Ebook Alcamo’s fundamentals of microbiology (9/E): Part 1

Part 1 book “Alcamo’s fundamentals of microbiology” has contents: The chemical building blocks of life, concepts and tools for studying microorganisms, cell structure and function in the bacteria and archaea, microbial growth and nutrition, airborne bacterial diseases, microbial genetics,… and other contents.

Pronouncing Organism Names Some of the scientific names for microorganisms, which have Latin or Greek roots, can be hard to pronounce As an aid in pronouncing these names, the primary microorganisms used in this textbook are listed alphabetically below, followed by the pronunciation The following pronunciation key will aid you in saying these names The accented syllable (') is placed directly after the syllable being stressed Pronunciation Key a add –a ace ch check g go ã care e end –e even i it –ı ice ä father e˙ term ng ring Acanthamoeba castellani a-kan-thä-me–'bä kas-tel-än'e– Acetobacter aceti a-se–'to–-bak-te˙r a-set'e– –-bak-te˙r Acinetobacter baumannii a-si-ne'to bou-mä'ne–-e– Actinobacillus muris –-bä'cil-lus mu –'ris ak-tin-o –r'us Agaricus bisporis ä-gãr'i-kus bı–-spo Agrobacterium tumefaciens ag'ro–-bak-ti're–-urn tü'me-fa–sh-enz –-mı–'se–s Ajellomyces dermatitidis ä-jel-lo de˙r-mä-tit'i-dis Alcaligenes viscolactis al'kä-li-gen-e–s vis-co-lak'tis Amanita muscaria am-an-ı–'tä mus-kãr'e-ä A phalloides fal-loi'dez Amoeba proteus ä-me–'bä pro–'te–-us –Anaplasma phagocytophilum an'ä-plaz-mä fäg'-o-sı–-to fil-um –'sto–-mä du –-o–-de'näl-e– Ancylostoma duodenale an-sil-o – Aquifex ä'kwe -feks Armillaria är-mil-lãr'e–-ä Arthrobacter är-thro–-bak'te˙r Arthroderma är-thro–-de˙r'mä Ascaris lumbricoides as'kar-is lum-bri-koi'de–z Aspergillus favus a-spe˙r-jil'lus fla–'vus A fumigatus fü-mi-gä'tus A niger nı–'je˙r A oryzae ô'ri-zı– A parasiticus pãr-ä-si-ti-kus Azotobacter ä-zo'to-bak-te˙r Babesia bigemina ba-be–'se–-ä big-em-e–'na B microti mı–-kro–'te– Bacillus amyloliquefaciens bä-sil'lus –-li-kwä-fäs'e–-enz am-i-lo B anthracis an-thra–'sis 62582_CH30_CVRS_p002-005.pdf o odd – open o ou out u put sh rush ô order th thin ü rule – use u oi oil u up B cereus se're–-us B sphaericus sfe'ri-kus B subtilis su'til-us B thuringiensis thur-in-je–-en'sis Bacteroides fragilis bak-te˙-roi'de–z fra'gil-is B thetaiotaomicron tha–-tä-ı–-o–-täw-mi'kron Bartonella henselae bär-to–-nel'lä hen'sel-ı– Beggiatoa bej'je–-ä-to–-ä Blastomyces dermatitidis blas-to–-mı–'se–z de˙r-mä-tit'i-dis Bordetella bronchiseptica bor-de-tel'lä bron-ke–-sep'ti-kä B parapertussis pãr'ä-pe˙r-tus-sis B pertussis pe˙r-tus'sis Borrelia burgdorferi bôr-rel'e–-ä burg-dôr'fe˙r-e– B hermsii he˙rm-se–'-e– B recurrentis re–-cür-ren'tis B turicatae te˙r-i-kät'-ı– Botrytis cinerea bo-trı–'tis cin-e˙r-e–'ä Brevibacterium bre-vi-bak-ti're–-um Brucella abortus brü’sel-lä ä-bôr'tus B canis can'is B melitensis me-li-ten'sis B suis sü'is Brugia malayi brü'-ge–-ä mä-la–'e– –ld-e˙r-e–-ä se-pa–'se–-ä Burkholderia cepacia berk'ho –-bak-te˙r ko–'lı– (or ko–'le–) Campylobacter coli kam'pi-lo – – – C jejuni je -ju'ne Candida albicans kan'did-ä al'bi-kanz –-lo–-bak'te˙r kre-sen'tus Caulobacter crescentus ko Cellulomonas sel-u-lo-mo–'näs Cephalosporium acremonium sef-ä-lo–-spô're–-um ac-re-mo–'ne–-um Chlamydia trachomatis kla-mi'de–-a trä-ko–'mä-tis 2/4/10 3:16 PM Pronouncing Organism Names (continued) –-mo –'näs Chlamydomonas klam-i-do –'ne–-ı– Chlamydophila pneumoniae kla-mi'dof-i-la nü-mo – C psittaci sit'a-se –-bak'-te˙r Chromobacter violaceum kro–-mo – – – – vı -o-la 'se -um Claviceps purpurea kla'vi-seps pür-pü-re–'ä Clostridium acetobutylicum klôs-tri’de–-um –a -se–-to––-til'i-kum bu –-lı–'num C botulinum bot-u C difficile dif'fi-sil-e– C perfringens pe˙r-frin'jens C tetani te'tän-e– Coccidioides immitis kok-sid-e–-oi'de–z im'mi-tis –-sä-da'se–-e– C posadasii po Corynebacterium diphtheriae kôr'e–-ne–-bak-ti-re–-um dif-thi're–-ı– Coxiella burnetii käks'e–-el-lä be˙r-ne'te–-e– –-kok-kus Cryptococcus neoformans krip'to – – ne -o-fôr'manz –-spô-ri-de–-um Cryptosporidium coccidi krip'to – kok'sid-e C hominis ho–'mi-nis C parvum pär'vum Cyclospora cayetanensis sı–'klo–-spô-rä kı–'e–-tan-en-sis Deinococcus radiodurans dı–'no–-kok-kus ra–-de–-o–dür'anz –-vib-re–-o – Desulfovibrio de–'sul-fo – – –-näs Desulfuromonas de 'sul-für-o-mo –-kok'kus Echinococcus granulosus –e -kı–n-o –-1o –'sis gra-nu Ehrlichia chaffeensis e˙r'lik-e–-ä chäf-fen'sis –-cı–-to'fı–-lä E phagocytophila fa–-go Emmonsiella capsulata em'mon-se–-el-lä cap-sül-ä'tä –-li'ti-kä Entamoeba histolytica en-tä-me–'bä his-to – Enterobacter aerogenes en-te-ro-bak'te˙r ã-rä'jen-e–z E cloacae klo–-a–'ki –'be–-us ver-mi-ku –-lar'is Enterobius vermicularis en-te-ro –-kok'kus fe–-ka–'lis Enterococcus faecalis en-te˙-ro – – E faecium fe 'se -um –-fı–'ton Epidermophyton ep-e–-der-mo Erysipelothrix rhusiopathiae –a r-e–-sip'e-lo–-thriks rü'sı–-o–-pa-the– –’le–) Escherichia coli esh-e˙r-e–'ke–-ä ko–'lı– (or ko –-gle–'nä Euglena u Filobasidiella neoformans fı–-lo-ba-si-de–-el'lä ne–-o-fôr'mäns Francisella tularensis fran'sis-el-lä tü'lä-ren-sis –-so–-bak-ti're–-um Fusobacterium fu Gambierdiscus toxicus gam'be–-e˙r-dis-kus toks'i-kus Gardnerella intestinalis gärd-ne˙-rel'lä in-tes-ti-nal'is G vaginalis va-jin-al'is Geobacillus stearothermophilus je–-o–-bä-sil'lus ste-är-o–-the˙r-mä'fil-us Giardia lamblia je–-är'de–-ä lam'le–-ä –-bak-te˙r Gluconobacter glü'kon-o Gonyaulax catanella gon-e–-o–'laks kat-ä-nel'lä –-din'e–-um Gymnodinium jim-no Haemophilus ducrcyi he–-mä'fil-us dü-krä'e– H influenzae in-flü-en'zı– –-bak-ti're–-um Halobacterium salinarum ha-lo sal-i-när'um Hartmannella vermiformis hart-mä-nel'lä vêr-mi-fôr'mis –-bak-te˙r pı–'lo–-re– Helicobacter pylori he–'lik-o –-plaz'mä kap-su-lä'tum Histoplasma capsulatum his-to Klebsiella pneumoniae kleb-se–-el'lä nü-mo–'ne-ı– Lactobacillus acidophilus lak-to–-bä-sil'lus a-sid-o'fil-us L bulgaricus bul-gã'ri-kus L caseii ka–'se–-e– L plantarum plan-tär'um L sanfranciscensis san-fran-si-sen'-sis –-kok'kus lak'tis Lactococcus lactis lak-to Lagenidium giganteum la-je-ni'de–-um jı–-gan'te–-üm Legionella pneumophila le–-jä-nel'lä nü-mo–'fi-lä Leishmania donovani lish'mä-ne–-ä don'o–-vän-e– L tropica trop'i-kä –-ganz Leptospira interrogans lep-to–-spı–'rä in-te˙r'ro – – Leuconostoc citrovorum lü-ku-nos'tok sit-ro-vôr'um L mesenteroides mes-en-ter-oi'de–z Listeria monocytogenes lis-te're–-ä mo-no–-sı–-tô'je-ne–z Methanobacterium meth-a-no–-bak-te˙r'e–-um Methanococcus jannaschii meth-a-no–-kok'kus jan-nä'she–-e– –'te–-us Micrococcus luteus mı–-kro–-kok'kus lu – – – – Micromonospora mı -kro-mo-nos'por-ä (continued on inside back cover) 62582_CH30_CVRS_p002-005.pdf 2/4/10 3:16 PM Alcamo’s FUNDAMENTALS OF Microbiology 62582_FMXX_i_xxx.pdf i 2/10/10 10:37 AM Jones and Bartlett Titles in Biological Science AIDS: Science and Society, Fifth Edition Laboratory and Field Investigations in Marine Life, Ninth Edition Hung Fan, Ross F Conner, & Luis P Villarreal James L Sumich & Gordon Dudley AIDS: The Biological Basis, Fifth Edition Laboratory Fundamentals of Microbiology, Eighth Edition Benjamin S Weeks & I Edward Alcamo Jeffrey C Pommerville Alcamo’s Fundamentals of Microbiology: Body Systems Edition Laboratory Investigations in Molecular Biology Jeffrey C Pommerville Steven A Williams, Barton E Slatko, & John R McCarrey 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Health, Second Edition James D Mauseth Robert I Krasner Case Studies for Understanding the Human Body Microbial Genetics, Second Edition Stanton Braude, Deena Goran, & Shelley Maxfield Stanley R Maloy, John E Cronan, Jr., & David Freifelder Clinical Information Systems: Overcoming Adverse Consequences Microbiology Pearls of Wisdom, Second Edition Dean F Sittig & Joan S Ash S James Booth Defending Evolution: A Guide to the Evolution/Creation Controversy Molecular Biology: Genes to Proteins, Third Edition Brian J Alters Burton E Tropp The Ecology of Agroecosystems Neoplasms: Principles of Development and Diversity John H Vandermeer Jules J Berman Electron Microscopy, Second Edition Perl Programming for Medicine and Biology John J Bozzola & Lonnie D Russell Jules J Berman Encounters in Microbiology, Volume 1, Second Edition Plant Cell Biology Jeffrey C Pommerville Brian E S Gunning & Martin W Steer Encounters in Microbiology, Volume Plants, Genes, and Crop Biotechnology, Second Edition Jeffrey C Pommerville Maarten J Chrispeels & David E Sadava Equilibria and Kinetics of Biological Macromolecules Plant Structure: A Color Guide, Second Edition Jan Hermans & Barry R Lentz Bryan G Bowes & James D Mauseth Essential Genetics: A Genomics Perspective, Fifth Edition Precancer: The Beginning and the End of Cancer Daniel L Hartl Jules J Berman Essentials of Molecular Biology, Fourth Edition Principles of Modern Microbiology George M Malacinski Mark Wheelis Evolution: Principles and Processes Protein Microarrays Brian K Hall Mark Schena, ed Exploring Bioinformatics: A Project-Based Approach Python for Bioinformatics Caroline St Clair & Jonathan E Visick Jason Kinser Exploring the Way Life Works: The Science of Biology R for Medicine and Biology Mahlon Hoagland, Bert Dodson, & Judy Hauck Paul D Lewis Genetics: Analysis of Genes and Genomes, Seventh Edition Ruby Programming for Medicine and Biology Daniel L Hartl & Elizabeth W Jones (late) Jules J Berman Genetics of Populations, Fourth Edition Strickberger’s Evolution, Fourth Edition Philip W Hedrick Brian K Hall & Benedikt Hallgrímsson Guide to Infectious Diseases by Body System Symbolic Systems Biology: Theory and Methods Jeffrey C Pommerville M Sriram Iyengar Human Biology, Sixth Edition Tropical Forests Daniel D Chiras Bernard A Marcus Human Biology Laboratory Manual 20th Century Microbe Hunters Charles Welsh Robert I Krasner Introduction to the Biology of Marine Life, Ninth Edition Understanding Viruses John F Morrissey & James L Sumich Teri Shors 62582_FMXX_i_xxx.pdf ii 2/10/10 12:26 PM 62582_FMXX_i_xxx.pdf iii 2/10/10 10:37 AM World Headquarters Jones and Bartlett Publishers 40 Tall Pine Drive Sudbury, MA 01776 978-443-5000 info@jbpub.com www.jbpub.com Jones and Bartlett Publishers Canada 6339 Ormindale Way Mississauga, Ontario L5V 1J2 Canada Jones and Bartlett Publishers International Barb House, Barb Mews London W6 7PA United Kingdom Jones and Bartlett’s books and products are available through most 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Robert W Holland, Jr V.P., Sales: William J Kane V.P., Design and Production: Anne Spencer V.P., Manufacturing and Inventory Control: Therese Connell Publisher, Higher Education: Cathleen Sether Acquisitions Editor: Molly Steinbach Senior Editorial Assistant: Jessica Acox Editorial Assistant: Caroline Perry Associate Production Editor: Leah Corrigan Senior Marketing Manager: Andrea DeFronzo Composition: Shepherd, Inc Cover Design: Scott Moden Senior Photo Researcher and Photographer: Christine Myaskovsky Cover Image: © Eye of Science/Photo Researchers, Inc Printing and Binding: Courier Kendallville Cover Printing: Courier Kendallville About the cover: A false-color transmission electron microscope image of the bacterium Escherichia coli These rod-shaped cells are a common inhabitant in the human large intestine where they use the short whisker-like appendages to attach to the intestinal lining Library of Congress Cataloging-in-Publication Data Pommerville, Jeffrey C Alcamo’s fundamentals of microbiology / Jeffrey C Pommerville — 9th ed p ; cm Other title: Fundamentals of microbiology Includes bibliographical references and index ISBN 978-0-7637-6258-2 (alk paper) Microbiology Medical microbiology I Alcamo, I Edward II Title III Title: Fundamentals of microbiology [DNLM: Microbiology QW P787a 2011] QR41.2.A43 2011 616.9’041—dc22 6048 2010002117 Printed in the United States of America 14 13 12 11 10 10 62582_FMXX_i_xxx.pdf iv 2/10/10 10:37 AM Brief Contents PART FOUNDATIONS OF MICROBIOLOGY Chapter Now Microbiology: Then and PART VIRUSES AND EUKARYOTIC MICROORGANISMS 438 Chapter 14 The Viruses and Virus-Like Agents 440 Chapter The Chemical Building Blocks of Life 35 Chapter 15 Viral Infections of the Respiratory Tract and Skin 474 Chapter Concepts and Tools for Studying Microorganisms 64 Chapter 16 Viral Infections of the Blood, Lymphatic, Gastrointestinal, and Nervous Systems 508 Chapter Cell Structure and Function in the Bacteria and Archaea 97 Chapter Microbial Growth and Nutrition 131 Chapter 18 Eukaryotic Microorganisms: The Parasites 567 Chapter Metabolism of Microorganisms 158 Chapter Control of Microorganisms: Physical and Chemical Methods 189 PART THE GENETICS OF MICROORGANISMS Chapter 222 Microbial Genetics 224 Chapter Gene Transfer, Genetic Engineering, and Genomics 260 PART BACTERIAL DISEASES OF HUMANS Chapter 17 Eukaryotic Microorganisms: The Fungi 535 298 Chapter 10 Airborne Bacterial Diseases 300 Chapter 11 Foodborne and Waterborne Bacterial Diseases 334 Chapter 12 Soilborne and Arthropodborne Bacterial Diseases 371 Chapter 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases 396 PART DISEASE AND RESISTANCE 607 Chapter 19 Infection and Disease 609 Chapter 20 Resistance and the Immune System: Innate Immunity 646 Chapter 21 Resistance and the Immune System: Acquired Immunity 669 Chapter 22 Immunity and Serology 698 Chapter 23 Immune Disorders and AIDS 729 Chapter 24 Antimicrobial Drugs 767 Appendix A Metric Measurement A-1 Appendix B Temperature Conversion Chart A-1 Glossary Index G-1 I-1 Photograph Acknowledgments P-1 v 62582_FMXX_i_xxx.pdf v 2/17/10 2:17 PM Contents Preface Acknowledgments About the Author To the Student—Study Smart A Tribute to I Edward Alcamo PART FOUNDATIONS OF MICROBIOLOGY Chapter Now xvii xxi xxii xxiv xxx Microbiology: Then and 1.1 The Beginnings of Microbiology Microscopy—Discovery of the Very Small Experimentation—Can Life Generate Itself Spontaneously? 1.2 Microorganisms and Disease Transmission Epidemiology—Understanding Disease Transmission Variolation and Vaccination—Prevention of Infectious Disease 14 The Stage Is Set 15 1.3 The Classical Golden Age of Microbiology (1854–1914) 15 Louis Pasteur Proposes That Germs Cause Infectious Disease 15 Pasteur’s Work Stimulates Disease Control and Reinforces Disease Causation 16 Robert Koch Formalizes Standards to Identify Germs with Infectious Disease 17 Koch Develops Pure Culture Techniques 18 Competition Fuels the Study of Infectious Disease 18 Other Global Pioneers Contribute to New Disciplines in Microbiology 20 1.4 Studying Microorganisms 22 The Spectrum of Microorganisms and Viruses Is Diverse 22 1.5 The Second Golden Age of Microbiology (1943–1970) 25 Molecular Biology Relies on Microorganisms 25 Two Types of Cellular Organization Are Realized 25 Antibiotics Are Used to Cure Infectious Disease 26 1.6 The Third Golden Age of Microbiology—Now 28 Microbiology Continues to Face Many Challenges 28 Microbial Ecology and Evolution Are Helping to Drive the New Golden Age 30 Chapter Review 31 Chapter The Chemical Building Blocks of Life 35 2.1 The Elements of Life 37 Matter Is Composed of Atoms 37 Atoms Can Vary in the Number of Neutrons or Electrons 38 Electron Placement Determines Chemical Reactivity 38 2.2 Chemical Bonding 39 Ionic Bonds Form between Oppositely Charged Ions 40 Covalent Bonds Share Electrons 40 Hydrogen Bonds Form between Polar Groups or Molecules 42 Chemical Reactions Change Bonding Partners 43 2.3 Water, pH, and Buffers 44 Water Has Several Unique Properties 44 Acids and Bases Affect a Solution’s pH 44 Cell Chemistry Is Sensitive to pH Changes 46 vi 62582_FMXX_i_xxx.pdf vi 2/10/10 10:37 AM Contents 2.4 Major Organic Compounds of Living Organisms 47 Functional Groups Define Molecular Behavior 47 Carbohydrates Consist of Sugars and Sugar Polymers 48 Lipids Are Water-Insoluble Compounds 48 Nucleic Acids Are Large, InformationContaining Polymers 50 Proteins Are the Workhorse Polymers in Cells 54 Chapter Review 60 Chapter Concepts and Tools for Studying Microorganisms 64 3.1 The Bacteria/Eukaryote Paradigm 66 Bacterial Complexity: Homeostasis and Biofilm Development 66 Bacteria and Eukaryotes: The Similarities in Organizational Patterns 70 Bacteria and Eukaryotes: The Structural Distinctions 71 62582_FMXX_i_xxx.pdf vii vii 3.2 Classifying Microorganisms 73 Classification Attempts to Catalog Organisms 73 Kingdoms and Domains: Trying to Make Sense of Taxonomic Relationships 73 Nomenclature Gives Scientific Names to Organisms 78 Classification Uses a Hierarchical System 78 Many Methods Are Available to Identify and Classify Microorganisms 79 3.3 Microscopy 83 Many Microbial Agents Are In the Micrometer Size Range 83 Light Microscopy Is Used to Observe Most Microorganisms 84 Staining Techniques Provide Contrast 84 Light Microscopy Has Other Optical Configurations 89 Electron Microscopy Provides Detailed Images of Cells, Cell Parts, and Viruses 91 Chapter Review 93 2/10/10 10:38 AM 13.5 Contact Diseases Caused by Exogenous Bacterial Species 423 (A) FIGURE 13.20 Facial Erysipelas Infection of the skin and subcutaneous tissue with streptococcal bacteria produces a bright red rash of the affected areas, in this case the cheek and nose »» What is most likely the source of this patient’s infection? (B) (C) FIGURE 13.19 Streptococci (A) A false-color scanning electron micrograph of streptococci growing as long chains (Bar = µm.) (B) An example of β-hemolysis caused by a toxin released from Streptococcus pyogenes cells (C) A close-up view of S pyogenes cells showing strands of M protein protruding through the capsule (Bar = 0.5 µm.) »» What function does M protein play in pathogenesis? 62582_CH13_396_437.pdf 423 die without treatment, dealing with STSS requires prompt action with high doses of penicillin and clindamycin Necrotizing fasciitis (occasionally described in the media as “the flesh-eating disease”) is a rare but dangerous infection that destroys muscles, fat, and skin tissue ( FIGURE 13.21 ) GAS reach the subcutaneous tissue through a wound or trauma to the skin surface The enzymes and toxins produced by the bacteria cause necrosis (cell death) of the subcutaneous tissue and adjacent fascia Early signs and symptoms of necrotizing fasciitis include fever along with severe pain, swelling, and redness at the wound site Widespread damage to the surrounding tissue along with blockage of small subcutaneous vessels produces additional dermal cell death For persons with necrotizing fasciitis, debridement and surgery often are needed to remove damaged tissue; in severe cases, amputation may be the only recourse Therefore, early diagnosis and treatment are critical to preventing devastating tissue destruction Failing to recognize necrotizing fasciitis and its severity can lead to death; in fact, about 20% of patients with necrotizing fasciitis die Fascia: The connective tissue covering or binding together parts of the body such as muscles or organs CONCEPT AND REASONING CHECKS 13.15 Assess the clinical significance of group A streptococci (GAS) in causing streptococcal toxic shock syndrome and necrotizing fasciitis 2/3/10 3:55 PM 424 CHAPTER 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases FIGURE 13.21 Necrotizing fasciitis The extensive loss of connective tissue can be seen in the leg of a 15-year-old AIDS patient Extensive wound debridement was required »» What tissues are most affected by GAS? Other Wounds Also Can Cause Skin Infections KEY CONCEPT 16 Traumatic wounds to the skin surface can lead to localized infections Opportunistic: Referring to a pathogen that invades tissues when body defenses are suppressed Eschar: A dry scab formed on skin that has been burned 62582_CH13_396_437.pdf 424 The risk of infection due to a traumatic wound, such as a deep cut, compound fracture, or thermal burn, depends on several factors, including: the extent of potential contamination; the contaminating dose of bacterial cells; and their virulence The physical and physiologic nature of the wound— that is, are there areas of necrosis, or poor blood and oxygen supply—also are important factors affecting bacterial colonization and infection Gas gangrene is often the result of a traumatic wound Because it is a soilborne disease, it was discussed in Chapter 12 Burns are one of the most common and devastating forms of trauma In the United States, the National Center for Injury Prevention and Control reports approximately million fires each year, resulting in 1.2 million burn injuries In a burn injury, the skin has been mechanically damaged and the underlying tissues are open to potential infection ( FIGURE 13.22 ) Thus, individuals with moderate to severe burn injuries require hospitalization, which accounts for 100,000 infectious cases each year Burn wounds can be classified as wound cellulitis, which involves the unburned skin at FIGURE 13.22 A Burn Trauma to the Leg Burns to this patient’s lower leg and ankle have reached underlying fat and muscle tissue, making the tissue extremely susceptible to infection »» What types of bacteria are likely to infect this patient? the margin of the burn, or as an invasive wound infection, which is characterized by microbial invasion of viable tissue beneath the burn Gramnegative bacteria are the most common agents of an invasive infection due to the extensive range of virulence factors and antimicrobial resistance mechanisms they possess ( TABLE 13.3 ) Although there is a variety of bacteria, fungi, and viruses that can cause infection, one of the most likely infective agents in many burn centers is Pseudomonas aeruginosa This aerobic, gram-negative rod is widely distributed in soil, water, plants, and animals (including humans) As an opportunistic pathogen, it rarely causes disease in healthy individuals However, P aeruginosa has emerged as an important source of burn wound sepsis, especially when nosocomially acquired About 5,000 hospitalized patients die each year from burn-related complications Invasive burn wound infections due to P aeruginosa can form mature biofilms within about 10 hours after colonization The area soon appears black or as a violet discoloration or eschar Limiting burn wound infections and patient mor- 2/3/10 3:56 PM 13.5 Contact Diseases Caused by Exogenous Bacterial Species 425 Animal Bites Can Puncture the Skin KEY CONCEPT 17 Bacterial disease can arise from animal bites or scratches Content removed due to copyright restrictions aTable modified from Clin Microbiol Rev., 2006 19(2): p 403–434, DOI and reproduced with permission from the American Society for Microbiology tality requires rapid burn debridement and wound closure In addition, patients with serious invasive burns require immediate topical and systemic antibiotic therapy to further minimize morbidity and mortality Double antibiotic therapy—a combination of a beta-lactam, such as penicillin or cephalosporin, and an aminoglycoside, such as gentamicin—usually is administered because hospital burn centers may harbor strains of P aeruginosa that are resistant to multiple drugs CONCEPT AND REASONING CHECKS 13.16 Why is debridement necessary for most burn wounds? (A) Each year in the United States, about 3.5 million people are bitten by animals Most of these wounds heal without complications, but in certain cases, bacterial skin disease may develop Pasteurellosis is caused by Pasteurella multocida, a small, aerobic, gram-negative rod common in the nasopharynx of cats and various other animals The pathogen causes most wound infections resulting from a dog or cat bite In humans, symptoms develop rapidly, with local redness, warmth, swelling, and tenderness at the wound site Abscesses frequently form, especially if the wound has been sutured The disease responds slowly to penicillin therapy Cat-scratch disease (CSD) affects an estimated 20,000 Americans each year, primarily children who have been scratched, bit, or licked by an infected cat Most cases are associated with Bartonella henselae, a rickettsia ( FIGURE 13.23A ) Symptoms of CSD include red-crusted blisters at the site of entry, headache, malaise, and low-grade fever Swollen lymph glands, generally on the side of the body near the bite, accompany the disease ( FIGURE 13.23B ) Rat-bite fever can be caused by one of two different bacterial species In the United States, Actinobacillus muris (formerly Streptobacillus moniliformis), a gram-negative rod that occurs in long chains, is found in the pharynx of wild rats and other rodents feeding on infected rodents Patients experience a lesion at the site of the bite or scratch, (B) FIGURE 13.23 Cat-Scratch Disease (A) A photomicrograph of Bartonella henselae (dark rods), the causative agent of catscratch disease (Bar = 10 µm.) (B) A patient displaying in the groin the considerable lymph node swelling accompanying cat-scratch disease »» Can B henselae be cultured in microbiological growth media? Explain Pasteurella multocida Actinobacillus muris and Spirillum minus 426 CHAPTER 13 Maculopapular rash: A flat, red area on the skin with small, raised papules Sexually Transmitted and Contact Transmitted Bacterial Diseases then a typical triad of prolonged fever, pain in the back and joints, and skin rash In Asia, Spirillum minus, a rigid spiral cell with polar flagella, causes lesions at the wound site, and a maculopapular rash that spreads out from this point In Japan and other parts of Asia, Spirillum-related rat-bite fever is known as sodoku Antibiotic therapy with penicillin or erythromycin is recommended for either form of the disease CONCEPT AND REASONING CHECKS 13.17 Describe the symptoms of the diseases caused by animal bites or scratches Leprosy (Hansen Disease) Is a Chronic, Systemic Infection KEY CONCEPT 18 Mycobacterium leprae infects the skin and peripheral nerves Mycobacterium leprae 62582_CH13_396_437.pdf 426 For most of the past 2600 years, leprosy has been considered a curse of the damned It did not kill, but neither did it seem to end Instead, it lingered for years, causing the tissues to degenerate and deforming the body In biblical times, the afflicted were ostracized from the community, though what was called leprosy in the Old Testament often was not that specific disease Among the more heroic stories of medicine is the work of Father Damien de Veuster, the Belgian priest who in 1870 established a hospital for leprosy patients on Molokai, Hawaii An equally heroic story was written more recently (MicroFocus 13.5) The agent of leprosy is Mycobacterium leprae, an acid-fast rod related to M tuberculosis (see Chapter 10) M leprae was observed for the first time in 1874 by the Norwegian physician Gerhard Hansen It is referred to as Hansen bacillus, and leprosy is commonly called Hansen disease M leprae is an obligate intracellular parasite, so it cannot be cultivated in artificial laboratory media In 1960, researchers at the CDC succeeded in cultivating the bacillus in the footpads of mice, and in 1969, scientists discovered it would grow in the skin of nine-banded armadillos Leprosy is hard to transmit because about 95% of the world’s population has a natural immunity to the disease It is spread by contact with nasal secretions, which are taken up through the upper respiratory tract The disease has an unusually long incubation period of three to six years, a factor making diagnosis very difficult Because the organisms are heat sensitive, the symptoms occur in the skin and peripheral nervous system in the cooler parts of the body, such as the hands, feet, face, and earlobes Severe cases also involve the eyes and the respiratory tract Susceptibility is highest in childhood and decreases with age More males appear to be infected than females Patients with leprosy experience disfiguring of the skin and bones, twisting of the limbs, and curling of the fingers to form the characteristic claw hand The largest number of deformities develops from the loss of pain sensation due to nerve damage caused by lower numbers of bacilli This form is called paucibacillary (pauci = “few”) or tuberculoid leprosy Inattentive patients, for example, might pick up a pot of boiling water without flinching Disease progression can lead to the loss of facial features accompanied by a thickening of the outer ear and collapse of the nose ( FIGURE 13.24A ) Many tumor-like growths called lepromas form on the skin and in the respiratory tract This form is referred to as multibacillary or lepromatous leprosy This is the most serious form of the disease because the immune system fails to react, meaning there can be millions of bacilli in the body For many years, the principal drug for the treatment and cure of leprosy was a sulfur compound known commercially as Dapsone In many cases, such as the one shown in FIGURE 13.24B , the results were dramatic Today, multidrug therapy with dapsone, rifampin, and clofazimine has cured more than 16 million people of leprosy worldwide In 1985, the WHO began a campaign to “eliminate” leprosy In 2009, 119 countries achieved the WHO’s elimination goal of fewer than one patient per 10,000 population The genomes of both M leprae and M tuberculosis have been sequenced and comparative genomics has revealed some interesting findings The most interesting discovery so far is that more than half of the genes in M tuberculosis are missing from M leprae This suggests at some time in the distant past M leprae lost a substantial number of essential genes for metabolism, requiring the organism to depend on infection of host cells to provide its necessary metabolic and growth needs More analysis may discover an “Achilles heel” by which leprosy can be eliminated TABLE 13.4 summarizes the bacterial contact diseases MICROINQUIRY 13 presents four cases for study involving sexually transmitted and contact diseases CONCEPT AND REASONING CHECKS 13.18 Distinguish between tuberculoid and lepromatous leprosy 2/3/10 3:56 PM 13.5 Contact Diseases Caused by Exogenous Bacterial Species 427 13.5: History The “Star” of Carville On December 1, 1894, seven leprosy patients arrived at an old plantation on a crook in the Mississippi River Soon thereafter, four nuns of the Order of St Vincent de Paul joined them Together this small band formed the nucleus of what was to become the National Hansen’s Disease Center at Carville, Louisiana Change came slowly In 1921, the United States Public Health Service acquired the institution, but it remained essentially a prison, patrolled by guards and surrounded by a chain link fence with barbed wire Then, in 1931, a leprosy patient named Stanley Stein arrived Stanley Stein was not his real name—he had forsaken that for fear of bringing shame to his family Soon, Stein instituted a weekly paper to bring a sense of community to the patients Originally named The Sixty-Six Star (Carville was United States Marine Hospital Number 66), the name was eventually shortened to The Star As the circulation of The Star increased, Stein and others launched a campaign for change In 1936, the patients acquired a telephone so they could hear the voices of their families Three Stanley Stein stands next to the years later, the swamps were drained to reduce the incidence of printing press as copies of The Star malaria Soon there came a better infirmary, a new recreation hall, are printed and removal of the barbed wire In 1946, the State of Louisiana allowed the patients to vote in local and national elections Through all these years, Stein’s leprosy worsened Originally he had tuberculoid leprosy, the form in which the nerves are damaged Afterward, however, he developed lepromatous leprosy, which causes lesions to form on the face, ears, and eyes Soon he was totally blind Without feeling in his fingers, he could not even learn Braille But Stein was not finished He and his newspaper tirelessly fought for a new post office and weekend passes for patients In 1961, President Kennedy paid tribute to The Star on its thirtieth anniversary and singled out its indomitable editor for praise Stanley Stein died in 1968 By that time, The Star had a circulation of 80,500 in all 50 states and 118 foreign countries The Star is still being published today by Carville patients (A) (B) FIGURE 13.24 Treating Leprosy The young boy with lepromatous leprosy is pictured (A) before treatment with dapsone and (B) some months later, after treatment Note that the lesions of the ear and face and the swellings of the lips and nose have largely disappeared »» Why is the disfiguring caused by Mycobacterium leprae limited to the body extremities? 62582_CH13_396_437.pdf 427 2/3/10 3:56 PM 428 CHAPTER 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases TABLE 13.4 A Summary of the Major Contact Diseases Caused by Bacterial Species Inflammation or Disease Causative Agent Acne Propionibacterium acnes TABLE Furuncle and Carbuncle Staphylococcus aureus Impetigo Scalded skin syndrome Staphylococcus aureus Streptococcus pyogenes Staphylococcus aureus Toxic shock syndrome (TSS) Staphylococcus aureus TABLE Erysipelas Streptococcus pyogenes Streptococcal TSS (STSS) Streptococcus pyogenes Necrotizing fasciitis Streptococcus pyogenes Burn infections Pseudomonas aeruginosa Other bacterial species Pasteurellosis Cat-scratch disease Rat-bite fever Leprosy (Hansen disease) 62582_CH13_396_437.pdf 428 Signs and Symptoms Comedones (whiteheads and blackheads) Painful single or cluster of boils Thin-walled blisters forming a crust Red, wrinkled and tender skin Epidermis may peel Fever, vomiting, watery diarrhea, sore throat, muscle aches, and sunburn-like rash High fever, shaking and chills, headache leading to fiery rash on lower limbs and face Fever, dizziness, confusion, and flat body rash Fever with pain and swelling at the wound site Difficult to diagnose May be absent, minimal or late developing Pasteurella Redness, warmth, multocida swelling, and tenderness at the wound site Bartonella henselae Red-crusted blisters, headache, malaise, low-grade fever Actinobacillus muris Fever, pain in the Spirillum minus back and joints, and a skin rash Mycobacterium leprae Disfiguring of skin and bones, loss of pain sensation, loss of facial features Transmission Treatment Prevention and Control Not transmissible Benzoyl peroxide Antibiotics Isotretinoin Drainage Debridement Gentle washing of affected skin Benzoyl peroxide Practicing good hygiene Skin cleansing Topical antibiotic Practicing good hygiene Direct or indirect contact Cefazolin Practicing good hygiene Vaginal tampons Skin wounds Surgery Supportive care Antibiotics Avoiding highly absorbent vaginal tampons Minor skin trauma Eczema Surgical incisions Oral or intravenous Avoiding dry skin antibiotics Preventing cuts and scrapes Direct contact with patients or carriers Trauma to skin surface Clean any wounds Cleaning wounds Debridement Autoinfection Contact with infected person Direct or indirect contact Nosocomial Broad spectrum antibiotics Debridement Surgery Antibiotic therapy Debridement Cat and dog scratch Penicillin or bite Doxycycline Scratch, bite, or lick from healthy cat Symptomatic management Scratch or bite from an infected rat Penicillin Tetracycline Nasal secretions Cleaning skin after a cut, scrape, or other deep wound Protecting burn patients Practicing high levels of disinfection and sterilization Cleaning animal scratches and bites Cleaning cat scratches and bites Avoiding contact with rats and rat contaminated dwellings Multidrug therapy Avoiding contact with dapsone, where endemic rifampin, and clofazimine 2/3/10 3:56 PM 13.5 Contact Diseases Caused by Exogenous Bacterial Species 429 INQUIRY 13 Sexually Transmitted and Contact Disease Identification Below are several descriptions of sexually transmitted, contact, and miscellaneous bacterial diseases based on material presented in this chapter Read the case history and then answer the questions posed Answers can be found in Appendix D Case The patient is a 17-year-old woman who comes to the clinic indicating that several days ago she started feeling nauseous but had not experienced any vomiting She tells the physician that the day before coming to the clinic she had a fever and chills; she also has been urinating more frequently and the urine has a foul smell She is diagnosed as having a urinary tract infection 13.1a What types of bacterial species could be responsible for her illness? 13.1b Why are these types of diseases more prevalent in women than they are in men? 13.1c What types of urinary infections can occur? 13.1d How could this patient attempt to avoid another UTI? 13.1e What role biofilms play in UTIs? Case A 19-year-old unwed mother arrives at the emergency room of the county hospital complaining of having cramps and abdominal pain for several days She says she had never had a urinary tract infection and could not have gonorrhea, as she was treated and cured of that two years ago She has not experienced nausea or vomiting When questioned, she tells the emergency room nurse that she has a single male sexual partner and condoms always are used Based on further examination, the patient is diagnosed with pelvic inflammatory disease (PID) An endocervical swab is used for 62582_CH13_396_437.pdf 429 preparing a tissue culture Staining results indicate the presence of cell inclusions 13.2a What bacterial species can be associated with PID? What disease does she most likely have? 13.2b Why was a tissue culture inoculum ordered? Describe the reproductive cycle of this organism 13.2c What other tests could be ordered for the patient’s infection? 13.2d Why was the emergency room concerned about her sexual activity? 13.2e What misconception does the patient have about her past gonorrhea infection? Case A 71-year-old man visits the local hospital emergency room at 6:00 PM after noticing a red infection streak running up his left forearm He tells the physician that he was playing with his cat this morning when it bit him on the left wrist Thinking nothing of it and being an amateur photographer, he went about printing some photographs in his darkroom At 3:00 PM, he finished and, in the daylight, noticed that his wrist was swollen and painful The physician also notes that the patient experiences tenderness at the site She then notices a small puncture wound on the wrist and a small abscess A Gram stain smear from the abscess indicates the presence of gram-negative rods 13.3a What bacterial species is responsible for the patient’s illness? 13.3b What clues lead you to identify this specific organism? 13.3c Where is this organism normally found in cats? 13.3d What could the patient have done to make it less likely that an infection occurred? Case A 17-year-old man comes to a free neighborhood clinic He says that he noticed some white pus-like discharge and a tingling sensation in his penis Since yesterday, he has had pain on urinating He tells the physician that he has been sexually active with several female partners over the past eight months, but no one has had any sexually transmitted disease Examination determines that there is no swelling of the lymph nodes in the groin or pain in the testicles A Gram stain indicates the presence of gram-negative diplococci The patient is given antibiotics, instructed to tell his female partners they both should be medically examined, and then he is released 13.4a Based on the clinic findings, what disease does the patient have and what bacterial species is responsible for the infection? 13.4b Why is it important for his sexual partners to be medically examined, even if they experience no symptoms? What complications could arise if they are infected? 13.4c For which other organisms is this patient at increased risk? Why? 13.4d What significance can be drawn from the fact that the patient does not have any swelling of the lymph nodes in the groin or pain in the testicles? 13.4e What antibiotics most likely would be given to the patient? 2/3/10 3:56 PM 430 CHAPTER 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases 13.6 Contact Diseases Affecting the Eye Although the eye has a multilayered defense against infection, eye diseases occur As we will discover, trachoma is the most prevalent infectious eye disease in the world However, in the United States and in other developed nations, eye infections typically involve inflammation of the eyelid, conjunctiva, or cornea ( FIGURE 13.25 ) The most common diseases of the eye surface are described below Some Bacterial Eye Infections Can Cause Blindness KEY CONCEPT 19 Bacterial eye infections can involve the eyelid, cornea, or conjunctiva Several eye infections are caused by a few bacterial species Staphylococcus aureus, often a transient member of the skin, is a major cause of infections of the eyelid and the cornea When the bacterium infects the eyelid margin, a painful red swelling develops The inflammation, called blepharitis, makes the sufferer have a burning sensation and feeling that there is a foreign body in the eye The inflammation sometimes leads to the formation of a stye Treatment usually involves warm compresses and a topical antibiotic, such as one containing bacitracin One form of bacterial conjunctivitis, commonly called pink eye or red eye, is an eye redness due to dilation of the conjunctival blood vessels ( FIGURE 13.26 ) It is common in childhood, but the inflammation can occur in people of any age The organisms that most commonly cause bacterial conjunctivitis are staphylococci, pneumococci, or streptococci that are picked up by contact with the eye Symptoms include eye pain, swelling, redness, and a moderate to large amount of discharge, usually yellow or greenish in color After sleeping, some affected individuals have a situation where their “eyes are stuck shut,” requiring a warm washcloth applied to the eyes to remove the dried discharge Pupil Iris Lacrimal gland Sclera (covered by the conjunctiva) Eyelid Retina Choroid Nasolacrimal duct Lens Optic nerve Cornea FIGURE 13.25 Eye Anatomy External infections are most often associated with the eyelid, conjunctiva, or cornea »» Why would the conjunctiva and cornea be most susceptible to infection? 62582_CH13_396_437.pdf 430 2/3/10 3:56 PM 13.6 Contact Diseases Affecting the Eye Bacterial conjunctivitis is a fairly common condition and usually causes no long-term eye or vision damage Still, it is important to see a doctor because some types require treatment with antibiotic eye drops or ointment Prevention includes frequent hand washing with soap and warm water Infected individuals should not share eye drops, tissues, eye makeup, washcloths, towels, or other objects that come in contact with the eye A form of chronic bacterial conjunctivitis, leading to keratitis, also is caused by S aureus The bacterium invades the cornea after some form of eye trauma that causes a break in the corneal epithelium The resulting ulcers are painful and are treated with antibiotic drops The most common and severe form of hyperacute bacterial conjunctivitis is caused by Neisseria gonorrhoeae Left untreated, it can progress to keratitis and corneal perforation Ceftriaxone can be used to treat gonococcal conjunctivitis Any delay in treatment can lead to corneal damage or eye loss A perforation also can be a portal of entry leading to septicemia Neonatal conjunctivitis is an inflammation of the conjunctiva of the newborn The inflammation, also called ophthalmia of the newborn, results from contact with the bacterium during passage through the birth canal of a mother infected with N gonorrhoeae or Chlamydia trachomatis Infection with N gonorrhoeae is the most serious and, if untreated, can lead to blindness ( FIGURE 13.27 ) Infection with C trachomatis is the most common form of ophthalmia It usually heals without permanent eye damage Treatment for both forms of conjunctivitis involves the antibiotics doxycycline or erythromycin In the United States, prevention involves the use of antimicrobial drugs put into the eyes of all newborns after delivery Silver nitrate drops are still used in some parts of the world Trachoma is the world’s leading cause of preventable blindness It occurs in hot, dry regions of the world and it is prevalent in Mediterranean countries, parts of Africa and Asia, and in the southwestern United States in Native American populations There are 500 million infections, mostly children, worldwide and to million individuals have been blinded by trachoma Trachoma is caused by serotypes A, B, and C of C trachomatis that are not sexually transmitted but rather by personal contact with contaminated fingers, towels, and optical instruments Face-toface contact and flies also are important modes of transmission The chlamydiae multiply in the conjunctiva of the eye A series of tiny, pale nodules form on this membrane, giving it a rough appearance (trach = “rough”; oma = “tumor”) An initial infection typically heals without permanent damage However, the initial infection sets up a hypersensitive state, FIGURE 13.26 Conjunctivitus The inflammation on the conjunctiva also called pink eye, causes swelling in the surface »» What causes the redness in the sclera? FIGURE 13.27 Gonorrheal conjunctivitus This case of gonorrheal conjunctivitus resulted in partial blindness due to the spread of N gonorrhoaea bacteria »» How does one become infected with N gonorrhoeae? 62582_CH13_396_437.pdf 431 431 2/3/10 3:56 PM 432 CHAPTER 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases FIGURE 13.28 Worldwide Trachoma Blinding or suspected blinding trachoma affects individuals worldwide, but especially in Africa, Southeast Asia, Mexico, and parts of South America »» How can trachoma be treated? (Map by Silvio Mariotti/WHO.) such that repeated infections result in a chronic inflammation Over many years, scarring of the conjunctiva occurs as the eyelashes turn inwards and abrade the cornea, eventually leading to blindness ( FIGURE 13.28 ) Azithromycin helps reduce the symptoms of trachoma, but in many patients, the relief is only temporary because chlamydiae reinfect the tissues ( FIGURE 13.29 ) In 1997, the WHO established the Alliance for Global Elimination of Trachoma by 2020 (GET 2020) Since then, ten national programs, making up 50% of the global trachoma burden, have reduced acute infections in children by 50% This has involved using a “SAFE strategy”; that is, Surgery of the eyelids; Antibiotics for acute infections; Facial hygiene improvements; and Environmental access to safe water TABLE 13.5 summarizes the bacterial eye diseases CONCEPT AND REASONING CHECKS FIGURE 13.29 Trachoma An opthalmic surgeon in rural Malawi, Africa, attends to a trachoma patient »» How is trachoma spread? 62582_CH13_396_437.pdf 432 13.19 What are the challenges facing health officials trying to eliminate trachoma? 2/3/10 3:56 PM Summary of Key Concepts 433 TABLE 13.5 A Summary of Infectious Bacterial Eye Diseases Inflammation or Disease Causative Agent Signs and Symptoms Blepharitis Staphylococcus aureus Burning sensation in eye Stye may form Bacterial conjunctivitis Staphylococcus aureus Streptococcus pyogenes Haemophilus influenzae Neisseria gonorrhoeae Neisseria gonorrhoeae Chlamydia trachomatis Chlamydia trachomatis Eye pain, swelling, redness, and a yellow or greenish discharge Neonatal conjunctivitis Trachoma Prevention and Control Transmission Treatment Contaminated instruments Hands Shared towels Droplets Direct or indirect contact Pink eye Warm compress Antibiotic medication Practicing good hygiene Antibiotic eye drops Practicing good hygiene Eye swelling and pus discharge Watery discharge Infected mother to child during childbirth Topical and oral antibiotics Tiny, pale nodules on the conjunctiva Upper eyelid abrasion can cause blindness Direct or indirect contact Topical or oral antibiotics Using silver nitrate or antibiotics Screening mother Washing face Controlling flies Freshwater source SUMMARY OF KEY CONCEPTS 13.1 The Structure and Indigenous Microbiota of the Female and Male Reproductive Systems The primary sex organs in the male are the testes, while the epididymis, vas deferens, seminal vesicles, prostate, and penis are accessory reproductive organs In females, the primary sex organs are the ovaries, while the accessory organs consist of the fallopian tubes, uterus, vagina, and vulva Antimicrobial defenses in the reproductive tracts include the urethral mucosa, the vagina, vulva, and cervix in females Lactobacillus species in the vagina as well as antibodies and other antimicrobial products of the systems produce an environment not favorable for pathogen colonization Nonsexually transmitted illnesses include: • Bacterial vaginosis – Gardnerella vaginalis – Prevotella – Peptostreptococcus – Other indigenous bacterial species 13.2 Sexually Transmitted Diseases Caused by Bacteria • Chlamydial urethritis Chlamydia trachomatis • Gonorrhea Neisseria gonorrhoeae • Syphilis Treponema pallidum 62582_CH13_396_437.pdf 433 • Chancroid Haemophilus ducreyi • Ureaplasma urethritis Ureaplasma urealyticum • Lymphogranuloma venereum Chlamydia trachomatis • Granuloma inguinale Klebsiella granulomatis 13.3 The Structure and Indigenous Microbiota of the Female and Male Urinary System The organs of the urinary system that are susceptible to infection are the kidneys and the urinary tract (ureters, urinary bladder, and urethra) The kidneys, ureters, and bladder are normally sterile due to normal urine flow However, the urethra is colonized by microbes either along its whole length or near the terminus Bacterial diseases include: • Urethritis Escherichia coli Chlamydia trachomatis 10 Mycoplasma 11 Other bacterial species • Cystitis 12 Escherichia coli 2/3/10 3:56 PM 434 CHAPTER 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases • Prostatitis (males not shown) – Escherichia coli – Staphylococcus aureus – Proteus – Pseudomonas aeruginosa • Pyelonephritis 13 Escherichia coli 14 Staphylococcus aureus 15 Klebsiella pneumoniae 16 Pseudomonas aeruginosa 13.4 Contact Diseases Caused by Indigenous Bacterial Species 10 Many bacterial diseases are caused by contact with the skin, which normally protects the underlying tissues from bacterial colonization and infection • Acne 17 Propionibacterium acnes • Burn infections 18 Pseudomonas aeruginosa 13.5 Contact Diseases Caused by Exogenous Bacterial Species • Furuncles (boils) and carbuncles 19 Staphylococcus aureus • Impetigo 20 Staphylococcus aureus 21 Streptococcus pyogenes • Scalded skin and toxic shock syndromes 22 Staphylococcus aureus • Erysipelas and necrotizing fasciitis 23 Streptococcus pyogenes • Animal bite diseases 24 Pasteurella multocida 25 Bartonella henselae 26 Actinobacillus muris 27 Spirillum minus 13.6 Contact Diseases Affecting the Eye • Conjunctivitis 28 Neisseria gonorrhoeae 29 Chlamydia tachomatis • Trachoma 30 Chlamydia tachomatis 62582_CH13_396_437.pdf 434 28–30 17–21 18 22–27 13–16 12 1–3, 4–11 18 22–27 2/3/10 3:56 PM Step A: Self-Test 435 LEARNING OBJECTIVES After understanding the textbook reading, you should be capable of writing a paragraph that includes the appropriate terms and pertinent information to answer the objective Trace the pathway of (a) a sperm cell through the male reproductive system and (b) an egg through the female reproductive system Identify the defenses in the male and female reproductive systems that normally prevent colonization and infection Describe the causes of bacterial vaginosis Distinguish between the signs and symptoms of chlamydial urethritis in males and females Describe (a) the possible complications resulting from gonorrhea in females and (b) explain the danger of gonorrhea in pregnant females Distinguish among the three possible stages of syphilis Describe the signs and symptoms of chancroid and ureaplasmal urethritis Assess the role of urination and indigenous microbiota to maintaining a healthy urinary system free from infection Differentiate among the various forms of UTIs: urethritis, cystitis, prostatitis, and pyelonephritis 10 Identify the skin layers and other chemical skin defenses protecting underlying tissues from microbial colonization 11 Name the significant members of the indigenous skin microbiota that normally out-compete most transient microbiota and pathogens 12 Assess the role of Propionibacterium acnes in triggering acne and describe the follicle-associated lesions 13 Estimate the significance of infections by indigenous microbiota resulting from surgical procedures 14 Assess the role of Staphylococcus aureus as an agent for contact diseases 15 Describe the contrast skin infections caused by Streptococcus pyogenes 16 Summarize the types of diseases caused by traumatic wounds, including burns 17 Identify and discuss the characteristics of the three animal bite diseases 18 Summarize the clinical significance of leprosy (Hansen disease) 19 Explain why trachoma is a major cause of blindness in many developing nations STEP A: SELF-TEST Each of the following questions is designed to assess your ability to remember or recall factual or conceptual knowledge related to this chapter Read each question carefully, then select the one answer that best fits the question or statement Answers to even-numbered questions can be found in Appendix C The primary sex organs of the female reproductive system is/are the A uterus B vagina C fallopian tubes D ovaries What part or parts of the male and female reproductive systems are typically colonized by indigenous microbiota? A Male: ureters; female: vagina and ovaries B Male: testes and epididymis C Male: urethra; female: vagina, vulva, and cervix D Male: bladder and ureters; female: fallopian tubes and cervix Which one of the following microbes is NOT associated with vaginosis? A Peptostreptococcus B Gardnerella C Prevotella D Staphylococcus Which one of the following statements is NOT correct concerning the reproductive cycle of Chlamydia? A Reticulate bodies are infectious B Reticulate bodies reorganize into elementary bodies C Elementary bodies infect host cells D Elementary bodies transform into reticulate bodies Salpingitis is associated with _ and can lead to _ A syphilis; gumma formation B gonorrhea; sterility C chlamydia; ophthalmia D chancroid; soft chancre 62582_CH13_396_437.pdf 435 A chancre is typical of which stage of syphilis? A Primary B Secondary C Tertiary D Chronic, latent Besides chlamydia urethritis, what other STD is associated with another serotype of Chlamydia trachomatis? A Lymphogranuloma venereum (LGV) B Genital warts C Granuloma inguinale D Chancroid Which one of the following is NOT part of the urinary tract? A Urethra B Bladder C Kidneys D Ureters What bacterial species is most often associated with cystitis? A Treponema pallidum B Escherichia coli C Chlamydia trachomatis D Pseudomonas aeruginosa 10 What type of immune defensive cell is found in the sublayers of the epidermis? A Keratinocyte B Dendritic (Langerhans) cell C Neutrophil D Basophil 11 The skin is A dominated by gram-negative bacterial cells B free of bacterial cells C without a microbiota D dominated by gram-positive bacterial cells 2/3/10 3:56 PM 436 CHAPTER 13 Sexually Transmitted and Contact Transmitted Bacterial Diseases 12 Which one of the following statements is NOT true of acne? A Acne is caused by Propionibacterium acnes B Plugged sebaceous glands are called erythemas C Whiteheads are completely blocked follicles D Acne is not a preventable disease 13 An acute wound could be due to A surgical procedures B cuts C lacerations D All the above (A–C) are correct 14 In children, this skin disease is characterized by the production of thin-walled blisters oozing a yellowish fluid and forming yellowishbrown flakes A Toxic shock syndrome B Scalded skin syndrome C Erysipelas D Impetigo 15 Which one of the following skin diseases is NOT caused by Streptococcus pyogenes? A Necrotizing fasciitis B Toxic shock syndrome C Gas gangrene D Erysipelas 16 The most common cause of an invasive wound infection, such as a burn, is A gram-positive bacterial species B Treponema pallidum C Pseudomonas aeruginosa D Escherichia coli 17 Bartonella henselae is the causative agent of this skin disease A Leprosy B Cat-scratch disease C Necrotizing fasciitis D Rat-bite fever 18 Leprosy can be contracted by contact with A contaminated water B insects C nasal secretions D contaminated food 19 The SAFE strategy has greatly reduced the global burden of what disease? A Trachoma B Neonatal conjunctivitis C Leprosy D Blepharitis STEP B: REVIEW Answer each of the following by filling in the blank with the correct word or phrase Answers to even-numbered questions can be found in Appendix C 20 Ureaplasmal urethritis is a type of 21 is the disease caused by Haemophilus ducreyi 22 Lymphogranuloma venereum (LGV) is prevalent in -Asia 23 A is absent in Mycoplasma species 24 Granuloma inguinale is characterized by having bacterial masses called bodies 25 Gardnerella is the cause of 26 Mycoplasma is the agent responsible for mycoplasmal urethritis 27 are a group of connected, deep abscesses caused by S aureus 28 is the most common agent of urinary tract infections 29 Sufferers of UTIs have a on urination 30 Dapsone, rifampin, and clofazimine are drugs used to treat STEP C: APPLICATIONS Answers to even-numbered questions can be found in Appendix C 31 Suppose a high incidence of leprosy existed in a particular part of the world Why is it conceivable that there might be a correspondingly low level of tuberculosis? 32 An African patient reports to a local hospital with an upper lip swollen to about three times its normal size Probing with a safety pin at facial points where major nerve endings terminate showed that the area to the left of the nose and above the lip was without feeling When a biopsy of the tissue was examined, it revealed round reservoirs of immune system cells called granulomas within the nerves On bacteriological analysis, acid-fast rods were observed in the tissue What disease all these data suggest? 33 During a field trip, an undergraduate biology student is bitten on the left index finger by a wild rat Within 12 hours, her finger is swollen and throbbing Soon thereafter she is hospitalized with swollen lymph 62582_CH13_396_437.pdf 436 nodes, a skin rash, fever, and exquisite sensitivity of the finger Gramnegative, branching rods were found in the tissue What infectious disease had she contracted? 34 Certain microscopes have the added feature of a small hollow tube that fits over the eyepieces or oculars Viewers are encouraged to rest their eyes against the tube and thereby block out light from the room Why is this feature hazardous to health? 35 After a young man suffers an abrasion on the right arm, his affectionate cat licks the wound Several days later, a pustular lesion appears at the site and a low-grade fever develops He also experiences “swollen glands” on the right side of his neck What disease has he acquired? 36 A woman suffers two miscarriages, each after the fourth month of pregnancy She then gives birth to a child, but impaired hearing and vision become apparent as it develops Also, the baby’s teeth are shaped like pegs and have notches What medical problem existed in the mother? 2/3/10 3:56 PM Step D: Questions for Thought and Discussion 437 STEP D: QUESTIONS FOR THOUGHT AND DISCUSSION Answers to even-numbered questions can be found in Appendix C 37 One of the major problems of the current worldwide epidemic of AIDS is the possibility of transferring the human immunodeficiency virus (HIV) among those who have a sexually transmitted disease Which diseases in this chapter would make a person particularly susceptible to penetration of HIV into the bloodstream? 38 Studies indicate that most cases of Staphylococcus-related impetigo occur during the summer months Why you think this is the case? 39 In some African villages, blindness from trachoma is so common that ropes are strung to help people locate the village well, and bamboo poles are laid to guide farmers planting in the fields What measures can be taken to relieve such widespread epidemics as this? 40 At a specified hospital in New York City, hundreds of patients pay a regular visit to the “neurology ward.” Some sign in with numbers; others invent fictitious names All receive treatment for leprosy Why you think this disease still carries such a stigma? 41 Several years ago the Rockefeller Foundation offered a $1 million prize to anyone who could successfully develop a simple and rapid test to detect chlamydia and/or gonorrhea The test had to use urine as a test sample, and be performed and interpreted by someone with a high school education No one ever claimed the prize Can you guess why? HTTP://MICROBIOLOGY.JBPUB.COM/9E The site features eLearning, an online review area that provides quizzes and other tools to help you study for your class You can also follow useful links for in-depth information, read more MicroFocus stories, or just find out the latest microbiology news 62582_CH13_396_437.pdf 437 2/3/10 3:56 PM ... paper) Microbiology Medical microbiology I Alcamo, I Edward II Title III Title: Fundamentals of microbiology [DNLM: Microbiology QW P787a 2 011 ] QR 41. 2.A43 2 011 616 .9’0 41 dc22 6048 2 010 00 211 7 Printed... in the United States of America 14 13 12 11 10 10 62582_FMXX_i_xxx.pdf iv 2 /10 /10 10 :37 AM Brief Contents PART FOUNDATIONS OF MICROBIOLOGY Chapter Now Microbiology: Then and PART VIRUSES AND EUKARYOTIC... on inside back cover) 62582_CH30_CVRS_p002-005.pdf 2/4 /10 3 :16 PM Alcamo’s FUNDAMENTALS OF Microbiology 62582_FMXX_i_xxx.pdf i 2 /10 /10 10 :37 AM Jones and Bartlett Titles in Biological Science