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Introduction to

Medical Microbiology
Dr.T.V.Rao MD

Aim of the Programme

The world is going for more and more towards the Digital learning ( e-learning). The Subject of Medical Microbiology is wide and deep and given time period to learn many details becomes difficult. However students can orient with Digital modules for rapid learning and makes their online searches easier for rapid references.
Dr.T.V.Rao MD Professor of Microbiology

Dr.T.V.Rao MD

Aims for Learning Medical Microbiology

What is medical microbiology? Why is it relevant? Some important concepts. Basic classification of organisms. Classifying bacteria. Dr.T.V.Rao MD

What is Microbiology?
Microbes, or microorganisms are minute living things that are usually unable to be viewed with the naked eye. What are some examples of microbes?
Bacteria, fungi, protozoa, algae, viruses are examples! Some are pathogenic Germ refers to a rapidly growing cell.
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What is Microbiology
Microbiology study of microorganisms (simple forms of life visible only with a microscope) Microorganisms may be
Normal flora Pathogenic

Why is it Important?
Infection is one of the most important causes of mortality and morbidity in the population. Approximately 30% of hospital patients are on antibiotics at any one time 1 in 10 patients acquires an infection whilst in hospital.
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The Early Years of Microbiology contributed by discovery of Microscope

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History of Microbiology started with

1673-1723, Antoni van Leeuwenhoek (Dutch) described live microorganisms that he observed in teeth scrapings, rain water, and peppercorn infusions.

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Pioneers of Microbiology
Antoni van Leeuwenhoek, DE (1673)
First observed live microorganisms (animalcules)

Schleiden and Schwann, DE

Formulated Cell Theory: cells are the fundamental units of life and carry out all the basic functions of living things

Pasteur, FR and Tyndall, UK (1861)

Finally disproved S.G.
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Pioneers of Microbiology
Louis Pasteur (1822-1895), Chemist
Fermentation (1857) Pasteurization: heat liquid enough to kill spoilage bacteria (1864) Vaccine development rabies Proposed the germ theory of disease Proposed aseptic techniques (prevent contamination by unwanted microbes) Director of Pasteur Institute, Paris (1894)
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Pioneers of Microbiology
Joseph Lister, UK (1867)
Used phenol (carbolic acid) to disinfect wounds First aseptic technique in surgery

Robert Koch, DE (1876)

Postulates Germ theory (1876) Identified microbes that caused anthrax (1876), tuberculosis (1882) and cholera (1883) Developed microbiological media & streak plates for pure culture (1881)
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The Golden Age of Microbiology 1857-1914

Beginning with Pasteurs work, discoveries included the relationship between microbes and disease, immunity, and antimicrobial drugs

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The study of organisms too small to be seen without magnification
bacteria viruses fungi protozoa Helminths (Parasites) algae
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Classification of Organisms
All living organisms are classified into:
Kingdom Phyllum (family) Genus Species

Organisms that can cause disease are many and varied and include:
Viruses Bacteria Fungi Parasites
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Branches of study within Microbiology

Immunology Public health microbiology & epidemiology Food, dairy and aquatic microbiology Biotechnology Genetic engineering & recombinant DNA technology
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Microbes are involved in

nutrient production & energy flow decomposition production of foods, drugs & vaccines bioremediation causing disease
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Impact of pathogens
Nearly 2,000 different microbes cause diseases 10 B infections/year worldwide 13 M deaths from infections/year worldwide
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Characteristics of microbes

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Antonie van Leeuwenhoek

First to observe living microbes his single-lens magnified up to 300X
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Science of Microbiology begins

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Scientific Method
Form a hypothesis - a tentative explanation that can be supported or refuted by observation & experimentation A lengthy process of experimentation, analysis & testing either supports or refutes the hypothesis. Results must be published & repeated by other investigators.
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Hypothesis becomes Principles

If hypothesis is supported by a growing body of evidence & survives rigorous scrutiny, it moves to the next level of confidence - it becomes a theory Evidence of a theory is so compelling that the next level of confidence is reached - it becomes a Law or principle

Dr.T.V.Rao MD


Spontaneous generation
Early belief that some forms of life could arise from vital forces present in nonliving or decomposing matter. (flies from manure, etc)

Louis Pasteur Laid foundations in Microbiology

Showed microbes caused fermentation & spoilage Disproved spontaneous generation of m.o. Developed aseptic techniques. Developed a rabies vaccine. Dr.T.V.Rao MD 26


Germ theory of disease Replaces Fate and Sins

Many diseases are caused by the growth of microbes in the body and not by sins, bad character, or poverty, etc.

Robert Koch 1843 - 1910

A German scientist Formulated the Bacteriological techniques Staining Methods Discovered the Mycobacterium and Vibrio cholera
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Robert Koch
Established a sequence of experimental steps to show that a specific m.o. causes a particular disease. Developed pure culture methods. Identified cause of anthrax, TB, & cholera.
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Robert Koch establishes many Principals and postulations

Koch perfected his methods of diagnostics and expanded on the work of others. Koch invented the method of cultivating bacteria on nutrient mediums, using potatoes as his source of nutrients for bacteria, and created a medium that could be stored in dishes created by his colleague Petri.

Kochs work on diseases and diagnostics culminated with the creation of what are now known as Kochs Postulates. Kochs Postulates are the 4 steps necessary to confirm if a suspected pathogen is indeed the cause of a disease.:
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Robert Koch and Postulates

Kochs work on diseases and diagnostics culminated with the creation of what are now known as Kochs Postulates. Kochs Postulates are the 4 steps necessary to confirm if a suspected pathogen is indeed the cause of a disease.:
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How do we know that a given pathogen causes a specific disease? Koch's postulates
the pathogen must be present in every case of the disease the pathogen must be isolated from the diseased host & grown in pure culture the specific disease must be reproduced when a pure culture of the pathogen is inoculated into a healthy susceptible host the pathogen must be recoverable from the experimentally infected host
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Koch's Postulates
1. Microorganisms are isolated from dead animals


Microorganisms are grown in pure culture

2b. Microorganisms are identified

3. 4. 5. Microorganisms are injected into healthy animals Disease is reproduced in second animal Microorganisms are grown in pure culture

5b. Identification of identical microorganism.

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Figure 14.3, steps 12

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Figure 14.3, steps 34

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Exceptions to Kochs Postulates

Microorganisms that are unable to be cultured on artificial media (example: Treponema pallidum) 2 or more organism work in synergy to cause a disease. Symptoms and diseases can be causes by any one of several microbes.
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Joseph Lister
Joseph Lister, was a British surgeon and a pioneer of antiseptic surgery. By applying Louis Pasteur's advances in microbiology, he promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary. .
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Joseph Lister
He instructed surgeons under his responsibility to wear clean gloves and wash their hands before and after operations with 5% carbolic acid solutions. Instruments were also washed in the same solution and assistants sprayed the solution in the operating theatre. One of his additional suggestions was to stop using porous natural materials in manufacturing the handles of medical instruments.
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Joseph Lister
Lister successfully introduced carbolic acid (now known as phenol) to sterilise surgical instruments and to clean wounds, which led to a reduction in postoperative infections and made surgery safer for patients. Dr.T.V.Rao MD


Taxonomy - system for organizing,

classifying & naming living things
Domain - Archaea, Bacteria & Eukarya Kingdom - 5 Phylum or Division Class Order Family Genus species
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Eubacteria -true bacteria, peptidoglycan Archaea odd bacteria that live in extreme environments, high salt, heat, etc Eukarya- have a nucleus, & organelles
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Naming Microorganisms
Binomial (scientific) nomenclature Gives each microbe 2 names
Genus - noun, always capitalized species - adjective, lowercase

Both italicized or underlined

Staphylococcus aureus (S. aureus) Bacillus subtilis (B. subtilis) Escherichia coli (E. coli)
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Evolution- living things change gradually over millions of years

Changes favoring survival are retained & less beneficial changes are lost. All new species originate from preexisting species. Closely related organism have similar features because they evolved from common ancestral forms. Evolution usually progresses toward greater complexity.
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500-800nm Capable of independent replication Cause of most infections seen in hospital Pneumonia, bacterial meningitis, cellulitis, UTI Many different species Treated with antibiotics
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Smallest known infectious agents Subcellular microorganism
Have only nucleic acid surrounded by a protein coat Must live and grow in living cells of other organisms
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Hepatitis virus


Small (50-300nm)
Unable to replicate independently

Invade host cells and use their cellular machinery to replicate

Influenza, Chickenpox (varicella), Herpes, Rhinovirus, HIV/AIDS Often difficult to treat
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Viruses (cont.)
Illnesses caused by viruses
Colds Influenza Croup Hepatitis Warts
AIDS Mumps Rubella Measles Herpes

Vaccines are available for many viruses

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Complex, large organisms Eukaryotes (as are humans!) Divided into yeasts & moulds Cause a range of diseases e.g.:
Thrush Athletes foot Invasive & allergic Aspergillosis

Many diseases are opportunistic.

Dr.T.V.Rao MD


Eukaryotic organisms with rigid cell wall Yeasts
Single-celled Reproduce by budding

Superficial infections
Athletes foot Ringworm Thrush

Large, fuzzy, multicelled organisms Produce spores

Can cause systemic infections

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Multicellular Parasites
Organisms that live on or in another organism and use it for nourishment
Parasitic worms
Usually due to poor sanitation Roundworms Flatworms Tapeworms

Parasitic insects
Bite or burrow under the skin Mosquitoes Ticks Lice mites
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Single-celled eukaryotic organisms, larger than bacteria
Found in soil and water Illnesses
Malaria Amebic dysentery Trichomoniasis vaginitis
Protozoan Trichomonas vaginalis

Leading cause of death in developing countries

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Normal Flora
Human beings are not microbiologically sterile. We are ALL covered with bacteria, fungi and some parasites. Skin, nose, mouth, gastrointestinal tract ~109 bacteria per gram of faeces Each person carries more non-human cells on their body than their own
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How Microorganisms Cause Disease (cont.)

Localized symptoms
Swelling Pain Warmth Redness

Generalized symptoms
Fever Tiredness Aches Weakness

Normal flora
Provides a barrier Can cause an infection
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How Microorganisms Cause Disease

Cause disease in variety of ways
Use nutrients needed by cells and tissues Damage cells directly Produce toxins

May remain localized or become systemic Transmission

Direct contact Indirect contact
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How Infections Are Diagnosed

Steps to diagnosis and treatment
1. Examine the patient
Presumptive diagnosis May or may not need additional tests

2. Obtain specimen(s)
Label properly Include presumptive diagnosis
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How Infections Are Diagnosed

3. Examine specimen directly
Wet mount Smear

4. Culture specimen
Culture medium contains nutrients Examine culture visually and microscopically

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How Infections Are Diagnosed (cont.)

5. Determine sensitivity to antibiotics 6. Treat the patient as ordered
Antimicrobial to kill pathogen or suppress its growth
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Programme created by Dr.T.V.Rao MD for Medical and Paramedical Students in the Developing World Email doctortvrao@gmail.com

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