for pathogens based on their general degree of pathogenicity and the relative danger in handling them This system is explained in more detail in Insight 13.2 Becoming Established: Step One—Portals of Entry To initiate an infection, a microbe enters the tissues of the body by a characteristic route, the portal of entry, usually a cutaneous or membranous boundary The source of the infectious agent can be exogenous, originating from a source outside the body (the environment or another person or animal), or endogenous, already existing on or in the body (normal biota or a previously silent infection) For the most part, the portals of entry are the same anatomical regions that also support normal biota: the skin, gastrointestinal tract, respiratory tract, and urogenital tract The majority of pathogens have adapted to a specific portal of entry, one that provides a habitat for further growth and spread This adaptation can be so restrictive that if certain pathogens enter the “wrong” portal, they will not be infectious For instance, inoculation of the nasal mucosa with the influenza virus invariably gives rise to the flu, but if this virus contacts only the skin, no infection will result Likewise, contact with athlete’s foot fungi in small cracks in the toe webs can induce an infection, but inhaling the fungus spores will not infect a healthy individual Occasionally, an infective agent can enter by more than one portal For instance, Mycobacterium tuberculosis enters through both the respiratory and gastrointestinal tracts, and pathogens in the genera Streptococcus and Staphylococcus have adapted to invasion through several portals of entry such as the skin, urogenital tract, and respiratory tract 369 Infectious Agents That Enter the Skin The skin is a very common portal of entry The actual sites of entry are usually nicks, abrasions, and punctures (many of which are tiny and inapparent) rather than unbroken skin Intact skin is a very tough barrier that few microbes can penetrate Staphylococcus aureus (the cause of boils), Streptococcus pyogenes (an agent of impetigo), the fungal dermatophytes, and agents of gangrene and tetanus gain access through damaged skin The viral agent of cold sores (herpes simplex, type 1) enters through the mucous membranes near the lips Some infectious agents create their own passageways into the skin using digestive enzymes For example, certain helminth worms burrow through the skin directly to gain access to the tissues Other infectious agents enter through bites The bites of insects, ticks, and other animals offer an avenue to a variety of viruses, rickettsias, and protozoa An artificial means for breaching the skin barrier is contaminated hypodermic needles by intravenous drug abusers Users who inject drugs are predisposed to a disturbing list of well-known diseases: hepatitis, AIDS, tetanus, tuberculosis, osteomyelitis, and malaria Contaminated needles often contain bacteria from the skin or environment that induce heart disease (endocarditis), lung abscesses, and chronic infections at the injection site Although the conjunctiva, the outer protective covering of the eye, is ordinarily a relatively good barrier to infection, bacteria such as Haemophilus aegyptius (pinkeye), Chlamydia trachomatis (trachoma), and Neisseria gonorrhoeae have a special affinity for this membrane The Gastrointestinal Tract as Portal The gastrointestinal tract is the portal of entry for pathogens contained in food, drink, and other ingested substances They are adapted to survive digestive enzymes and abrupt pH changes The best-known enteric agents of disease are gram-negative rods in the genera Salmonella, Shigella, Vibrio, and certain strains of Escherichia coli Viruses that enter through the gut are poliovirus, hepatitis A virus, echovirus, and rotavirus Important enteric protozoans are Entamoeba histolytica (amoebiasis) and Giardia lamblia (giardiasis) Recent research has also shown that the intestines contain a wide variety of plant bacteria (which enter on food) It is not known whether these organisms cause disease, but scientists speculate they may be responsible for complaints that doctors can’t diagnose The anus is a portal of entry in people who practice anal sex See chapter 22 for details of these diseases The Respiratory Portal of Entry The oral and nasal cavities are also the gateways to the respiratory tract, the portal of entry for the greatest number of pathogens Because there is a continuous mucous membrane surface covering the upper respiratory tract, the sinuses, and the auditory tubes, microbes are often transferred from one site to another The extent to which an agent is carried into the respiratory tree is based primarily 370 Chapter 13 Microbe-Human Interactions INSIGHT 13.2 Laboratory Biosafety Levels and Classes of Pathogens Personnel handling infectious agents in the laboratory must be protected from possible infection through special risk management or containment procedures These involve: carefully observing standard laboratory aseptic and sterile procedures while handling cultures and infectious samples; using large-scale sterilization and disinfection procedures; refraining from eating, drinking, and smoking; and wearing personal protective items such as gloves, masks, safety glasses, laboratory coats, boots, and headgear Some circumstances also require additional protective equipment such as biological safety cabinets for inoculations and specially engineered facilities to control materials entering and leaving the laboratory in the air and on personnel Table 13.B summarizes the primary biosafety levels and agents of disease as characterized by the Centers for Disease Control and Prevention TABLE 13.B Primary Biosafety Levels and Agents of Disease Biosafety Level Facilities and Practices Risk of Infection and Class of Pathogens Standard, open bench, no special facilities needed; typical of most microbiology teaching labs; access may be restricted Low infection hazard; microbes not generally considered pathogens and will not colonize the bodies of healthy persons; Micrococcus luteus, Bacillus megaterium, Lactobacillus, Saccharomyces At least level facilities and practices; plus personnel must be trained in handling pathogens; lab coats and gloves required; safety cabinets may be needed; biohazard signs posted; access restricted Agents with moderate potential to infect; class pathogens can cause disease in healthy people but can be contained with proper facilities; most pathogens belong to class 2; includes Staphylococcus aureus, Escherichia coli, Salmonella spp., Corynebacterium diphtheriae; pathogenic helminths; hepatitis A, B, and rabies viruses; Cryptococcus and Blastomyces Minimum of level facilities and practices; plus all manipulation performed in safety cabinets; lab designed with special containment features; only personnel with special clothing can enter; no unsterilized materials can leave the lab; personnel warned, monitored, and vaccinated against infection dangers Agents can cause severe or lethal disease especially when inhaled; class microbes include Mycobacterium tuberculosis, Francisella tularensis, Yersinia pestis, Brucella spp., Coxiella burnetii, Coccidioides immitis, and yellow fever, WEE, and HIV Minimum of level facilities and practices; plus facilities must be isolated with very controlled access; clothing changes and showers required for all people entering and leaving; materials must be autoclaved or fumigated prior to entering and leaving lab Agents are highly virulent microbes that pose extreme risk for morbidity and mortality when inhaled in droplet or aerosol form; most are exotic flaviviruses; arenaviruses, including Lassa fever virus; or filoviruses, including Ebola and Marburg viruses on its size In general, small cells and particles are inhaled more deeply than larger ones Infectious agents with this portal of entry include the bacteria of streptococcal sore throat, meningitis, diphtheria, and whooping cough and the viruses of influenza, measles, mumps, rubella, chickenpox, and the common cold Pathogens that are inhaled into the lower regions of the respiratory tract (bronchioles and lungs) can cause pneumonia, an inflammatory condition of the lung Bacteria (Streptococcus pneumoniae, Klebsiella, Mycoplasma) and fungi (Cryptococcus and Pneumocystis) are a few of the agents involved in pneumonias Other agents causing unique recognizable lung diseases are 13.2 The Progress of an Infection Mycobacterium tuberculosis and fungal pathogens such as Histoplasma Chapter 21 describes infections of the respiratory system and gonorrhea have been supplanted by a large and growing list of STDs led by genital warts, chlamydia, and herpes Evolving sexual practices have increased the incidence of STDs that were once uncommon, and diseases that were not originally considered STDs are now so classified.2 Other common sexually transmitted agents are HIV (AIDS virus), Trichomonas (a protozoan), Candida albicans (a yeast), and hepatitis B virus STDs are described in detail in chapter 23, with the exception of HIV (see chapter 20) and hepatitis B (see chapter 22) Not all urogenital infections are STDs Some of these infections are caused by displaced organisms (as when normal biota from the gastrointestinal tract cause urinary tract infections) or by opportunistic overgrowth of normal biota (“yeast infections”) Urogenital Portals of Entry The urogenital tract is the portal of entry for many pathogens that are contracted by sexual means (intercourse or intimate direct contact) Sexually transmitted diseases (STDs) account for an estimated 4% of infections worldwide, with approximately 13 million new cases occurring in the United States each year The most recent available statistics for the estimated incidence of common STDs are provided in table 13.5 The microbes of STDs enter the skin or mucosa of the penis, external genitalia, vagina, cervix, and urethra Some can penetrate an unbroken surface; others require a cut or abrasion The once predominant sexual diseases syphilis Pathogens That Infect During Pregnancy and Birth The placenta is an exchange organ—formed by maternal and fetal tissues—that separates the blood of the developing fetus from that of the mother yet permits diffusion of dissolved nutrients and gases to the fetus The placenta is ordinarily an effective barrier against microorganisms in the maternal circulation However, a few microbes such as the syphilis spirochete can cross the placenta, enter the umbilical vein, and spread by the fetal circulation into the fetal tissues (figure 13.3) Other infections, such as herpes simplex, can occur perinatally when the child is contaminated by the birth canal Table 13.5 Incidence of Common Sexually Transmitted Diseases STD Estimated Number of New Cases per Year in United States Human papillomavirus Trichomoniasis Chlamydiosis Herpes simplex Gonorrhea Hepatitis B AIDS Syphilis 6,000,000 5,000,000 3,000,000 1,600,000 356,000 77,000 41,000 41,000 371 Amoebic dysentery, scabies, salmonellosis, and Strongyloides worms are examples Placenta Maternal blood pools within intervillous space Bacterial cells Umbilical cord Umbilical vein Placenta Umbilical arteries Maternal blood vessel (a) (b) Umbilical cord Figure 13.3 Transplacental infection of the fetus (a) Fetus in the womb (b) In a closer view, microbes are shown penetrating the maternal blood vessels and entering the blood pool of the placenta They then invade the fetal circulation by way of the umbilical vein 372 Chapter 13 Microbe-Human Interactions The common infections of fetus and neonate are grouped together in a unified cluster, known by the acronym TORCH, that medical personnel must monitor TORCH stands for toxoplasmosis, other diseases (hepatitis B, AIDS, and chlamydia), rubella, cytomegalovirus, and herpes simplex virus The most serious complications of TORCH infections are spontaneous abortion, congenital abnormalities, brain damage, prematurity, and stillbirths The Size of the Inoculum Another factor crucial to the course of an infection is the quantity of microbes in the inoculating dose For most agents, infection will proceed only if a minimum number, called the infectious dose (ID), is present This number has been determined experimentally for many microbes In general, microorganisms with smaller infectious doses have greater virulence On the low end of the scale, the ID for rickettsia, the causative agent of Q fever, is only a single cell, and it is only about 10 infectious cells in tuberculosis, giardiasis, and coccidioidomycosis The ID is 1,000 bacteria for gonorrhea and 10,000 bacteria for typhoid fever, in contrast to 1,000,000,000 bacteria in cholera Numbers below an infecF Bacteria Host cell (a) Fimbriae Bacterial cell C Host cell (b) Capsules S tious dose will generally not result in an infection But if the quantity is far in excess of the ID, the onset of disease can be extremely rapid Becoming Established: Step Two—Attaching to the Host How Pathogens Attach Adhesion is a process by which microbes gain a more stable foothold on host tissues Because adhesion is dependent on binding between specific molecules on both the host and pathogen, a particular pathogen is limited to only those cells (and organisms) to which it can bind Once attached, the pathogen is poised advantageously to invade the body compartments Bacterial, fungal, and protozoal pathogens attach most often by mechanisms such as fimbriae (pili), surface proteins, and adhesive slimes or capsules; viruses attach by means of specialized receptors (figure 13.4) In addition, parasitic worms are mechanically fastened to the portal of entry by suckers, hooks, and barbs Adhesion methods of various microbes and the diseases they lead to are shown in table 13.6 Firm attachment to host tissues is Table 13.6 Adhesive Properties of Microbes Microbe Disease Adhesion Mechanism Neisseria gonorrhoeae Gonorrhea Fimbriae attach to genital epithelium Escherichia coli Diarrhea Fimbrial adhesin Shigella Dysentery Fimbriae attach to intestinal epithelium Mycoplasma Pneumonia Specialized tip at ends of bacteria fuse tightly to lung epithelium Pseudomonas aeruginosa Burn, lung infections Fimbriae and slime layer Streptococcus pyogenes Pharyngitis, impetigo Lipoteichoic acid and capsule anchor cocci to epithelium Streptococcus mutans, S sobrinus Dental caries Dextran slime layer glues cocci to tooth surface after initial attachment Influenza virus Influenza Viral spikes attach to receptor on cell surface Poliovirus Polio Capsid proteins attach to receptors on susceptible cells HIV AIDS Viral spikes adhere to white blood cell receptors Giardia lamblia (protozoan) Giardiasis Small suction disc on underside attaches to intestinal surface Virus Host cell (c) Spikes Figure 13.4 Mechanisms of adhesion by pathogens (a) Fimbriae (F), minute bristlelike appendages (b) Adherent extracellular capsules (C) made of slime or other sticky substances (c) Viral envelope spikes (S) See table 13.6 for specific examples 373 13.2 The Progress of an Infection almost always a prerequisite for causing disease since the body has so many mechanisms for flushing microbes and foreign materials from its tissues Cell cement Epithelial cell Bacteria Becoming Established: Step Three—Surviving Host Defenses Microbes that are not established in a normal biota relationship in a particular body site in a host are likely to encounter resistance from host defenses when first entering, especially from certain white blood cells called phagocytes These cells ordinarily engulf and destroy pathogens by means of enzymes and antimicrobial chemicals (see chapter 14) Antiphagocytic factors are a type of virulence factor used by some pathogens to avoid phagocytes The antiphagocytic factors of resistant microorganisms help them to circumvent some part of the phagocytic process (see figure 13.5c) The most aggressive strategy involves bacteria that kill phagocytes outright Species of both Streptococcus and Staphylococcus produce leukocidins, substances that are toxic to white blood cells Some microorganisms secrete an extracellular surface layer (slime or capsule) that makes it physically difficult for the phagocyte to engulf them Streptococcus pneumoniae, Salmonella typhi, Neisseria meningitidis, and Cryptococcus neoformans are notable examples Some bacteria are well adapted to survival inside phagocytes after ingestion For instance, pathogenic species of Legionella, Mycobacterium, and many rickettsias are readily engulfed but are capable of avoiding further destruction The ability to survive intracellularly in phagocytes has special significance because it provides a place for the microbes to hide, grow, and be spread throughout the body Causing Disease How Virulence Factors Contribute to Tissue Damage Virulence factors from a microbe’s perspective are simply adaptations it uses to invade and establish itself in the host (You will remember from chapter that many virulence factors can be found on pathogenicity islands, genetic regions that have been passed horizontally from other microbes.) These same factors determine the degree of tissue damage that occurs The effects of a pathogen’s virulence factors on tissues vary greatly Cold viruses, for example, invade and multiply but cause relatively little damage to their host At the other end of the spectrum, pathogens such as Clostridium tetani or HIV severely damage or kill their host Microorganisms either inflict direct damage on hosts through the use of exoenzymes or toxins (figure 13.5a,b), or they cause damage indirectly when their presence causes an excessive or inappropriate host response (figure 13.5c) For convenience, we divide the “directly damaging” virulence factors into exoenzymes and toxins Although this distinction is useful, there is often a very fine line between enzymes and toxins because many substances called toxins actually function as enzymes Microbial virulence factors are often responsible for inducing the host to cause damage, as well The capsule (a) Exoenzymes Bacteria Exotoxins Epithelial cells Nucleus (b) Toxins Capsule Bacteria cannot be engulfed Blocked Phagocyte Continued presence of microbes damages host tissue (c) Blocked phagocytic response Figure 13.5 Three ways microbes damage the host (a) Exoenzymes Bacteria produce extracellular enzymes that dissolve intracellular connections and penetrate through or between cells to underlying tissues (b) Toxins (primarily exotoxins) secreted by bacteria diffuse to target cells, which are poisoned and disrupted (c) Bacterium has a property that enables it to escape phagocytosis and remain as an “irritant” to host defenses, which are deployed excessively of Streptococcus pneumoniae is a good example Its presence prevents the bacterium from being cleared from the lungs by phagocytic cells, leading to a continuous influx of fluids into the lung spaces, and the condition we know as pneumonia Extracellular Enzymes Many pathogenic bacteria, fungi, protozoa, and worms secrete exoenzymes that break down and inflict damage on tissues Other enzymes dissolve the host’s defense barriers and promote the spread of microbes to deeper tissues Examples of enzymes are: mucinase, which digests the protective coating on mucous membranes and is a factor in amoebic dysentery; 374 Chapter 13 Microbe-Human Interactions keratinase, which digests the principal component of skin and hair, and is secreted by fungi that cause ringworm; collagenase, which digests the principal fiber of connective tissue and is an invasive factor of Clostridium species and certain worms; and hyaluronidase, which digests hyaluronic acid, the ground substance that cements animal cells together This enzyme is an important virulence factor in staphylococci, clostridia, streptococci, and pneumococci Some enzymes react with components of the blood Coagulase, an enzyme produced by pathogenic staphylococci, causes clotting of blood or plasma By contrast, the bacterial kinases (streptokinase, staphylokinase) just the opposite, dissolving fibrin clots and expediting the invasion of damaged tissues In fact, one form of streptokinase (Streptase) is marketed as a therapy to dissolve blood clots in patients with problems with thrombi and emboli.3 Bacterial Toxins: A Potent Source of Cellular Damage A toxin is a specific chemical product of microbes, plants, and some animals that is poisonous to other organisms Toxigenicity, the power to produce toxins, is a genetically controlled characteristic of many species and is responsible for the adverse effects of a variety of diseases generally called toxinoses Toxinoses in which the toxin is spread by the blood from the site of infection are called toxemias (teta3 These conditions are intravascular blood clots that can cause circulatory obstructions nus and diphtheria, for example), whereas those caused by ingestion of toxins are intoxications (botulism) A toxin is named according to its specific target of action: Neurotoxins act on the nervous system; enterotoxins act on the intestine; hemotoxins lyse red blood cells; and nephrotoxins damage the kidneys Another useful scheme classifies toxins according to their origins (figure 13.6) A toxin molecule secreted by a living bacterial cell into the infected tissues is an exotoxin A toxin that is not actively secreted but is shed from the outer membrane is an endotoxin Other important differences between the two groups are summarized in table 13.7 Exotoxins are proteins with a strong specificity for a target cell and extremely powerful, sometimes deadly, effects They generally affect cells by damaging the cell membrane and initiating lysis or by disrupting intracellular function Hemolysins (hee-mahl′-uh-sinz) are a class of bacterial exotoxin that disrupts the cell membrane of red blood cells (and some other cells, too) This damage causes the red blood cells to hemolyze—to burst and release hemoglobin pigment Hemolysins that increase pathogenicity include the streptolysins of Streptococcus pyogenes and the alpha (α) and beta (β) toxins of Staphylococcus aureus When colonies of bacteria growing on blood agar produce hemolysin, distinct zones appear around the colony The pattern of hemolysis is often used to identify bacteria and determine their degree of pathogenicity The exotoxins of diphtheria, tetanus, and botulism, among others, attach to a particular target cell, become internalized, and interrupt an essential cell pathway The consequences of Exotoxins Cell wall Endotoxin (a) Target organs are damaged; heart, muscles, blood cells, intestinal tract show dysfunctions (b) General physiological effects— fever, malaise, aches, shock Figure 13.6 The origins and effects of circulating exotoxins and endotoxin (a) Exotoxins, given off by live cells, have highly specific targets and physiological effects (b) Endotoxin, given off when the cell wall of gram-negative bacteria disintegrates, has more generalized physiological effects 13.2 The Progress of an Infection Table 13.7 Differential Characteristics of Bacterial Exotoxins and Endotoxin Characteristic Exotoxins Endotoxin Toxicity Toxic in minute amounts Toxic in high doses Effects on the body Specific to a cell type (blood, liver, nerve) Systemic: fever, inflammation Chemical composition Small proteins Lipopolysaccharide of cell wall Heat denaturation at 60°C Unstable Stable Toxoid formation Can be converted to toxoid* Cannot be converted to toxoid Immune response Stimulate antitoxins** Does not stimulate antitoxins Fever stimulation Usually not Yes Manner of release Secreted from live cell Released by cell via shedding or during lysis Typical sources A few gram- All gram-negative positive and gramnegative bacteria *A toxoid is an inactivated toxin used in vaccines **An antitoxin is an antibody that reacts specifically with a toxin is not a trait inherent in microorganisms, but is really a consequence of the interplay between microbe and host Of course, it is easier to study and characterize the microbes that cause direct damage through toxins or enzymes For this reason, these true pathogens were the first to be fully understood as the science of microbiology progressed But in the last 15 to 20 years, microbiologists have come to appreciate exactly how important the relationship between microbe and host is, and this has greatly expanded our understanding of infectious diseases The Process of Infection and Disease Establishment, Spread, and Pathologic Effects Aided by virulence factors, microbes eventually settle in a particular target organ and cause damage at the site The type A Note About Terminology Words in medicine have great power and economy A single technical term can often replace a whole phrase or sentence, thereby saving time and space in patient charting The beginning student may feel overwhelmed by what seems like a mountain of new words However, having a grasp of a few root words and a fair amount of anatomy can help you learn many of these words and even deduce the meaning of unfamiliar ones Some examples of medical shorthand follow • cell disruption depend upon the target One toxin of Clostridium tetani blocks the action of certain spinal neurons; the toxin of Clostridium botulinum prevents the transmission of nervemuscle stimuli; pertussis toxin inactivates the respiratory cilia; and cholera toxin provokes profuse salt and water loss from intestinal cells More details of the pathology of exotoxins are found in later chapters on specific diseases In contrast to the category exotoxin, which contains many specific examples, the word endotoxin refers to a single substance Endotoxin is actually a chemical called lipopolysaccharide (LPS), which is part of the outer membrane of gramnegative cell walls Gram-negative bacteria shed these LPS molecules into tissues or into the circulation Endotoxin differs from exotoxins in having a variety of systemic effects on tissues and organs Depending upon the amounts present, endotoxin can cause fever, inflammation, hemorrhage, and diarrhea Blood infection by gram-negative bacteria such as Salmonella, Shigella, Neisseria meningitidis, and Escherichia coli are particularly dangerous, in that it can lead to fatal endotoxic shock Inducing an Injurious Host Response Despite the extensive discussion on direct virulence factors, such as enzymes and toxins, it is probably the case that more microbial diseases are the result of indirect damage, or the host’s excessive or inappropriate response to a microorganism This is an extremely important point because it means that pathogenicity 375 • • • The suffix -itis means an inflammation and, when affixed to the end of an anatomical term, indicates an inflammatory condition in that location Thus, meningitis is an inflammation of the meninges surrounding the brain; encephalitis is an inflammation of the brain itself; hepatitis involves the liver; vaginitis, the vagina; gastroenteritis, the intestine; and otitis media, the middle ear Although not all inflammatory conditions are caused by infections, many infectious diseases inflame their target organs The suffix -emia is derived from the Greek word haeima, meaning blood When added to a word, it means “associated with the blood.” Thus, septicemia means sepsis (infection) of the blood; bacteremia, bacteria in the blood; viremia, viruses in the blood; and fungemia, fungi in the blood It is also applicable to specific conditions such as toxemia, gonococcemia, and spirochetemia The suffix -osis means “a disease or morbid process.” It is frequently added to the names of pathogens to indicate the disease they cause: for example, listeriosis, histoplasmosis, toxoplasmosis, shigellosis, salmonellosis, and borreliosis A variation of this suffix is -iasis, as in trichomoniasis and candidiasis The suffix -oma comes from the Greek word onkomas (swelling) and means tumor Although it is often used to describe cancers (sarcoma, melanoma), it is also applied in some infectious diseases that cause masses or swellings (tuberculoma, leproma) The Classic Stages of Clinical Infections and scope of injuries inflicted during this process account for the typical stages of an infection (Insight 13.3), the patterns of the infectious disease, and its manifestations in the body In addition to the adverse effects of enzymes, toxins, and other factors, multiplication by a pathogen frequently weakens host tissues Pathogens can obstruct tubular structures such as blood vessels, lymphatic channels, fallopian tubes, and bile ducts Accumulated damage can lead to cell and tissue death, a condition called necrosis Although viruses not produce toxins or destructive enzymes, they destroy cells by multiplying in and lysing them Many of the cytopathic effects of viral infection arise from the impaired metabolism and death of cells (see chapter 6) Patterns of Infection Patterns of infection are many and varied In the simplest situation, a localized infection, the microbe enters the body and remains confined to a specific tissue (figure 13.7a) Examples of localized infections are boils, fungal skin infections, and warts Many infectious agents not remain localized but spread from the initial site of entry to other tissues In fact, spreading is necessary for pathogens such as rabies and Height of infection Convalescent period healing nature of the immune response During this period many patients stop taking their antibiotics, even though there are still pathogens in their system And think about it—the ones still alive at this stage of treatment are the ones in the population with the most resistance to the antibiotic In most cases, continuing the antibiotic dosing will take care of them But stop taking the drug now and the bugs that are left to repopulate are the ones with the higher resistance The transmissibility of the microbe during these four stages must be considered on an individual basis A few agents are released mostly during incubation (measles, for example); many are released during the invasive period (Shigella); and others can be transmitted during all of these periods (hepatitis B) Period of invasion There are four distinct phases of infection and disease: the incubation period, the prodrome, the period of invasion, and the convalescent period The incubation period is the time from initial contact with the infectious agent (at the portal of entry) to the appearance of the first symptoms During the incubation period, the agent is multiplying at the portal of entry but has not yet caused enough damage to elicit symptoms Although this period is relatively well defined and predictable for each microorganism, it does vary according to host resistance, degree of virulence, and distance between the target organ and the portal of entry (the farther apart, the longer the incubation period) Overall, an incubation period can range from several hours in pneumonic plague to several years in leprosy The majority of infections, however, have incubation periods ranging between and 30 days The earliest notable symptoms of infection appear as a vague feeling of discomfort, such as head and muscle aches, fatigue, upset stomach, and general malaise This short period (1–2 days) is known as the prodromal stage The infectious agent next enters a period of invasion, during which it multiplies at high levels, exhibits its greatest toxicity, and becomes well established in its target tissue This period is often marked by fever and other prominent and more specific signs and symptoms, which can include cough, rashes, diarrhea, loss of muscle control, swelling, jaundice, discharge of exudates, or severe pain, depending on the particular infection The length of this period is extremely variable As the patient begins to respond to the infection, the symptoms decline—sometimes dramatically, other times slowly During the recovery that follows, called the convalescent period, the patient’s strength and health gradually return owing to the Prodromal stage INSIGHT 13.3 Microbe-Human Interactions Incubation period Chapter 13 Intensity of Symptoms 376 Initial exposure to microbe Time Stages in the course of infection and disease Dashed lines represent periods with a variable length hepatitis A virus, whose target tissue is some distance from the site of entry The rabies virus travels from a bite wound along nerve tracts to its target in the brain, and the hepatitis A virus moves from the intestine to the liver via the circulatory system When an infection spreads to several sites and tissue fluids, usually in the bloodstream, it is called a systemic infection (figure 13.7b) Examples of systemic infections are viral diseases (measles, rubella, chickenpox, and AIDS); bacterial diseases (brucellosis, anthrax, typhoid fever, and syphilis); and fungal diseases (histoplasmosis and cryptococcosis) Infectious agents can also travel to their targets by means of nerves (as in rabies) or cerebrospinal fluid (as in meningitis) A focal infection is said to exist when the infectious agent breaks loose from a local infection and is carried into other tissues (figure 13.7c) This pattern is exhibited by tuberculosis or by streptococcal pharyngitis, which gives rise to scarlet fever In the condition called toxemia,4 the infection itself remains localized at the portal of entry, but the toxins produced by the pathogens are carried by the blood to the actual target tissue Not to be confused with toxemia of pregnancy, which is a metabolic disturbance and not an infection Index Hybridoma, 444 Hydra, 327 Hydramacin, 327, 330 Hydrated ions, 38 Hydrogen atomic structure, 28f covalent bonding, 33f elements of life, 29t, 30f microbial nutrition, 169t, 170 Hydrogen bonds, 33f, 36–37, 170 Hydrogen peroxide, 183, 314, 315t, 317–18 Hydrogen sulfide, 750 Hydrolases, 203 Hydrologic cycle, 755 Hydrolysis reactions, 45, 204, 205f Hydrophilic ions, 38 Hydrophobia, 568 Hydrophobic ions, 38 Hydrosphere, 743 Hydrothermal vents, 173, 186, 228, 756 Hydroxyl, 41f Hygiene hypothesis, for allergies, 462 Hymenolepis diminuta, 696 Hymenolepis nana, 696 Hymenostomatida (Order), 21f Hymenostomea (Class), 21f Hyperbaric oxygen therapy, 524 Hypersensitivities, and allergy, 461t, 470–79 Hyperthermophiles, 105 Hypertonic conditions, 176, 177 Hypervariable regions, 437 Hyphae, 121 Hyphomicrobium, 758 Hypochlorites, 315, 316 Hypochlorous cid (HOCI), 315 Hypogammaglobulinemia, 484 Hypolimnion, 757 Hyposensitization, to allergens, 469 Hypothalamus, 416 Hypothesis, and scientific method, 15 Hypotonic conditions, 176, 177 -Iasis (suffix), 375 Iceberg effect, in epidemiology, 390–91 Icosahedral viruses, 144–45, 146f Identification, of microorganisms, 18 See also Diagnosis animal viruses, 160–62 fungi, 126 helminths, 135 overview of laboratory techniques, 56f, 65–66 protozoa, 131 selection of antimicrobial drugs, 354 IgA, 438, 439f, 484, 720 IgD, 438, 439f IgE, 438–39 IgE-mediated allergies, 463–64, 466–67 IgG, 438, 439f IgG blocking antibodies, 470 IgM, 438, 439, 531 Imipenem, 357 Immediate hypersensitivity, 461t Immigration See also Travel health care for refugees, 397 helminthic infections, 692 tuberculosis, 642 Immune complex-mediated hypersensitivity, 461t Immune complex reactions, 474–76 Immune deficiency, theory of, 480 Immune disorders autoimmunity, 479–82 immune response, 460–61 immunodeficiency diseases, 482–86 type II hypersensitivities, 470–74 type III hypersensitivities, 474–76 type IV hypersensitivities, 476–79 Immune privilege, 540 Immune response atopy and anaphylaxis as type I allergic reactions, 461–70 bacterial toxins, 375t immune disorders, 460–61 Immune serum globulin (ISG), 446 Immune system See Host defenses; Immune disorders; Immune response; Immunology; Immunotherapy; Specific immunity Immune testing, 499–502 Immunity, 398, 425 Immunization, 446–47 See also vaccination and vaccines Immunoassays, 504–507 Immunocompetence, 425 Immunocompromised patients, and chickenpox, 525 Immunodeficiency diseases, 461, 482–86 See also Acquired immunodeficiency syndrome Immunofluorescence testing, 504, 505f Immunogens, 425, 432, 436 Immunoglobulins, 430f, 431, 438–39, 484 Immunologic methods, of diagnosis, 491– 92, 499–507 Immunologic privilege, 552 Immunologic reactions, and viral encephalitis, 564t Immunology, 4t, 401 Immunopathology, 460 Immunosuppressant agents and immunosuppressed patients, 483t, 649 Immunotherapy, 445 Impellers, of fermentor, 781 Impetigo, 516–18, 520–21 Inactivated vaccines, 449t, 571 Inactive viruses, 141 Inappropriate expression of MHC II markers, 480 Incidence, of infectious disease, 389 Incineration, and microbial control, 308 Inclusion bodies, 82f, 95–96, 156 Incubating carriers, 380 I-13 Incubation, of cultures, 56f, 57, 65–66 Incubation period, of infection, 376 Index case, 390 India, and plague epidemics, 591 India ink, 74, 75f Indiana State Department of Health, 424, 455, 550, 576 Indicator bacteria, 767 Indinavir, 345t Indirect ELISA, 506–507 Indirect testing methods, 504 Indirect transmission, 383 Induced mutations, 256 Induction, of bacteriophage, 159 Inductive reasoning, 16 Induration, and diagnosis of tuberculosis, 642–43 Industry and industrial microbiology, 5t, 126, 778–83 See also Mining industry; Pharmaceutical industry Infant(s) See also Children; Pregnancy botulism, 574, 575–76 chlamydial infections, 722 congenital rubella, 531–32 gonorrhea, 719–20 group B streptococcus “colonization” neonatal disease, 733–34 herpes, 728 HIV transmission, 611 “hygiene hypothesis” for allergies, 462 melamine in formulas, 285 neonatal conjunctivitis, 540, 541t neonatal meningitis, 558–60 normal microbiota, 365–66 pertussis, 634 pneumonia, 646 respiratory syncytial virus, 635 rotavirus, 681 staphylococcal scalded skin syndrome, 522 TORCH infections, 372 Infantile paralysis, 570, 572 Infection(s) See also Diseases; Infectious diseases allergies mistaken for, 461 attachment, 372–73 biofilm, 87 classic stages of, 376 establishment of, 373 fungi, 127t Koch’s postulates and etiology of, 386–87 progress of, 366–87 protozoa, 131–32 viral, 165 Infection control officer, 385 Infectious, use of term, 382 Infectious allergy, 476 Infectious disease, 363 See also Disease(s); Infection(s) Infectious dose (ID), 372 Infectious mononucleosis, 596–97 I-14 Index Infectious particles, 141 Infertility, and pelvic inflammatory disease, 720 Inflammation pelvic inflammatory disease, 720 signs and symptoms, 378 stages of, 410–14 Inflammatory bowel disease (IBD), 400, 663, 694 Inflammatory mediators, 412 Inflammatory response, 410 Influenza, 635–39 adhesive properties, 372t antiviral drugs, 345t, 639 causative agent, 636–37 creation of artificial viruses, 163 culture and diagnosis, 162, 637, 639 cytopathic changes in cells, 156t epidemiology, 637 Google Flu Trends, 362, 388, 392 history of, 636 importance of study, 635 pathogenesis and virulence factors, 637 prevention, 639 signs and symptoms, 635 transmission, 637 treatment, 345t, 639 Ingestants, and allergens, 463 Inhalants, and allergens, 462, 463f Injectant allergies, 463 Inoculating loop, 57 Inoculation, 56f, 57 Inoculum, 372 Inorganic nutrients, 169 Insect(s) See Arthropods; Black flies; Fleas; Houseflies; Insecticides; Mosquitoes; Sand fly; Ticks Insecticides See Bioinsecticides; DDT; DEET Insertion elements, 263–64 Inspection, of cultures, 56f, 65–66 Insulin, 282, 287 Integrase inhibitors, 165, 615 Integration, of viruses, 155 Integument, 513 Interferon (IFN), 165, 283t, 344, 412, 417–18 Interferon alpha and beta, 417 Interferon gamma, 412, 417 Interleukin (IL), 283t, 412 Interleukin–1 (IL–1), 416 Interleukin–2 (IL–2), 412, 434 Interleukin–4, 412 Interleukin–5, 412 Interleukin–6, 412 Interleukin–10, 412 Interleukin–12, 412 Intermediate filaments, 120 Intermediate-level germicides, 315 Intermittent sterilization, 307–308 International Committee on the Taxonomy of Viruses, 149 Internet, 362, 388, 392 Interphase, of mitosis, 115f Intoxications, 374 Intracellular function, of carbon compounds, 170 Intrauterine devices (IUDs), 717 Introns, 250 In vitro and in vivo cultures, 160 In vivo testing, 507 Iodine, 29t, 314t, 316 Iodophors, 316 Iodoquinol, 688 Ion(s), 36 Ionic bonds, 33f, 34–36 Ionization, 35–36 Ionizing radiation, 256t, 310 Iron, 29t, 169t, 171 Iron-binding proteins, 419, 421 Irradiation, 309–10 Irritable bowel syndrome, 684 Isocitric acid, 216 Isodine, 316 Isograft, 478 Isolation, of cultures, 56f, 57–58, 495–96 Isomerases, 203 Isoniazid (IHN), 336t, 339, 349, 352t, 644 Isopropyl alcohol, 317 Isotonic conditions, 176–77 Isotopes, 30 Isotypes, of immunoglobulins, 438 -Itis (suffix), 375, 411 Itraconazole, 538, 558, 651 Ivanovski, D., 140, A3 Ivermectin, 343, 543 Ixodes pacificus, 594 Ixodes scapularis, 594 Jablot, Louis,, 12 Jacob, Francois, 251 Janthinobacterium, 514 Jaundice, 688 JC virus, 564 Jeffreys, Alex, 290 Jejunum, 661 Jenner, Edward, 446, 529–30, A3 Jock itch, 537 Johne’s disease, 663 “Jumping genes,” 263 Kajander, Olavi, 99 Kanamycin, 354t Karposi’s sarcoma, 608, 609 Kell blood groups, 474 Keratin, 399, 514, 538 Keratinase, 374, 779t Keratinized surface, of skin, 514 Keratitis, 542 Ketoconazole, 342 Ketolides, 340 Kidneys, 352, 490, 709 Killed vaccines, 448 Killer whale, 752 KiloGrays, 310 Kinases, 374 Kingdom, and classification, 20 Kirby-Bauer technique, 354 Klebsiella pneumoniae, 652 Koch, Robert, 17–18, 329, 386–87, 606, 642, A3 Koch’s postulates, 17, 59, 386–87, 663 Komodo dragon, 673 Koplik’s spots, 530 Krebs, Sir Hans, 211 Krebs cycle, 214–16, 223 Labile, enzymes as, 206 Laboratory techniques See also Cultures and culturing methods; Identification; Incubation; Microscope overview of methods, 56f specimen analysis, 493–95 LaCrosse strain, of California encephalitis, 563 Lactase, 203 Lactate dehydrogenase, 203 Lactic acid, 322 Lactobacillus spp., 188, 712 L acidophilus, 773 L plantarum, 770, 772 L sanfrancisco, 20, 770 Lactoferrin, 419, 709 Lactose, 42, 43, 44f Lactose operon, 251–53 Lagered beer, 770–71 Lagging strand, 240 Lag phase, of growth curve, 191 Lakes, 141, 757f See also Aquatic microbiology Lambl, Vilem, 20 Lamivudine, 345t, 614, 690 Lancet, The (journal), 679 Landfills, and bioremediation, 764 Large intestine, 365t, 661, 663 Large pustular skin lesions, 535–36 Lassa fever, 598t, 599 Latent infections, 379, 725, 729 Latent period, of antigen response, 439 “Lawnmower” tularemia, 592 Leading strand, 240 Leavening, of bread, 770 Lectin pathway, of complement, 418, 419t Lederberg, Joshua, 255f, A3 Leeuwenhoek, Antonie van, 12–14, 66, 68, 685, A3 Legionella pneumophila, 646–47, 652t Legionellosis, 646–47 Legumes, 748–49 Leishmania brasiliensis, 131t, 535 Leishmania donovani, 131t Leishmania tropica, 131t, 535 Leishmaniasis, 131t, 535–36 Lemierre’s syndrome, 628–29 Leptospira interrogans, 714 Leptospirosis, 713–14, 734 Lethal factor, 606 Index Leuconostoc mesenteroides, 772 Leucovorin, 566 Leukemia, 485–86, 616 Leukocidins, 373 Leukocytes, 406 Leukocytosis, 378 Leukopenia, 378, 611 Leukotrienes, 412, 466 Levofloxacin, 341, 536 L forms, 93 Lice, 594 Life basic characteristics of, 120t major elements of, 29t Life cycles Chlamydia, 722f helminths, 134, 693f liver fluke, 699 Lyme disease, 595f Plasmodium spp., 603f protozoa, 130 Toxoplasma, 565–66 viruses, 160 Lifestyles, of microorganisms, 10 Ligases, 203, 238t, 271 Light-dependent reactions, 225, 226 Light-independent reactions, 225, 227 Limestone, 748 Linezolid, 341 Linkage maps, 290 Linolenic acid, 45f Lipids, 42t, 45–47 Lipmann, F A., 211 Lipopolysaccharide (LPS), 44, 93, 375 Lipoteichoic acid (LTA), 91, 630 Liquid(s), ultraviolet irradiation of, 311 Liquors, 772 Lister, Joseph, 17, 316, A3 Listeria monocytogenes, 181, 447, 555–56, 559t, 560t, 777 Listeriosis, 555–56 Lithoautotrophs, 172 Lithosphere, 743, 753–55 Lithotrophs, 745 Liver and liver disease, 352, 490, 686, 689, 690, 691, 700–701 Liver flukes, 133f, 698–99 Lobar pneumonia, 646 Localized infection, 376, 377f “Lock-and-key” fit, of enzyme, 202 Locomotion, of protozoa, 129 Loeffler, Friedrich, 140 Logarithms, 191, 303 Loop dilution technique, 57–58 Lophotrichous arrangement, of flagella, 84 Louisiana State University, 164, 756 Low-density lipoproteins (LDLs), 587 Lowenstein-Jensen (LJ) media, 63t Lower respiratory tract infectious diseases, 633–37, 639, 640–54, 655t, 656f normal microbiota, 365t structure and defenses of, 624 Lumen, 661 Lung(s) See also Respiratory tract fungal diseases, 649 tuberculosis, 640 Lyases, 203 Lyme disease, 593–96 See also Borrelia burgdorferi Lymphadenitis, 378 Lymphangitis, 521 Lymphatic fluid, 404 Lymphatic system, 585 AIDS-defining illnesses, 609 infectious diseases, 587–616, 617t, 618f structure and defenses of, 402–405, 586–87 Lymphatic vessels, 403f, 404 Lymph nodes, 403f, 404, 405 Lymphocytes, 426, 427f, 428–32, 434–35 See also B cells; T cells Lymphocytic choriomeningitis, 599 Lymphogranuloma venerum (LGV), 722 Lymphoid tissue, 402 Lyophilization, 309 Lysin, 503 Lysis, 90, 159 Lysogenic conversion, 160 Lysogeny, 159–60 Lysol, 315, 317, 323t Lysosomes, 117, 416 Lysozyme, 90, 400, 514, 709 Lyssavirus, 568–69 See also Rabies MacConkey agar (MAC), 63t, 64 MacLeod, Colin, 236, A3 Macroconidia, 125f Macrogametocytes, 604 Macrolides and macrolide polyenes, 340, 342 Macromolecules, 41–51, 432 Macronutrients, 169 Macrophage(s), 409, 414, 552 Macrophage colony-stimulating factor (MCSF), 412 Macroscopic fungi, 121 Macroscopic morphology, 491 Macule, 528 Maculopapular rash, 528, 530–33 Mad cow disease, 163 Magnesium, 29t, 30, 169t, 171 Magnetic resonance imaging (MRI), 80, 88, 507 Magnetotactic bacteria, 96 Magnification, and microscope design, 68 , 70f Maine Department of Health and Human Services, 139, 164 Maintenance, of cultures, 66 Major histocompatibility complex (MHC), 428 Malachite green, 322 I-15 Malaria, 8, 131t, 343, 368–69, 602–606, 727 See also Plasmodium spp Malassezia furfur, 538 Male reproductive system, 709–10 Malic acid, 216 Malnutrition, and enteroaggregative E coli, 685 MALT (mucosa-associated lymphoid tissue), 402, 404, 405 Malting, of beer, 770 Maltase, 203 Maltose, 42, 43 Mammalia (Class), 20, 21f Manganese, 29t Mannitol salt agar (MSA), 63, 64t Mantoux test, 642 Mapping, of genomes, 289–90 Marburg virus, 598–99 March of Dimes, 572 Margulis, Lynn, 110 Marine environments, 756 See also Aquatic microbiology; Oceans Marine microbiology See also Aquatic microbiology Markers, and immune system, 401 Mars, 19 Marshall, Barry J., 670 Mash, and beer brewing, 770 Mass, 31 Massachusetts Institute of Technology, 644 Mast cells, 408, 464, 466–67 Mastigophora, 130–31 Matrix, 118 Matter, 28 Maximum temperature, 180–81 McCarthy, Jenny, 452 McCarty, Maclyn, 236, A3 Measles, 156t, 424, 451, 455, 530–31, 533t, 566–68 See also Morbillivirus; Subacute sclerosing panencephalitis Mebendazole, 343, 692t Mechanical vectors, 381 Mechanical ventilation, and pneumonia, 652 Mediastinum, 650 Medical asepsis, 385 Medical microbiology, 4t, 17–18 Medical significance See also Medicine bacterial spores, 98 biofilms, 87 DNA and RNA viruses, 148t families and genera of bacteria, 103t viruses, 163 Medicare and Medicaid, 385 Medicine See also Diseases; Health care personnel; Hospitals; Medical significance; Nosocomial infections antimicrobial therapy and history of previous conditions, 357 bacterial meningitis as emergency, 554 concepts of fever, 417 drug resistance, 349 genetic treatments, 287–89 I-16 Index Medium (media), 57, 58–65 Meiosis, 116 Melamine, 285 Melarsoprol, 578 Mello, Craig, 242 Membrane See Cell membrane Membrane attack complex, 419, 420f Membrane filtration, 312f, 768 Membrane lipids, 46–47 Memory, and host defenses, 425 Memory cells, 436, 442f Mendeleev, Dimitri, 32 Mendosicutes, 102 Meninges, 551 Meningitis, 375, 522, 552–58, 641, 669 See also Neisseria meningitidis Meningococcal meningitis, 553–54 Meningococcemia, 553 Meningoencephalitis, 561 Mercurochrome, 320 Mercury and mercurial compounds, 314t, 320, 727, 752 Merozoites, 603–604 Mesophiles, 182 Messenger RNA (mRNA), 51, 154, 243–44, 246–47 Metabacterium polyspora, 96 Metabolic analog, 333 Metabolic pathways, 206–208 Metabolism, 40, 199 biosynthesis, 223–25 drug resistance, 348 enzymes, 199–208 pursuit and utilization of energy, 208–23 Metabolites, 780 Metabolomics, 290 Metachromatic granules, 96 Metagenomics, 290, 363, 753 Metaphase, of mitosis, 115f Metchnikoff, Elie, A3 Meteorites, 19 Methane, 33f, 104, 172 , 748 Methanococcus jannaschi, 172f Methanogens, 104, 172, 748 Methanosarcina, 172f Methicillin, 337t Methicillin-resistant Staphylococcus aureus (MRSA) , 341, 348, 512, 521, 543 Methyl alcohol, 317 Methylene blue and methylene blue reductase test (MBRT), 75f, 216, 228 Methylophilus methylotrophus, 774 Methyltransferases, 205 Metronidazole, 343, 352t, 671, 677, 688, 717, 718 Mezlocillin, 337 MIC See Minimum inhibitory concentration Michel, Harmut, A3 Miconazole, 538 Microaerophile, 183 Microarray analysis, 292, 293f Microbes, See also Microorganisms dimensions, 67–68, 99 ecological associations, 185–88 impact of on Earth, 2–3, interrelationships with humans, 188 Microbial antagonism, 365, 624 Microbial control chemical agents, 313–22, 323t decontamination by filtration, 312 general considerations in, 298 history of, 299 methods of, 298f, 301 microbial death, 301–304 modes of action of antimicrobial agents, 304–305 osmotic pressure, 312 physical methods of, 305–309 radiation, 309–11 relative resistance of microbial forms to, 299–300 selection of, 301 terminology, 300–301 Microbial death, 301–304 Microbial ecology, 742 Microbicide, 300 Microbiology, historical foundations of, 11–18 scope of, subdivisions of, 4–5t Microbiota See Normal microbiota Microbistatic effects, 301 Micrococcus spp., 518 M luteus, 65f Microconidia, 125f Microenvironment, 744 Microgametocytes, 604 Microglia, 552 Micronutrients, 169 Microorganisms, See also Bacteria; Microbes; Protozoa; Viruses classification of, 18, 20–24 as food, 774 general characteristics of, 10 human use of, 6–7 Micro RNAs, 242, 243t Microscope development of, 11–15, 66–67 magnification and design of, 68 microbial dimensions, 67–68 principles of light microscopy, 69–71 Microscopic fungi, 121 Microscopic morphology, 491 Microscopy, 68 Microsporum spp., 1, 537, 538 Microtubules, 112 Middle Ages, and malaria, 602 Military, and vaccinations, 454 Milk, 198, 216, 308, 384, 642, 673, 772–73 See also Dairy products Mimiviruses, 143 Mineralization, 746 Miniaturized test system, 519f Minimum inhibitory concentration (MIC), 355f, 356–57 Minimum temperature, 180 Mining industry, 27 Mini short tandem (DNA) repeats (miniSTR), 291 Miracidium, 700, 701f Missense mutation, 256 “Misspelling,” of DNA, 240 Mitochondria, 118 Mitosis, 114, 115f Mixed acid fermentation, 221 Mixed culture, 66 Mixed infection, 377 MMR vaccine, 450, 452, 531, 670 MN blood groups, 474 Mobiluncus, 716 Moist heat, and microbial control, 305–308 Molarity (M), 39 Mold spores, 462, 463t Molecular formula, 37 Molecular genetics, 22–23 Molecular mimicry, 480 Molecular weight (W), 31, 432 Molecule, 31 antigens, 432 chemical bonds, 33 polarity, 34 solutions, 38 structure of ATP, 210 Molluscum contagiosum, 534–35, 731t, 733 Monkeypox, 530 Monoclonal antibodies (MABs), 444 Monocytes, 409 Monod, Jacques, 251 Monolayer, and cell culture, 151–52 Monomers, 41–42, 438 Mononegavirales, 149t Mononucleosis, 596–97 Monosaccharide, 42, 43f Monospot test, 597 Monotrichous arrangement, of flagella, 84 Montagnier, Luc, A3 Montagu, Lady Mary, 446 Moraxella spp., 540 Morbidity and Mortality Weekly Report (CDC), 388 Morbidity rates, 390 Morbillivirus, 531 Morphology, 491 Mortality rates, 389 Mosquitoes, 381, 563, 597, 598, 603, 604, 605 Most probable number (MPN), 768 Motility, of microorganisms, 83, 84, 112, 120t Mouse neutralization test, 59 Mouth, and normal biota, 663 Moxalactam, 338f M protein, 520, 630 MRSA See Methicillin-resistant Staphylococcus aureus Index Mucinase, 373 Mucocutaneous leishmaniasis, 536 Mucor spp., 626 Mucous membranes, 399 Mueller tellurite, 63t Mullis, Kary, 14, 182, A3 Multicloning site (MCS), 280 Multidrug-resistant (MDR) pumps, 347 Multidrug-resistant tuberculosis (MDR-TB), 644 Multimammate rat, 599 Multiple sclerosis (MS), 480t, 482 Multiplication, of viruses, 151–60 Mumps, 668–70 Mupirocin, 521 Muramic acid, 91f Murray, Polly, 593 Must, and wine production, 771 Mutagens, 256 Mutant strain, 255 Mutations, genetic, 255–58, 346 Mutualism, 186, 187 Myastentia gravis, 480t, 482 Mycelium, 122 Mycobacterium spp., 92, 94, 96 M avium, 642, 644, 663 See also Mycobacterium avium complex M bovis, 642 M leprae, 190 M tuberculosis, 74–75 , 507, 640, 641–42 See also Tuberculosis Mycobacterium avium complex (MAC), 642, 644 Mycolic acid, 92 Mycoplasma(s), 92–93, 103t Mycoplasma spp., 372t M pneumoniae, 93, 645, 647, 652t See also Pneumonia Mycoprotein, 774 Mycorrhizae, 754, 755f Mycosis (mycoses), 122, 126 Myeloperoxidase, 416 Myocarditis, 632 Myocardium, 586 Myonecrosis, 523, 524 NADH, 210, 214 Naegleria fowleri, 131t, 561 Nafcillin, 337t, 588 Nails, and ringworm, 537 Naked viruses, 144, 145f Names and naming See also Terminology of enzymes, 203 of microorganisms, 18, 20 of viruses, 149 Nanobacteria, 99 Nanotechnology, 76 Narrow-spectrum drugs, 330t, 336 Nasal vaccines, 450 Nathans, Daniel, 14 National Aeronautics and Space Administration (NASA), 19 National Allergy Bureau Pollen and Mold Report, 463f National Center for Health Statistics, 720 National Institutes of Health, 288 National Oceanic and Atmospheric Agency (NOAA), 7f National Park Service, 182 Native state, of protein, 49, 304 Natromonas spp., 185 Natural immunity, 443 Natural killer (NK) cells, 418, 443, 466 Natural selection, 21, 258, 349–50 Nature (journal), 392 NDM–1, 339 Necator americanus, 697, 698t Necrosis, 376 Necrotizing fasciitis, 15, 519, 629 Necrotizing ulcerative gingivitis (NUG), 668 Necrotizing ulcerative periodontitis (NUP), 668 Needlesticks See Health care workers; Safety Negative exponents, A2 Negative results, of serological tests, 500 Negative-sense RNA, 148 Negative staining, 71, 74 Neisseria gonorrhoeae, 254, 306, 309, 372t, 540, 554, 559t See also Gonorrhea Neisseria meningtidis, 553–54 See also Meningitis Nematodes, 133, 135t, 697 Neomycin, 354t Neonatal meningitis, 558–60 Neonatal tetanus, 573f Nephritis, 629 Nervous system AIDS-defining illnesses, 609 antimicrobial therapy, 352 infectious diseases, 552–78, 579t, 580f structure and defenses of, 551–52 tuberculosis, 641 Neuraminidase, 636 Neuritis, 632 Neuromuscular autoimmunities, 482 Neurosyphilis, 725 Neurotoxins, 575 Neurotropic virus, 570 Neutralization reactions, 40, 438 Neutrons, 28, 551 Neutrophil(s), 406, 408 , 414 Nevirapine, 345t, 615 New Mexico, 648 Newton, Isaac, 16 New York City medical examiner, 268 New York State Health Department, 293, 297, 322, 490, 507 Niche, 744 Nicholson, C K., 47 Nickerson, Cheryl, 254 Niclosamide, 352t Nicotiana tabacum, 287t I-17 Nicotinamide adenine dinucleotide (NAD), 205, 210 Nidovirales, 149t Nightingale, Florence, 388 Nigrosin, 74 Nipahvirus, 382 Nitrate(s), 748, 778 Nitric oxide (NO), 416 Nitrification, 749 Nitrites, 748, 778 Nitrogen elements of life, 29t, 30f microbial nutrition, 169t, 170 Nitrogen cycle, 748–49 Nitrogenous base, 50, 235 Nitro-mersol, 320 Nitrous acid, 256t Nocardia, 75, 92 Nomenclature, 18 Noncommunicable infectious disease, 382 Noncompetitive inhibition, 207 Nongonococcal urethritis (NGU), 721 Nonhemorrhagic fever diseases, 599–606 Nonionizing radiation, 310–11 Non-nucleoside reverse transcriptase inhibitors, 344 Nonpolar molecules, 34 Nonpressurized steam, and sterilization, 307–308 Nonprogressors, and HIV infection, 613 Nonsense codons, 247 Nonsense mutation, 257 Normal microbiota, 188, 363 acquisition of, 363–65 antimicrobial drugs, 353–54 barriers to infection, 400 commercial antimicrobial chemicals, 312 eye, 540 gastrointestinal tract, 663 genitourinary tract, 364t, 365t, 711–12 initial colonization of newborn, 365–66 respiratory tract, 624 skin, 514–15 viable noncultured (VNC) microbes, 492 Norovirus, 682, 701 North American blastomycosis, 127t Norway, 752 Nosocomial infections, 232, 384–85, 521, 645, 652, 713 Notifiable diseases, 388, 391t, 612, 721, 729 Noxzema triple clean, 323t Nucleators, 756 Nucleic acid(s), 42t, 49–51, 147–48, 225 See also DNA; RNA Nucleic acid sequencing, 498 Nucleic acid synthesis, 304, 332, 345t Nucleocapsid, 144, 145 Nucleoid, 94 Nucleolus, 114 Nuceloside reverse transcriptase inhibitors, 344, 345t, 614–15 Nucleotides, 50, 235 I-18 Index Nucleus of atom, 28 of cell, 114–16, 117 Numerical aperture (NA), 70 Nursing bottle caries, 664 Nutrient agar, 60 Nutrient broth, 60 Nutrition See also Food(s); Malnutrition; Vitamins cytoplasm, 169–70 defined, 169 fungi, 122 nutritional flow in ecosystems, 744–46 protozoa, 128–29 sources of essential nutrients, 170–74 transport, 174–80 -Obe, 174t Obesity normal microbiota, 365 vaccine, 164 Objective, of microscope, 69 Obligate aerobe, 183 Obligate halophiles, 185 Obligate parasites, 142, 174 Obligate saprobes, 174 Oceans aquatic microbiology, 756 extreme habitats, 173, 185 viruses, 141 O’Connor, Basil, 572 Ohio State Department of Health, 424, 455 Ohio Valley, and histoplasmosis, 650, 654 Oil immersion lens, 70 Oil spills, and bioremediation, 7, 741, 744, 758 Okazaki fragments, 240 O’Leary, Paul A., 727 Oligodynamic action, 320 Oligotrophic ecosystems, 758 -Oma (suffix), 375 Omeprazole, 671 -Omics (suffix), 290 Onchocerca volvulus, 135t, 543 See also River blindness Onchocerciasis, 543 Oncogenic viruses, 157, 732 Oncoviruses, 157 Oocyst, 566, 678–79 Operator, and gene regulation, 251 Operons, 251 Opisthorchis sinensis, 698–99 Opportunistic pathogens, 126, 174, 366–67, 649 Opsonization, 437–38 Optical microscope, 71 Optimum temperature, 181 Oral cavity, and normal flora, 365t Oral contraceptives, 357, 516 Oral-fecal route, of disease transmission, 384 Oral hygiene, 667 Oral poliovirus vaccine (OPV), 571 Oral rehydration therapy (ORT), 679, 682 Oral vaccines, 450 Orbitals, of electrons, 30–31 Orchitis, 669 Order, and classification, 20 Oregon, 653 Oregon Harmful Algal Bloom Monitoring, 108, 128 Orfvirus, 143f Organelles, 10, 52, 109 Organic acids, 322, 778 Organic compounds, 40, 41t Organic nutrients, 169 Organ-specific autoimmune diseases, 479 Organ transplantation, and organ donation, 476–79, 569, 613 See also Bone marrow and bone marrow transplantation Orthomyxoviridae, 150t, 626 Orthophenyl phenol, 317 Ortho-phthalaldehyde (OPA), 321 Orthopoxvirus, 528 Oryza sativa, 287t -Osis (suffix), 375 Osmosis, 176–80 Osmotic pressure, 177, 185, 312, 778 Otitis media, 627, 628t Outer membrane (OM), 82f, 93 Ovaries, 710 Owens Lake (California), 104f Oxacillin, 337t, 588 Oxaloacetic acid, 214, 216 Oxazolidones, 340–41 Oxidase, 203 Oxidase detection test, 220 Oxidation-reduction (redox) reactions, 35 Oxidative phosphorylation, 211, 217–19 Oxidizing agent, 35 Oxidoreductases, 203 Oxygen aquatic microbiology, 758 covalent bonding, 33f electron shells, 30f elements of life, 29t microbial growth, 183–84 microbial nutrition, 169t, 170 Oxygenic photosynthesis, 6, 227 Oxytetracycline, 355f Pacemaker enzymes, 206 Palindromes, 271 Palisades arrangement, 101 Palmitic acid, 45f Pan American Health Organization, 598 Pancreas, 661 Pancreatitis, 669 Pandemics, 163, 299, 391f, 638 Pannus, 542 Papanicolaou, George, 733 Papillomas, 534 Papillomavirus, 147f, 150t See also Human papillomavirus (HPV) Papovaviridae, 150t Pap smear, 729, 732, 733 Papule, 528 Paracoccidioides brasiliensis, 649 Paracoccidioidomycosis, 127t Parainfluenza, 155f Paralytic shellfish poisoning, 108, 128, 758 Parameciidae (Family), 21f Paramecium spp., 72t, 84f P caudatum, 21f Paramyxoviruses, 150t, 669 See also Measles; Mumps Parasites, 10 See also Helminths; Malaria; Parasitism; Parasitology antimicrobial drugs, 343 fungi, 122 microbial nutrition, 171t, 172, 174 protozoa, 132 Parasitism, 187 Parasitology, 132 Parenteral administration, of drugs, 338 Park’s method, 319 Parotitis, 669 Paroxysmal stage, of pertussis, 634 Parvoviruses (PVs), 143, 150t, 532 Passive antibody preparation, 635 Passive carrier, 381 Passive immunity, 443, 445–46 Passive transport, 180t Pasteur, Louis, 9, 13, 17, 140, 220, 222, 319, 606, A3 Pasteur Institute (France), 608 Pasteurization, 216, 222, 308, 775–76 Pathogen(s) and pathogenesis, 8, 366 See also Pathogenicity; specific diseases biosafety levels and classes of, 370 fungi, 126 parasites, 174 Pathogen-associated molecular patterns (PAMPs), 415–16, 425 Pathogenicity, 366, 367 Pathogenicity islands, 264 Pathognomic diseases, 650 Patient chart, and specimen analysis, 494 Patient history, and brucellosis, 600 Pattern recognition receptors (PRRs), 415–16 Patterson, Meredith, 285 Payne, Roger, 752 P blood groups, 474 PCBs (polychlorinated biphenyls), 752 Pectinase, 779t Pediatrix, 454 Pediococcus cervisiae, 772 Pegylated interferon, 691 PEG-SOD, 283t Pellicle, 663 Pelvic inflammatory disease (PID), 719, 720, 722 Penetration, of virus, 151–53, 159, 160t Index Penicillin(s) cell wall, 332, 336–37 designer drugs, 334 discovery of, 329 drug allergies, 467 drug resistance, 348 industrial products, 779t, 780, 783 Kirby-Bauer test, 354t meningococcal infections, 554 Streptococcus pyogenes, 631 syphilis, 727 toxic reactions to, 352t Penicillinase, 203, 346 Penicillium spp., 27, 34 P chrysogenum, 336, 783 P roqueforti, 773 Pennsylvania Department of Health (PDH) and Department of Agriculture (PDA), 198, 228 Pentamidine, 578 Pentoses, 42, 50 Peptic ulcers, 670 Peptidase, 203 Peptide(s), 48, 350 Peptide bond, 48 Peptidoglycan (PG), 43, 89–90, 91f Perforins, 441, 443 Pericardium, 586 Periodic table, 31f, 32 Period of invasion, 376 Periodontal disease, 666–68 Peripheral nervous system (PNS), 551, 552 See also Nervous system Periplasmic flagella, 85 Peritrichous arrangement, of flagella, 84, 85 Persistent infections, 156, 160t Pertussis, 451, 633–35 Peru, 124, 640 Petechiae, 528, 553 Petri dish, 57 Peyer’s patches, 405 Pfiesteria piscicida, 127f, 128 pH scale, 39–40, 185 See also Acid(s) and acidity; Alkalines and alkalinity Phage See Bacteriophages Phage type and phage typing, 157, 164, 496 Phagocytes, 373, 414–16, 483t Phagocytosis, 179f, 180, 414–16 Phagolysosome, 416 Phagosome, 416 Pharmaceutical industry, 282–83, 348, 779t, 783 Pharyngitis, 628–31 See also Streptococcus pyogenes Pharynx, 663 Phase-contrast microscopy, 72t Phase variation, and genetic regulation, 254 Phenazopyridine, 713 Phenol, and phenolics, 314t, 316–17 Phenol coefficient, 316 Phenotype, 235 Phenotypic methods, of diagnosis, 491, 495–97 Phenylalanine, 48f Phenylethanol agar (PEA), 63t Phialospores, 125f -Phile, 174t Philippines, 714 Phosphates, 41f, 50, 171, 235 3-Phosphoglyceric acid (PGA), 227 Phospholipids, 42t, 46 Phosphorus, 29t, 30f, 169t, 171 Phosphorus cycle, 751 Phosphorylation, 209 Phosphotransferases, 205 Photo-, 174t Photoautotrophs, 171t, 172, 747 Photocenter, 225 Photoheterotroph, 171t Photolithotrophs, 227 Photons, 225 Photophosphorylation, 211, 227 Photosynthesis, 3, 6, 225–28, 747, 756 Photosystem I (P700) and Photosystem II (P680), 226–27 Phototaxis, 85 Phototrophs, 171 Phycobilins, 225 Phylogeny, 20, 22–24 Phylum, and classification, 20 Physical agents, and genetic mutations, 256 Physical maps, of genomes, 290 Physical methods, of microbial control, 305–309 Physical state, of culture media, 59t, 60 Physiology, 491 Phytoplankton, 756–57 Pickling, of foods, 772 Picornaviridae, 150t, 570f Picrophilus, 185 Pig(s), 636, 637f, 638, 695 See also Swine flu Pilin, 86 Pilus, 82f, 85, 86, 259 Pine-Sol, 323t Pinocytosis, 179f, 180 Pinworms, 134, 135t, 695 Piperacillin, 337 Piperazine, 692t Pisum sativum, 287t Pithomyces, 34 Placenta, 371 Plague, 299, 590–92 See also Yersina pestis Plankton, 128, 756–57 Plant(s) See also Agriculture; Photosynthesis contact dermatitis, 476 fungi, 124 mycorrhizae, 754, 755f nitrogen cycle, 748–49 transgenic, 284, 286, 287t Plantar warts, 534 Plaque, 162, 528, 664, 665f See also Teeth I-19 Plasma, of blood, 405 Plasma cells, 408 Plasmids, 82f, 95, 259 Plasmodium spp., 131, 343, 603 See also Malaria P falciparum, 131t P malariae, 131t P ovale, 604 P vivax, 131t, 604 Plastic, and cutting boards, 776 Platelet(s), 409 Platelet-activating factor, 412, 466 Pleomorphism, 100, 727 Pleuromutilins, 341 Pluripotential stem cells, 406 Pneumococcal meningitis, 554–55 Pneumococcal pneumonia, 554 Pneumocystis (carninii) jiroveci, 608, 649, 651–52, 653t Pneumocystis pneumonia (PCP), 651–52 Pneumonia, 370, 645–54 Pneumonic plague, 590, 650, 651 Point mutations, 256 Point source, of infection, 390 Poison ivy, poison oak, and poison sumac, 476, 478 Polar arrangement, of flagella, 84, 85 Polar bears, 752 Polarity, in molecules, 34 Poliomyelitis, 451, 570–71, 572 Poliovirus, 143f, 156t, 372t Pollen, 462, 463t Pollution, and genetically modified organisms, 284 See also Bioremediation; Oil spills; Water and water supplies Polyacrylamide gel, 276 Polyclonal antibodies, 444 Polyenes, 342 Polyhydroxyalkanoate (PHA), 95f Polymer(s), 41–42, 438 Polymerase(s), 149, 203 Polymerase chain reaction (PCR) DNA analysis, 276–78 identification of pathogens, 498, 508f invention of, 14 Mycobacterium tuberculosis, 643 oral bacteria in coronary arteries, 587 real-time PCR and enumeration of bacteria, 194 Taq polymerase and improvement of, 182 viable noncultured (VNC) microbes, 492 Polymerization, and complement cascade, 420f Polymicrobial diseases, 377 Polymorphonuclear neutrophils (PMNs), 406, 408 Polymyxins, 332–33, 336t, 341–42, 352t, 354t Polypeptides, 48 Polyribosomal complex, 249 I-20 Index Polysaccharides, 42, 43–45 Pontiac fever, 647 Population(s), and ecological communities, 744 Population growth, 189–91 Porin proteins, 93 Porospore, 125f Porphyrin, 225 Porphyromonas gingivalis, 587, 666 Portals of entry for allergens, 462–63 for infection, 369–72, 377f, 383 Portals of exit, for infection, 377f, 378–79, 383 Porter, Rodney, A3 Positive results, of serological tests, 500 Positive-sense RNA, 147 Positive staining, 71, 74 Positron emission tomography (PET), 507 Postal Service, and irradiation of mail, 310 Postexposure prophylaxis, for anthrax, 616 Postinfection encephalitis (PIE), 564 Postnatal rubella, 531 Post-polio syndrome (PPS), 570 Posttranslational modifications, and protein synthesis, 249 Potassium, 29t, 30f, 169t, 171 Potassium hydroxide, 538 Poverty, and tuberculosis, 642 Povidone (PVP), 316 Pox, 524 Poxviruses, 150t, 535 PPNG See Penicillinase-producing Neisseria gonorrhoeae Prairie dogs, 530 Praziquantel, 343, 692t, 696, 701, 715 Prebiotics, 351 Precipitation, and bacteria in rain and snow, 756 Precipitation reactions, 437f, 500, 502 Pre-erythrocytic development, of malaria, 603 Prefixes, 174t Pregnancy See also Infants chickenpox, 525–26 herpes, 728 HIV and perinatal prevention strategies, 613 maculopapular rash diseases, 530 portals of entry for infection, 371–72 side effects of antibiotics, 353, 516 toxoplasmosis, 565 Universal Precautions, 386 Pressure, and steam sterilization, 306–307 Presumptive data, 494 Prevalence, of infectious disease, 389 Prevention See Centers for Disease Control and Prevention; Public health; specific diseases Prevotella intermedia, 668 Primaquine, 343 Primary amoebic meningoencephalitis (PAM), 561 Primary cell cultures, 162 Primary chancre, and sleeping sickness, 578 Primary consumers, 745 Primary dye, 74 Primary immunodeficiency diseases, 482–85 Primary infection, 377 Primary metabolites, 780 Primary pathogens, 649 Primary phase, of wastewater treatment, 765–66 Primary response, to antigens, 439 Primary structure, of protein, 49 Primary syphilis, 724 Primary tuberculosis, 640 Primase, 238t Primates (Order), 20, 21f Primer(s), 243t Prince William Sound (Alaska), 168, 741, 744, 758 Prions, 163–64, 300, 566, 567t Probiotics, 351 Prodomal stage, of infection, 376 Producers, and ecosystems, 745 Products, of chemical reactions, 37 Professional phagocytes, 414 Proflavine, 322 Progressive multifocal leukoencephalopathy (PML), 564 Prokaryotes, Archaea compared to, 104t cell structure, 10, 111f characteristics of, 52 classification, 101–102 DNA transcription and translation, 249–50 eukaryotes compared to, 81, 104t, 120t form and function, 81–88 shapes, arrangements, and sizes of cells, 98–101 Proliferative stage, of lymphocyte development, 429 Promoter region, 244, 251 Proof, of liquor, 772 Propagated epidemic, 390 Prophage, 159 Prophylaxis, 330t Propionibacterium spp., 221, 773 P acnes, 514, 515–16 Propionic acid, 322 Propylene oxide, 322, 778 Prostaglandins, 412, 466 Prostate cancer, 447 Prostate gland, 710 Prostatitis, 718 Prosthetic valves, 588 Protease(s), 203, 222 , 779t Protease inhibitors, 344, 345t, 615 Protective antigen, 606 Protein(s) See also Protein synthesis cell composition, 169 genetics, 234, 241–42 macromolecules, 42t, 47–49 microbial control, 304–305 Proteinaceous infectious particles, 566 Proteinase, 203 Protein synthesis anabolism and formation of macromolecules, 225 antimicrobial drugs, 304, 332 events in process of, 247, 248f genetic regulation of, 251–55 ribosomes, 95 RNA and organization of, 51 Proteomics, 290 Proteorhodopsin, 228 Proteus spp., 185 P mirabilis, 712, 713t Protista (Kingdom), 20, 21f, 23, 127–32 Proton(s), 28 Proton motive force (PMF), 218 Protoplast, 93 Prototheca, 128 Protozoa, 20, 21f, 128–32, 186, 343 Provenge, 447 Provirus, 156 Provocation, and type I allergy, 463–65 Pruteen, 774 Pseudocyst, 565 Pseudohypha, 121–22 Pseudomembranes, 632, 633 Pseudomembranous colitis, 676 Pseudomonas spp., 514, 764 P aeruginosa, 174, 205, 350, 372t P fluorescens, 284 P stutzeri, 782 P syringae, 284 Pseudo-nitzschia, 108 Pseudopods, 129 Psychro-, 174t Psychrophiles, 105, 181 Psychrotrophs, 181 Public health, 388, 452, 622, 639, 644, 727 See also U S Public Health Service Public health microbiology, 4t Pulmonary amoebiasis, 686 Pulmonary anthrax, 606, 650 Pulse-field gel electrophoresis (PFGE), 683 PulseNet, 683 Pure cultures, 65–66, 744 Purell Instant hand sanitizer, 323t Purines, 50, 235 Purpura, 528 Pus, 413 Pustule, 528 Pyelonephritis, 712 Pyogenic bacteria, 413 Pyrantel, 343, 352t, 692t Pyrazinamide, 644 Pyretotherapy, 417 Pyrimethamine, 566 Index Pyrimidine(s), 50, 235 Pyrimidine dimers, 311 Pyruvic acid (Pyruvate), 214 Q fever, 384, 600, 602t Quarantines, 592 Quaternary ammonium compounds (quats), 314t, 315t, 318–19 Quaternary consumers, 745 Quaternary structure, of protein, 49 Quellung test, 504 Quick test kits, 495 Quinine, 605 Quinolones, 332, 341, 352t Quorum sensing, 188 Rabbits, and tularemia, 592–93 Rabies, 156t, 376, 568–70 Racoons, and rabies, 569 Radiation See also Ultraviolet radiation food preservation, 777–78 genetic mutations, 256 microbial control, 299t, 309–11 microbial environments, 185 Radioactive isotopes, 30 Radioallergosorbent (RAST) test, 468, 505 Radio-frequency identification (RFID), 486 Radioimmunoassay (RIA), 505 Radioimunosorbent test (RIST), 505 Rales, 466, 635 Rapid diagnostic test kits, 630, 631f Rapid multitest systems, 518 Rapid plasma reagin (RPR) test, 500, 502 Rashes, 524–30 Reactants, and chemical reactions, 37 Real image, 69 Receptors B-cell, 431 drug resistance, 347–48 lymphocytes, 428 T-cell, 431–32 Recombinant DNA technology, 7, 278–83 See also Genetic engineering Recombinant human interferon, 690 Recombination, of DNA, 259–64 Recycling, of bioelements, 747–52 Red blood cells (RBCs), 503–504, 603–604 Redi, Francesco, 12, A3 Redox pair, 209 Redox reactions, 35, 205, 209–10 Red Sea, 104 Red snow, 181f Red tide, 128, 757–58 Reducing agent, 35 Reducing media, 64 Redundancy, in genetic code, 246 Reduviid bug, 132 Reemerging diseases, Refraction, 68 Refractive index, 71 Refrigeration, of foods, 777 Refugees, and infectious disease, 397 Regulation of enzymatic activity, 204, 206–208 of protein synthesis, 251–55 Regulator, of lactose operon, 251 Regulatory B cells, 436, 442f Regulatory genes, 235 Regulatory T cells, 426, 441, 447 Relaxin, 283t Release, of viruses, 155, 160t Relenza, 344, 345t, 639 Renal tuberculosis, 641 Rennet, 779t ReNu contact lens solution, 323t Reoviruses, 151t, 156t Replica plating technique, 255f Replication of DNA, 238–40 of viruses, 153–55, 159 Replication forks, 240 Reportable diseases See Notifiable diseases Repressible operon, 253–54 Repressor, and gene regulation, 251 Reproduction See also Reproductive tract eukaryotes, prokaryotes, and viruses compared, 120t fungi, 125–26 helminths, 134 protozoa, 130 Reproductive tract, 709, 715–34, 735t, 736f, 737f See also Genitourinary tract; Sexually transmitted diseases Reservoirs, of infectious disease, 379–82 See also Animal(s); Zoonosis; specific diseases Resident flora See Normal flora Resistance, of microbes to control, 299–300 Resistance (R) factors, 260–61, 346 Resolution, of microscope, 69–70, 76 Respiration, of prokaryotes, eukaryotes, and viruses compared, 120t See also Respiratory tract Respiratory syncytial virus (RSV), 289, 345t, 625, 635 Respiratory tract AIDS-defining illnesses, 609 barriers as host defenses, 399–400 infectious diseases, 624–54, 655t, 656f normal microbiota, 365t, 624 portals of entry for infection, 369–71 portals of exit for infection, 379 structure and defenses of, 623–24 Restriction endonucleases, 270–71 Restriction enzymes, 14, 290 Restriction fragment(s), 271 Restriction fragment length polymorphisms (RFLPs), 271 Retapamulin, 341, 521 Reticuloendothelial system (RES), 402, 403f Retrotransposon, 264 Retroviruses, 148, 151t, 344, 610, 616 Reverse transcriptase, 149, 271, 344 I-21 Reverse transcriptase inhibitors, 344, 614–15 Reversible reactions, 38 Rhabdoviridae, 150t rHDNase (Pulmozyme), 283t Rheumatic fever, 629 Rheumatoid arthritis, 480t, 481, 593 Rh factor, 473–74 Rhinitis, 624–25 Rhizobia, 748–49 Rhizobium, 748 Rhizopus spp., 123f Rhizosphere, 754 Rhodococcus, 764 RhoGAM, 474 Ribavirin, 345t, 635, 691 Ribonucleic acid See RNA Ribose, 243 Ribosomal RNA (rRNA), 51, 95, 101, 243t, 244 Ribosomes, 82f, 95, 119, 244 Riboswitches, 242, 243t Ribozymes, 202, 243t Rickettsia rickettsii, 601 See also Rocky Mountain spotted fever Ricord, Phillipe, A3 Rifampin, 352t, 644 Rifamycin, 341 Rifkin, Jeremy, 284 Riftia, 186 Rimantidine, 639 Ringworm, 536–38, 539t Risk factors, for endocarditis, 588 River blindness, 135t, 543 Rivers, T M., 387 RNA (ribonucleic acids) alternative splicing and editing of, 250–51 antibacterial drugs, 341 cell assembly, 242–43 drug resistance, 350 importance of small, 15 macromolecules, 42t nucleic acid sequencing, 498 structure and functions of, 49–51 types of, 243t viruses, 147–48 RNA-induced silencing complex (RISC), 289 RNA polymerase, 244 RNA primer, 239 RNA viruses, 147–48, 150–51t, 152f Rock decomposition, 753–54 Rocky Mountain spotted fever (RMSF), 601–602 See also Rickettsia ricksettsii Roferon-A, 280, 282 Roman Empire, 299 Roosevelt, Franklin Delano, 572 Root nodules, 748–49 Roseola, 532–33 Ross, R., A3 Rotavirus, 146f, 451, 680–82 I-22 Index Rough endoplasmic reticulum (RER), 116 Rounding off, of numbers, A1-A2 Roundworms, 133, 135t, 696–97 Rous, Francis, A3 Rubella, 153–54, 531–32, 533t Rubivirus, 532 Rubor, 410 Runs, of flagella, 84–85 Ruska, Ernst, A3 Russia See Soviet Union Sabin, Albert, 571, 572 Sabouraud’s agar, 63t Saccharide, 42 Saccharomyces spp., 126 S cerevisiae, 122f, 280, 770, 772 S uvarum (carlsbergensis), 770 Safety See also Health care personnel biosafety levels and classes of pathogens, 369, 370 food handling, 671, 774 Hazard Analysis and Critical Control Point, 774 Universal Precautions, 385–86 St Helens, Mount (volcano eruption, 1980), 647 St Louis encephalitis (SLE), 88, 563 Saliva See also Oral cavity antimicrobial properties, 661 portals of exit for infection, 379 specimen collection, 492 Salk, Jonas, 571, 572, A3 Salmonella spp., 63, 64, 672–73, 777 See also Salmonellosis S enterica, 139, 164, 198, 228, 672 S enteriditis, 94f, 190 See also Typhoid fever S hirschfeldii, 672 S paratyphi, 672 S typhimurium, 254, 258, 672 Salmonella/Shigella (SS) agar, 63t Salmonellosis, 139, 157, 198, 228, 672–73, 680t See also Salmonella spp Salpingitis, 719 Salt See also Sodium chloride adaptations to extreme habitats, 104, 173, 178 food preservation, 778 microbial growth, 185 Salvarsan, 329, 727 Sand fly, 535, 536 San Diego Zoo, 512 Sanger, Frederick, 274 Sanger method, of DNA sequencing, 275f, 276 Sanitization, 301 Sapro-, 174t Saprobes, 122, 171t, 172, 174 Saquinavir, 345t Sarcina, 100 Sarcodina, 131 Sargasso Sea, 756 SARS See Severe acute respiratory syndrome Satcher, David, Satellite viruses, 164 Satellitism, 187 Saturated fatty acids, 45–46 Saturation, and facilitated diffusion, 178 Sauerkraut, 772 Saxitoxins, 108, 128 Scale, 528 Scalp, and ringworm, 536, 538 Scanning confocal microscope, 73t Scanning electron microscope (SEM), 73t Scanning probe microscopes, 76 Scanning tunneling microscope (STM), 73t, 76 Scarlet fever, 533, 629 Schatz’s method, 319 Schaudinn, Fritz, A3 Schistosoma haematobium, 715 Schistosoma japonicum, 135t, 700–701, 702t Schistosoma mansoni, 700–701, 702t Schistosomiasis, 700–701, 714–15 Schizogony, 603 Schizophrenia, Schizont, 603–604 Schultz, Heide, 99 Schwann, Theodor, 13 Scientific method, 15 Scope mouthwash, 323t Scorpion venom, 330 Seasonal influenza, 635–36 Sebaceous glands, 514 Sebum, 514 Secondary consumers, 745 Secondary immunodeficiency diseases, 483t, 485–86 Secondary infections, 377, 525, 530 Secondary metabolites, 780 Secondary phase, of wastewater treatment, 766 Secondary response, to antigens, 440 Secondary structure, of protein, 49 Secondary syphilis, 724–25 Secondary tuberculosis, 640–41, 643 Secretory IgA, 438 Sedimentary cycles, 749–51 Seed warts, 534 Segmented RNA, 148 Selective medium, 62, 63t, 74 Selective permeability, of cell membrane, 94, 176 Selective toxicity, of antimicrobial drugs, 330–35 Self, reaction of lymphocytes to, 430 Semiconservative replication, 238 Semisolid media, 60 Semisynthetic drugs, 330t, 334, 336 Semmelweis, Ignaz, 17, A3 Sensitivity, in immune testing, 500, 501f Sensitization, and type I allergy, 463–65 Sensitizing dose, 463 Sepsis, 300 Septa, 122–23 September 11, 2001 (terrorist attacks), 268, 291, 292 Septicemia, 375 , 378, 587, 589–90, 762 Septicemic anthrax, 606 Septic shock, 15 Sequelae, of infection, 379 Sequence maps, 290 Sequencing, of DNA, 274–76 Sequestered antigen theory, 480 Serology and serological tests, 499–500, 508f Serotonin, 412, 466 Serotype and serotyping, 102, 504 Serous exudate, 413 Serratia marcescens, 65f Serum, of blood, 405 Serum hepatitis, 690 Serum sickness, 475, 476 Severe acute respiratory syndrome (SARS), 387, 653 Severe combined immunodeficiency disease (SCID), 290, 484–85 Sewage treatment, 678, 715 Sexual intercourse, and HIV transmission, 611, 613, 614 Sexual phase, of malaria, 604 Sexually transmitted diseases (STDs), 371, 379, 388, 611, 613, 715, 721 See also Gonorrhea; Syphilis Sexual spore formation, 125–26 Shapes, of prokaryotes, 98, 100–101 , 120t Sheep, 364, 503, 566 Shell(s), of electrons, 30–31 Shellfish, and food poisoning, 108, 128, 135, 168, 678, 758 Shiga toxin, 673, 674, 675 Shiga-toxin-producing E coli (STEC), 674, 680t Shigella spp., 372t S dysenteriae, 673 S flexneri, 673 S sonnei, 673 Shigellosis, 673–74, 680t Shingles, 526–27 Shultze, Franz, 13 “Sick building syndrome,” 124 Sickle cell disease, 368–69 Side effects of antimicrobial therapy, 352–54 of vaccines, 450–51 Siderophores, 419 Signs, of disease, 378, 508f See also Symptoms Silent mutation, 257 Silver compounds, and microbial control, 314t, 320–21 Silver nitrate, 320 Silver sulfadiazine ointment, 320–21 Simian immunodeficiency viruses (SIVs), 614 Index Simple stains, 74 Singer, S J., 47 Single-cell protein (SCP), 774 Single nucleotide polymorphism (SNP), 290, 292 Single-stranded (ss) DNA viruses, 155 Single-stranded (ss) RNA, 154 Sinorhizobium, 88f Sinusitis, 626 Size of genomes, 235 of microbes, 67–68 of prokaryotes, 98, 99 of viruses, 142f, 143 Skin See also Skin testing AIDS-defining illnesses, 609 allergies, 466, 468 barriers and host defenses, 398–99 diseases and infections of, 512, 515–38 hookworms, 697 naming of lesions, 528 normal microbiota, 364t, 365t, 514–15 portals of entry for infection, 369 portals of exit for infection, 379 side effects of antimicrobial therapy, 352–53 sterility, 319 structure and defenses, 513–14 Universal Precautions, 386 Skin testing allergies, 468 coccidioidomycosis, 557–58 tuberculosis, 641f, 642–43 Skunks, and rabies, 569 Sleeping sickness, 132, 577–78 Slime layer, 86, 88 Sludge, 766 Small interfering (si) RNAs, 242, 243t, 289 Small intestine, 661 Smallpox, 156t, 446, 527–30, 650 Smith, Hamilton, 14 Smooth endoplasmic reticulum (SER), 116 Snow, John, A3 Soap and Detergent Association, 313 Soaps, 314t, 318–19, 320f, 323t Sodium elements of life, 29t, 30f ionic bonds, 34–35 microbial nutrition, 169t Sodium chloride, 35 Sodium stibogluconate, 536 Soil and soil microbiology, 5t, 382, 753–55 Solid media, 60 Solutions, 38–39 Solvents, 38 Sorbic acid, 322 Southern, E M., 272 Southern blot test, 272, 273f Soviet Union, and diphtheria epidemic, 632 Space-filling models, 37 Spanish flu pandemic (1918), 638 Sparger, of fermentor, 781 Specialized transduction, 262 Species, 20, 102, 149, 400, 492 Specific immune globulin (SIG), 446–47 Specific immunity, 425–27, 443–52 Specificity antigens, 428 apoenzymes, 201 host defenses, 425–26 immune testing, 500, 501f osmosis, 178 Specimen collection and preparation, 56f, 492–95 Spheroplast, 93 Spine, and tuberculosis, 641 Spirillium, 98, 100f Spirochetes, 85, 98, 100f Spirogyra, 127f Spiroketal, 27 Spirulina, 774 Spleen, 80, 88, 405 Spliceosome, 250 Split gene, 250 Spongiform encephalopathies, 163–64 Spontaneous generation, 12–13 Spontaneous mutation, 256, 258 Sporadic CJD, 568 Sporadic disease, 390, 391f Sporangium, 96, 125 Spore(s), 17, 96, 123, 125–26 See also Endospores Spore stain, 75f Sporicidal liquid, 299t Sporocarcina, 96 Sporozoites, 131, 603 Sporulation, 96, 97f Spread plate technique, 58 Sputum, and specimen collection, 492–93 Squamous intraepithelial lesion (SIL), 733 Ss blood groups, 474 ssRNA See Single-stranded RNA Stains and staining, 71, 74–76 See also Acid-fast staining; Dyes; Gram staining Stanford University, 492, 566 Staphylococcal scalded skin syndrome (SSSS), 522–24 Staphylococcus spp., 63 S aureus See also Staphylococcal scalded skin syndrome antimicrobial therapy, 350 endocarditis, 588 food poisoning, 682, 684t heat resistance and thermal death, 306 impetigo, 516–18 names and naming, 20 osmotic pressure, 185 parasitic microorganisms, 174 PNA FISH testing for, 498f population growth and generation time, 190–91 temperature range for growth, 181 I-23 S epidermidis, 514, 518 S saprophyticus, 712, 713t Starch, 44f Start codon, 247 Starter cultures, 769 State University of New York at Stony Brook, 163 Stationary growth phase, 191–92 Stavudine (d4T), 345t, 614 Steam sterilization, 306–307 Stem cells, 406, 407f, 429, 479 Stentor, 129f Sterilants, 300 Sterile, 17, 57, 300, 319 Sterile milk, 308 Sterilizing gas, 299t Sterilization, 17, 298, 300 See also Asepsis and aseptic techniques Steroids, 42t, 47, 779t, 783 Sterols, 113 Stierle, Andrea, 27, 34 Stock cultures, 66 Stomach antimicrobial properties of fluid, 661 Helicobacter pylori and cancer of, 670 normal biota, 663 Strains, of bacteria, 102 Stratum basale, 514 Streak plate method, 57 Streptococcal infections, 15 Streptococcus spp., 15 S agalactiae, 559, 560t S mutans, 372t, 664 S pneumoniae See also Pneumonia cold and desiccation, 309 conjunctivitis, 540 glycocalyx, 88 otitis media, 627 phase variation, 254 pneumococcal meningitis, 554–55, 559t transformation of DNA, 261 S pyogenes See also Pharyngitis; Scarlet fever adhesive properties, 372t cell envelope structure, 94 conjunctivitis, 540 erysipelas, 518–19 impetigo, 516–17, 520–21 parasitic microorganisms, 174 role of enzymes in disease, 205 S sobrinus, 372t, 664 S thermophilus, 770 Streptokinase, 374, 520, 779t Streptolysins, 205, 374, 630 Streptomycin, 336t, 354t Stress hormones, 369 Stroke, and nosocomial pneumonia, 652 Stroma, 119 Strongyloides stercoralis, 698 Structural formulas, 37f Structural genes, 234 I-24 Index Structural locus, and gene regulation, 251 Sty, in eye, 541 Subacute encephalitis, 564–68 Subacute endocarditis, 589 Subacute sclerosing panencephalitis (SSPE), 530, 567t Subclinical infections, 378 Subculture, 66 Subspecies, 102 Substrate(s), 122, 200 Substrate-level phosphorylation, 211 Subunit vaccines, 449 Succinic acid, 216 Succinyl CoA, 216 Sucrose, 42, 43 Suffixes, 174t, 375, 587 Sugars, and food preservation, 778 Sulfadiazine, 566 Sulfa drugs, 329, 335f Sulfamethoxazole-trimethoprim (TMP-SMZ) See Trimethoprimsulfamethoxazole Sulfate, 750 Sulfhydryl, 41f Sulfisoxazole, 341 Sulfites, 778 Sulfolobus, 173 Sulfonamides, 329, 333, 335, 336t, 341, 349, 352t Sulfur, 29t, 30f, 169t, 171 Sulfur cycle, 749–51 Sulfur indole motility (SIM), 60f, 64t Sumerians, 770 Sun, as source of energy, 225–28 Superantigens, 433, 517, 518, 630 Superficial mycoses, 538, 539t Superinfection, 353, 357 Superoxide dismutase, 183, 220 Suramin, 578 Surfactants, 304, 318 Surgical asepsis, 385 Surgical debridement, 522 Susceptibility allergy, 462 infectious disease and host defenses, 400 of microorganisms to drugs, 354–56 Svedberg (S), 95 Sweat glands, 514 Swimming pool(s), and infectious disease, 561, 680 Swine See Pig(s) Swine flu, 636, 637f, 638 Sydenham, Sir Thomas, 417 Symbiosis, 186, 187 Symptoms, of disease, 378, 508f See also specific diseases Syncephalastrum, 123f Syncytium (syncytia), 156, 531, 669 Syndrome, 378 Synercid, 340 Synergism, 187, 335 Synthesis See also Protein synthesis regulation of enzymes, 207 of viruses, 153–55, 160t Synthesis reaction, 37 Synthetic biology, 286–87 Synthetic drugs, 330t Synthetic medium, 61 Syphilis, 329, 502, 724–27, 730t See also Treponema pallidum Systemic anaphylaxis, 468 Systemic autoimmune diseases, 479, 481 Systemic infections, 376, 377f, 586 Systemic leishmaniasis, 535 Systemic lupus erythematosus (SLE), 80, 480t, 481 Tachyzoite, 565 Taenia saginata, 695 Taenia solium, 135t, 695, 696t Tamiflu, 344, 345t, 639 Tannerella forsythia, 666 Tapeworm, 133, 135t, 695–96 Taq polymerase, 182, 276 Target cells, and cytotoxic T cells, 443 Taste, and normal microbiota, 368 Tatum, E L., A3 Taxa (taxon), 18 Taxonomy, 18, 102, 121 See also Classification T cell(s), 408 B-cell recognition and cooperation, 436 cell-mediated immunity, 440–41, 443 foreign MHC receptors, 477–78 immunodeficiency diseases, 483t, 484 organ transplantation, 476–79 receptors, 431–32, 434 specific events in maturation, 429, 430f T-cell-mediated hypersensitivity, 461t Tears, and eye, 539 Teeth diseases and infections, 664–68 normal biota, 663 side effects of antibiotics, 353 Teichoic acid, 91 Telithromycin, 340 Temperate phages, 159 Temperature See also Cold; Heat food preservation, 775–77 microbial adaptations, 180–82 microbial control, 306t, 309 Template strand, 244 Teratogenic effects, 516, 531 Terbinafine, 538 Termination, of DNA replication, 240, 247, 249 Terminology See also Names and naming antisense in molecular genetics, 288 antitoxins, 438 of chemotherapy, 330t, 331 clones and cloning, 279 epitopes and antigens, 433 infection and disease, 375, 382 microbial adaptations, 174t microbial control, 300–301 skin lesions, 528 spores and sporulation, 96 use of “transformation,” 262 Termites, 186, 750 Terrorism See Bioterrorism; World Trade Center attacks Terry, Luther, Tertiary consumers, 745 Tertiary structure, of protein, 49 Tertiary syphilis, 725 Testes, 709 Tetanospasmin, 573 Tetanus, 573–74 See also Clostridium tetani Tetanus immune globulin (TIG), 574 Tetracycline(s), 332, 334, 336t, 340, 352t, 353, 354t Tetrads, 100 Tetrapeptide, 91f T-even bacteriophages, 158–59 Texas , 576, 600 Texas A & M University, 364 Thailand, and dengue fever, 598 Thayer-Martin medium, 62, 721 T helper cells, 441 Theory, and scientific method, 3, 16 Therapeutic index, 356–57 Thermal death point (TDP), 306 Thermal death time (TDT), 306, 775 Thermal springs, 182 Thermo-, 174t Thermocline, 757 Thermococcus litoralis, 276 Thermoduric microbes, 182 Thermophiles, 182 Thermoplasma, 105, 185 Thermus aquaticus, 182, 276 Thiabendazole, 538, 692t Thimerosal, 320, 452 Thiobacillus spp., 750–51 T ferrooxidans, 751 T thiooxidans, 750–51 Thioglycollate broth, 184f Thiomargarita namibia, 99 Thiosulfate, 750 Third World See Africa; Developing countries Threadworm, 698 Thylakoid(s), 119, 226 Thymidine kinase 344 Thymine (T), 50, 235 Thymus, 402, 404–405, 484 Ticarcillin, 337t, 355f Ticks, 594, 601 Tigecycline, 340 Tilex mildew remover, 323t Time, and microbial control, 306t Tinctures, 314 Tinea, 536 Index Tinea versicolor, 127t, 536, 539t TI (tumor-inducing) plasmid, 286 Tissue culture, 161–62 Tissue plasminogen activator (tPA), 283t Titer, and antigen-antibody interactions, 500 T lymphocytes See T cell(s) Tobacco mosaic virus, 144–45 Tobramycin, 336t Togaviridae, 150t Toll-like receptors, 416 Tolnaftate, 538 Tomato juice agar, 63t Tonsil(s), 661 Tonsillitis, 628 Topoisomerases I and II, 238t Topsoil, 754 TORCH, 372 Total cell count, 193–94 Toxemias, 374, 376–77 Toxic epidermal necrolysis (TEN), 523 Toxicity See also Toxins antimicrobial drugs, 330, 352–53 heavy metals, 320 Toxicodendron, 478 Toxic shock syndrome (TS), 629 Toxigenicity, 374 Toxin(s) See also A-B toxins; Endotoxins; Exotoxins; Toxicity bacterial and cellular damage, 374–75 biogeochemical cycling, 751 fungi, 122, 126 specialized transduction, 263 Toxin neutralization test, 504 Toxinoses, 374 Toxoid vaccines, 449 Toxoplasma gondii, 131, 564, 565, 567t Toxoplasmosis, 131t , 565 Trace elements, 169 Tracheal cytotoxin, 634 Tracheotomy, 574 Trachoma, 541–42 See also Chlamydia trachomatis Transamination, 224 Transcription, of DNA, 240–51 Transduction, and DNA recombination, 259, 262–64 “Trans fat,” 46 Transferases, 203 Transfer reactions, by enzymes, 205 Transferrin, 419 Transfer RNA (tRNA), 51, 243t, 244 Transformation DNA recombination events, 259, 261–62 of viruses, 157 Transgenic animals, 286 Transgenic plants, 284, 286, 287t Translation, of DNA code, 240–51 Translocation, of RNA, 247 Transmissible agent, 567 Transmissible spongiform encephalopathies (TSEs), 566 Transmission, of infectious agents, 382–84 See also Droplet contact; specific diseases Transmission electron microscope (TEM), 73t Transport cell membrane, 94 nutrient absorption, 174–80 Transport media, 64–65 Transposons, 263–64 Travel, and infectious disease, 604, 622, 675, 689, 692 Treatment See specific diseases Tree of life, 22–24 Trematodes, 133, 135t Trench fever, 601, 602t Treponema pallidum, 495f, 725, 726 See also Syphilis Treponema vincentii, 668 Trichinella spiralis, 135t Trichinosis, 695, 699–700 Trichomonas vaginalis, 129f, 130, 717–18 Trichomoniasis, 131t Trichophyton spp., 537 Trichuris suis, 694 Trichuris trichiura, 694, 696t Triclosan (Irgasan), 313, 317 Trifluridine, 542 Triglycerides, 42t , 45 Trimethoprim, 333, 335, 341, 349 Trimethoprim-sulfamethoxazole, 556, 634, 652, 673 Triple-sugar iron agar (TSIA), 64t Triplet code, 241 Trojan horse vaccine, 450 Troph-, 174t Trophozoite, 130, 685, 686 Tropisms, 151 Trovafloxacin, 341 True pathogens, 366 Trypanosoma spp., 132 T brucei, 131t , 132, 577–78 See also Sleeping sickness T b gambiense, 578 T.b rhodesiense, 578 T cruzi, 131t, 132 Trypanosomes, 132 Trypanosomiasis, 131t, 577–78 Trypticase soy agar (TSA), Tsetse fly, 577–78 TSG101, 351 Tube agglutination test, 501f Tube dilution tests, 354, 356 Tubercle(s), 640 Tuberculin test, 507 Tuberculosis, 449, 476, 640–44, 645t See also Mycobacterium tuberculosis Tube worms, 186 Tubulin, 96 I-25 Tularemia, 592–93, 650, 651 See also Francisella tularensis Tulip(s), 141 Tumbles, of flagella, 84–85 Tumor(s), 410 Tumor necrosis factor (TNF), 283t, 412, 416, 481, 630 Turbidity, and measurement of growth, 193 Turgid cytoplasmic membrane, 178 Tuskegee Study, 724 Twinrix, 689 Twort, Frederick, 157 Tyndall, John, 17, 307 Tyndallization, 307–308 Type(s), of bacteria, 102 Typhoid fever, 381, 672, 673 See also Salmonella enteritidis Typhoid Mary, 381 Tyrosine, 48f Ubiquitous, microbes as, Ulcerative colitis, 684, 694 Ulcer diseases, of reproductive tract, 715, 723–31 Ulcers See Gastric ulcers Ultrahigh-temperature (UHT) pasteurization, 776 Ultraviolet radiation (UV), 72t, 185, 256, 257, 310, 322 Unclotted blood, 405 Uncoated viruses, 152–53, 159 Undulant fever, 599 Undulating membrane, 129 UNICEF, 452, 679 Unified atomic mass unit (U), 31 United Nations, 382, 604 U S Department of Agriculture (USDA), 286, 774, 775, 776 U S Department of Health and Human Services, 455 U S Public Health Service (USPHS), 4t, 388, 650 Universal donor, 472 Universal Precautions (UPs), 385–86 University of Hawaii, 708, 734, 769 University of Iowa, 694 University of Keil (Germany), 327 University of Montana, 27, 34 University of Tennessee, 289 University of Wisconsin, 776 Unsaturated fatty acids, 45–46 Upper respiratory tract infectious diseases, 624–37, 639 normal microbiota, 365t structure and defenses of, 623, 624 Upwelling, 757 Uracil (U), 50, 243 Urea, 185 Urea breath test, 671 Urea broth, 60f, 64t Urease, 670, 671 I-26 Index Urethra, 709 Urethritis, 712 Urinary schistosomiasis, 714–15 Urinary tract, 709 See also Genitourinary tract; Urogenital tract infectious diseases, 712–15, 735t, 736f, 737f normal microbiota, 364t, 365t specimen collection, 492 Urinary tract infections (UTIs), 712–13 Urine, 709 Urogenital tract portals of entry for infection, 371 portals of exit for infection, 379 Urushiol, 478 Uterus, 710 Vaccination and vaccines See also Immunization; specific diseases allergy, 469–70 characteristics of effective, 448t chickens and infectious diseases, 139 dental caries, 666 development of new, 450 genetic engineering, 141, 283 HIV, 614 meningitis, 554 obesity, 164 otitis media, 627 recommended, 451–52, 453t, 454t rhinitis, 625 routes of administration and side effects, 450–51 salmonellosis, 673 specific immunity, 443–52 Streptococcus pneumoniae, 555 Vaccinia virus, 143f Vacuoles, 117–18 Vagina, 710, 712 Vaginitis and vaginosis, 715–18 Valacyclovir, 344 Valence, 31 Valine, 48f Valves, of heart, 588 Vampirovibrio chlorellavorus, 20 Vancomycin, 339, 348, 354t, 588, 677 Vancomycin intermediate Staphylococcus aureus (VISA), 348 Vancomycin-resistant Enterococcus faecalis (VRE), 341 Vancomycin-resistant Staphylococcus aureus (VRSA), 348 Van der Waals forces, 36–37 Variable (V) regions, 431 Variant form of CJD (VCJD), 568 Varicella-zoster virus (VZV), 526 Variola minor and major, 527–28 See also Smallpox Variolation, 446, 529–30 Varmus, Harold, A3 Vas deferens, 709–10 Vasoactive mediators, 410, 412 VDRL (Venereal Disease Research Laboratory) test, 502 Vector(s) for cloning, 278, 279–80 for disease, 381 Vegetations, on heart valves, 588 Vegetative cells, 75 , 306 Vegetative hyphae, 123f Vehicle, for infectious disease, 383–84 Veins, 586 Venter, J Craig, 274, 286, 756 Vent polymerase, 276 Ventricles, of heart, 586 Vesicle, 528 Vesicular or pustular rash diseases, 524–30 Vesicular stomatitis virus (VSV), 141 Vetter, David, 485 Viable noncultured (VNC) microbes, 492 Viable plate count, 192 Vibrio, 98, 100f Vibrio cholerae, 160, 677–78, 681t See also Cholera Vibrio fischeri, 84f Vibrio parahaemolyticus, 168, 183, 777 Vibrio vulnificus, 762, 769, 783 Vidarabine, 345t Viking Explorer spacecraft, 19 Vinegar, 222, 772 Viremia, 375, 378, 587 Virion, 10, 144 Viroids, 164 Virtual image, 69 Virucide, 300 Virulence, of infectious disease, 367 Virulence factors, 367, 373 See also specific diseases Virus(es), 10 See also specific diseases antibiotics, 357 antiviral drugs, 165, 332, 343–44, 345t artificial, 163 autoimmune disorders, 481 biological spectrum, 141–42 classification and naming of, 149 conjunctivitis, 541 cultivation and identification of, 160–62 diagnosis of infections, 507, 508f dimensions, 67 discovery of, 140 eukaryotes and prokaryotes compared to, 120t gastroenteritis, 682 gastrointestinal tract as portal of entry, 369 general structure, 143–49 genetically modified organisms, 284 genetics of, 251 important families, genera, names, and diseases of, 150–51t interferon, 418 medical importance of, 163 meningitis, 558, 559t microbial control, 309 multiplication, 151–60 normal microbiota, 364 in oceans, 756 positive view of, 141 properties of, 142t size of, 142f, 143 treatment of infections, 165 Vitamins, 203, 531, 779t Vitravene, 288 Vodka, 772 Von Borries, B., A3 Von Linné, Carl (Linnaeus), 18 Vulvovaginal candidiasis, 716 Waksman, Selman, A3 Walking pneumonia, 645, 647 Warren, J Robert, 670 Wart(s), and wartlike eruptions, 534–35 Wart diseases, of reproductive tract, 715, 731–33 Water and water supplies See also Aquatic microbiology cell composition, 169 cholera, 678 Cryptosporidium spp and contamination, 316, 322, 680 distribution of on Earth’s surface, 755t environmental influences on microbes, 185 fertilizer runoff into, 751 filtration for purification of, 312 giardiasis, 686 hepatitis, 689 hydrogen bonding, 36f on Mars, 19 microbial contamination of, 297 monitoring to prevent disease, 766–68 polar nature of, 34 reservoirs for disease, 382 solutions, 38 space-filling model of, 37f ultraviolet treatment system for disinfection, 311f wastewater treatment, 763–69 Water quality assays, 767 Watson, James, 235, 236, 284, A3 Wavelength, of light, 69–70 Waxes, 42t, 47 Websites, 274 Weight, 31 Weil-Felix reaction, 502 Weil’s syndrome, 713 Weiss, Benjamin, 19 Western blot analysis, 502–503, 614 Western equine encephalitis (WEE), 563 West Nile virus, 563, 564 Wet Ones antibacterial moist towellettes, 323t Whales, 752 Wheal and flare reaction, 466 Whey, 773 Whipworm, 694 Index Whiskey, 772 White blood cells (WBCs), 401f, 406, 413 Whittaker, Robert, 22 Whole blood, 405 Whooping cough, 633–35 Wilkins, Maurice, 236, A3 Wine, 222, 771–72 Wisconsin Division of Public Health, 55, 680, 766 Wobble, and genetic code, 247 Woese, Carl, 22–23 Wood, and cutting boards, 776 World Health Organization (WHO) emerging pneumonias, 653 epidemiology, 388 H1N1 flu epidemic, 638 malaria, 604, 606 oral rehydration therapy, 679 poliomyelitis, 570, 572 public health microbiology, 4t report on leading causes of death, smallpox, 446, 527 World Trade Center terrorist attack, 268, 291, 292 World War II, 774 Wort, 770 Wound botulism, 574, 576–77 Wright, James, A3 Xanthan, 779t Xenograft, 478 Xeroderma pigmentosa, 257 Xifaxan, 341 X-linked severe combined immunodeficiency disease (SCID), 288 X rays, 310, 643 Xylose, 42 Yahoo, 392 I-27 Yeast(s), 6, 122f See also Saccharomyces spp.; Yeast infections Yeast artificial chromosomes (YACs), 280 Yeast infections, 715 Yellow fever, 597, 598t See also Arboviruses Yellowstone National Park, 182 Yersinia spp., 676, 681t Y enterocolitica, 676 Y pestis, 590–91 See also Plague Y pseudotuberculosis, 676 Yogurt, 285, 351, 773 Zalcitabine, 345t Zidovudine (AZT), 345t, 352t Zinc, 29t, 171 Zoonosis, 381–82, 592, 713 Zooplankton, 757 Zostavax, 527 Zosyn, 337 ... Near East (especially Iraq and Iran) and southern Asia Many also emigrate from eastern Asia, especially Burma, and from Africa, particularly Somalia and Sudan In 20 08, the United States received... infection among young adults age 20 29 years Prevalence in United States 20 03 20 04 60 Malaria everywhere Malaria presence varies No known malaria (c) Malaria activity, 20 09 Figure 13.16 Graphical representation... cell Released by cell via shedding or during lysis Typical sources A few gram- All gram-negative positive and gramnegative bacteria *A toxoid is an inactivated toxin used in vaccines **An antitoxin