MEDICAL

MICROBIOLOGY





Dr.dr. Dewa Made Sukrama Msi,SpMK(K)
History of Microbiology
1. In 1674 Dutuch biologist Leeuwenhoek discovered a
world of tiny animalcules (microbes) by microscope.
2. In 1840 German Pathologist Friedrich Henle proposed
Germ Theory for proving microorganisms causing
diseases.
3. Robert Koch & Louis Pasteur confirmed this theory in
late 1870 -1880s.
4. A. Fleming discovered that the mold Penicillium
prevented the multiplication of staphyloocci.
=> The first antibiotic, Penicillin, was identified.
History of Microbiology-II
5. In 1946, American microbiologist John Enders develop
the virus culture for vaccine development.
Microbiology
Bacteriology
A) Zoology Protozoology
Biology B) Microbiology Rickettsiology
C) Botany Virology
Mycology
Bacteriology General Bacteriology
Agriculture Bacteriology
Food Bacteriology
Industrial Bacteriology
Medical Bacteriology.

5
Recognition of the Relationship between
Microorganisms and Disease
Robert Koch (1843-1910)
established the relationship between
Bacillus anthracis and anthrax
Announced that cause of tuberculosis(
) is a rod-shaped bacterium;
Mycobacterium tuberculosis
6
One of Kochs first micrographs showing
Bacillus anthracis
7
Kochs postulates
The microorganism must be present in every
case of the disease but absent from healthy
individuals.
The suspected microorganism must be isolated
and grown in a pure culture.
The same disease must result when the isolated
microorganism is inoculated into a healthy host.
The same microorganism must be isolated again
from the diseased host.

INTRODUCTION IN MEDICAL
MICROBIOLOGY
1. Medical microbiology
2. Classification of
microorganisms
3. Morphology of bacteria
4. Bacterial anatomy
5. Morphology of viruses
6. Morphology of
rickettsiae
7. Morphology of chlamidia
8. Methods of laboratory
diagnosis
Medical microbiology is the study of causative
agents of infectious diseases of humans and
their reactions to such infections. In other
words it deals with etiology, pathogenesis,
laboratory diagnosis, specific treatment and
control of infection (immunization).
Modern medical microbiology
Bacteriology the science of bacteria, the
causative agents of a member of infectious
diseases.
Virology the science of viruses, non-cellular
living systems, capable of causing infectious
diseases in man.
Immunology the science which concerned
with mechanisms of body protection against
pathogenic microorganisms and foreign cells
and substances.
Mycology the study of fungi pathogenic for
man.
Protozoology which deals with pathogenic
unicellular animal organisms.
CLASSIFICATION OF MICROORGANISMS
Protista Vira
DNA-viruses and RNA-viruses

Eukaryotes Prokaryotes
Fungi Blue-green algae
Algae Bacteria
Protozoa Scotobacteria Photobacteria
Slime moulds 1. Class Bacteria
2. Class Rickettsias
3. Class Mollicutes
Microbiological nomenclature
In microbiology the binominal system of
nomenclature is accepted where each
species has a generic and a specific
name. The generic name is written with a
capital letter, and the specific name with
a small letter. For example: the anthrax
bacillus Bacillus anthracis; the tetanus
bacillus Clostridium tetani.
The size of bacteria
The size of bacteria is measured in
micrometer (m) or micron () (1 micron or
micrometer is one thousandth of a
millimeter) and varies from 0.1 to 16-18 .
Most pathogenic bacteria measure from 0.1
to 10 .
The other units of measurement of
microorganisms are millimicron (m) or
nanometer (nm) (one millionth of a
millimeter) and 1 Angstrom () (one tenth of
nanometer).
Morphology of Bacteria
Bacteria are intracellular free-living
organisms having both DNA and RNA. Their
biological properties and predominant
reproduction by binary fission relates them to
prokaryotes.
Spherical (cocci)
Rod-shaped
(bacteria, bacilli,
and clostridia)
Spiral-shaped
(vibriones, spirilla, spirochaetes)
Spherical
(cocci)
bacteria
1.Micrococci
2. Diplococci
3. Streptococci
4. Staphylococci
5. Tetracocci
6. Sarcine
Representatives of pathogenic
cocci
1.Scanning Electron Micrograph of Streptococcus pneumoniae
2.Scanning electron micrograph of a Staphylococcus aureus
1 2

Electron Micrograph of
Neisseria gonorrhoeae

Rod-shaped bacteria
Bacteria (1) include those
microorganisms, which, as rule,
do not produce spores (E.coli,
Salmonella, Shigella).
Bacilli (2) (B.anthracis) and
clostridia (3) (C.tetani, C.botuli-
num) include organisms the
majority of which produce spores.
Size of rod-shaped bacteria varies
2-10 m: small rods are 2-4 m;
long rods are 5-10 m.
1
2
3
ARRANGEMENT OF ROD-SHAPED
BACTERIA






Rod-shaped bacteria
1. Single Rod
2. Streptobacillus
1
2
SPIRAL FORMS
1. Vibrios are cells, which resemble a
comma in appearance (curved rods).
Typical representative of this group is
Vibrio cholerae.
2. Spirilla are coiled forms of bacteria.
Pathogenic species: Spirillum minus (1) which
is responsible for a disease in humans
transmitted through the bite of rats rat-bite fever
sodoku; Helicobacter pylori (2) causative
agent of ulcer disease of stomach.
1
2
SPIROCHAETES
Treponema exhibits, thin, flexible cells
with 6-14 regular twists. The size of
Treponema varies from 10-18 (T.pallidum).
Leptospira are characterized by very thin
cell structure. The leptospirae form 12-18
regular coils (primary spirals)
(L.interrogans) and C- or S- shape according
secondary twist.
Borrelia have large irregular spirals, the
number of which varies from 3 to 10.
(B.recurrentis, B.persica).
3. Spirochaetes are flexuous spiral forms which
include: Treponema (T.pallidum) (1), Borrelia
(B.recurrentis) (2), Leptospira (L.interrogans) (3)
1
2
3
BACTERIAL CELL
FLAGELLA
Electron Micrograph of Bacteria with Flagella
CAPSULE
Klebsiella pneumoniae Enterobacter aerogenes
SPORE
Bacillus megaterium Bacillus anthracis
Cell wall
In addition to conferring rigidity upon
bacteria, the cell wall protects against
osmotic damage
Chemically, the rigid part of the cell wall is
peptidoglycan
First described by Gram in 1884. It is' used
to study morphologic appearance of
bacteria. Gram's stain differentiates all
bacteria into two distinct groups:
a. Gram-positive organisms
b. Gram-negative organisms
fuchsine
Gram
Staining
Technique
Bacteria with deficient cell walls
Mycoplasma: a genus of naturally occurring
bacteria which lack cell walls
L-forms: cell-wall-deficient forms of bacteria,
usually produced in the body of patients treated
with penicillin
Spheroplasts: derived from Gram-negative
bacteria; produced artificially by lysozyme or by
growth with penicillin or any other agent capable
of breaking down the peptidoglycan layer
Protoplasts: derived from Gram-positive bacteria
and totally lacking cell walls; produced artificially
by lysozyme and hypertonic medium
Electron micrograph mycoplasma
cells (1) and L-forms of Proteus
mirabilis (2)
1
2
Morphology of viruses
Do not possess cellular
organization
Contain one type of nucleic acid
either RNA or DNA
Lack enzymes necessary for
protein and nucleic acid
synthesis machinery of host
cells
They multiply by complex
process and not by binary
fission.
They are unaffected by
antibiotics.
They are sensitive to interferon.
Morphology of viruses
Morphology of Rickettsiae.
They are minute organisms having properties
in between bacteria and viruses.
It contains both DNA and RNA.
Contains enzymes for metabolic functions.
Multiplies by binary fission.
It is coccobacilli 300x600 nm in size, non-
motile, non-capsulated and is Gram-negative.
Sensitive to many antibiotics.
Can multiply only inside living cells.
Morphology of Rickettsiae
Morphology of chlamydia.
Chlamydiae are Gram-negative. They lack
some important mechanisms for the
production of metabolic energy, so they
are intracellular parasites. There are 2
morphological forms of chlamydia:
Elementary bodies
Initial bodies
Methods of laboratory diagnosis
1. Bacterioscopical
2. Bacteriological
3. Detection
sensitivity of
bacteria to
antibiotics
4. Serological
5. Biological
6. DNA-technology
test (PCR)
ORAL MICROBIOLOGY
Normal oral flora

Diverse organisms, including bacteria, fungi,
mycoplasmas, protozoa and viruses

~ 350 cultivable species

Unculturable flora (identified by molecular
techniques)

ORAL MICROBIOLOGY
Normal oral flora

Streptococci are the predominant
supra-gingival bacteria

Four main groups:
mutans
salivarius
anginosus
mitis