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MEDICAL MICROBIOLOGY
Dr.T.V.Rao MD
Dr.T.V.Rao MD 1
What is Microbiology?
Microbes, or microorganisms are minute living
things that are usually unable to be viewed with the
naked eye.
• Study of different
Microorganisms
• Can be
Bacteria
Viruses
Parasites
Fungus
Dr.T.V.Rao MD 4
What are Microorganisms
• Microbes are
products of
evolution,
Consequence of
Natural selection
operating upon
vast array of
genetically diverse
organisms
Dr.T.V.Rao MD 5
History of Microbiology
1673-1723, Antoni
van Leeuwenhoek
(Dutch) described
live
microorganisms
that he observed in
teeth scrapings,
rain water, and
peppercorn
infusions. Dr.T.V.Rao MD 6
Anton van Leeuwenhoek 1674
- 1st person to actually see living microorganisms
荷兰人吕文虎克
(Leeuwenhoek)1632-1723
“wee animalcules”
Dr.T.V.Rao MD 7
History of Microbiology
The Germ Theory of Disease
1835: Agostino Bassi showed a silkworm
disease was caused by a fungus.
1865: Pasteur believed that another silkworm
disease was caused by a protozoan.
1840s: Ignaz Semmelweis advocated
handwashing to prevent transmission of
puerperal fever from one OB patient to
another.
Dr.T.V.Rao MD 8
The Germ Theory of Disease
• 1860s: Joseph Lister used a
chemical disinfectant to
prevent surgical wound
infections after looking at
Pasteur’s work showing
microbes are in the air, can
spoil food, and cause animal
diseases.
Dr.T.V.Rao MD 9
History of microbiology
Anton van Leeuwenhoek (1632–1723): was the first
microbiologist and the first person to observe bacteria
using a single-lens microscope of his own design.
Louis Pasteur (1822–1895): Pasteur developed a
process (today known as pasteurization) to kill microbes.
pasteurization is accomplished by heating liquids to 63
to 65 C for 30 minutes or to 73 to 75 C for 15 seconds.
Robert Koch (1843–1910): was a pioneer in medical
microbiology and worked in cholera, anthrax and
tuberculosis. He was awarded a Nobel prize in 1905
(Koch's postulates) he set out criteria to test.
Alexander Fleming (1929): Discovered penicillin.
Dr.T.V.Rao MD 10
Joseph Lister
• 1860s: Joseph Lister
used a chemical
disinfectant to
prevent surgical
wound infections
after looking at
Pasteur’s work
showing microbes are
in the air, can spoil
food, and cause
animal diseases.
Dr.T.V.Rao MD 11
Course objectives
• To provide the student with the basic
knowledge of micro-organisms in
general
• To study the main characteristics of
Microbes of medical importance
• To teach aseptic techniques
• To provide an understanding of
antimicrobial agents
Dr.T.V.Rao MD 12
Other Objectives
• To teach the basic
immunological
principles
• Immunological
methods for the
study
immunological
disorders
Dr.T.V.Rao MD 13
Coverage of subject
• General
Microbiology
• Bacteriology
• Mycology
• Virology
• Immunology
• Parasitology
Dr.T.V.Rao MD 14
Microbes in Our Lives
• Microorganisms
are organisms that
are too small to be
seen with the
unaided eye.
• “Germ” refers to a
rapidly growing
cell.
Dr.T.V.Rao MD 15
Dr.T.V.Rao MD 16
Microbes make the Universe
Dr.T.V.Rao MD 19
Edward Jenner Vaccinating a
Child
Dr.T.V.Rao MD 20
Louis Pasteur
1922 - 95
• Contributed best in
Microbiology
• Sterilization
• Hot Air oven
• Autoclave
• Anthrax vaccine
• Rabies vaccine
• Built the Pasteur
Institute
Dr.T.V.Rao MD 21
Louis Pasteur
• Pasteur coined the
word Vaccine
• Vacca – Cow cow
pox virus are given for
the prevention of
Small Pox
• Louis Pasteur
considered the father
of Modern
Microbiology
Dr.T.V.Rao MD 22
Robert Koch
1843 - 1910
• A German scientist
• Formulated the
Bacteriological
techniques
• Staining Methods
• Discovered the
Mycobacterium and
Vibrio cholera
Dr.T.V.Rao MD 23
Biological Principles illustrated by
Microbiology
Microbiology
Molecular
Biochemistry Genetics
Biology
Dr.T.V.Rao MD 24
Microorganisms
Prokaryotes Bacterium
Eukaryotes Fungi
Dr.T.V.Rao MD 27
How to Study Medical Microbiology?
Fundamentals of Microbiology
•Biological Properties
Bacteriology •Morphology, identification,
•Antigenic structure
•Pathogenesis and Pathology
•Clinical findings
•Diagnostic Laboratory Tests
Virology •Immunity
•Treatment & Prevention
•Epidemiology & Control
Mycology
Dr.T.V.Rao MD 28
Basic Classification of Microorganism
• Eukaryotes Prokaryotes
Large in size Small in Size
Mitochondria Present DNA not separated from
Membrane bound Nucleus cytoplasm
Eg Algae Mitochondria absent
Protozoa
Fungi Eg Bacteria
Slime Moulds
Contains all enzymes for Contains all enzymes like
production of metabolic Eukaryotes
energy
Dr.T.V.Rao MD 29
Summary of differences between
prokaryote and eukaryote cells
Prokaryotic cells Eukaryote cells
Small cell (< 5µm) Larger cells (> 10 µm)
Always unicellular Often multicellular
No nucleus or any membrane bound organelles Always have nucleus and membranes bound
organelles.
DNA circular, without proteins DNA is linear and associated with proteins to
form chromatin.
Dr.T.V.Rao MD 32
Bacterial Cell Wall
The structure of bacterial cell walls is quite different from
the relatively simple structure of eukaryotic cell walls,
although they serve the same functions, providing rigidity,
strength, and protection. The main constituent of most
bacterial cell walls is a complex macromolecular polymer
known as peptidoglycan (murein), consisting of many
polysaccharide chains linked together by small peptide
(protein) chains. Peptidoglycan is only found in bacteria. The
thickness of the cell wall and its exact composition vary with
the species of bacteria. The cell walls of “Gram-positive
bacteria” have a thick layer of peptidoglycan combined with
teichoic acid and lipoteichoic acid molecules. The cell walls of
“Gram-negative bacteria” have a much thinner layer of
peptidoglycan, but this layer is covered with a complex layer
of lipid macromolecules, usually referred to as bacteria
capsule.
Figure 1-9: Gram
Stain
Figure 3-1. Various forms of bacteria, including single cocci, diplococci, tetrads,
octads, streptococci, staphylococci, single bacilli, diplobacilli, streptobacilli,
branching bacilli, loosely coiled spirochetes, and tightly coiled spirochetes.
Morphologic arrangements of
bacteria.
Capsule stain. The capsule stain is an example of a negative staining technique. The
bacterial cells and the background stain, but the capsules do not. The capsules are
seen as unstained “halos” around the bacterial cells.
. Flagellar arrangement. The four basic types of flagellar arrangement on bacteria:
peritrichous, flagella all over the surface; lophotrichous, a tuft of flagella at one end;
amphitrichous, one or more flagella at each end; monotrichous, one flagellum.
Binary fission. Note that DNA replication must occur before the actual
splitting (fission) of the parent cell.
Pathogenic Prokaryotes
Bacteria
Mycoplasma
Spirochetes
Chlamydiae
Rickettsia
Actinomyces
Dr.T.V.Rao MD 40
Viruses
A viral particle consists of a nucleic acid molecule, either DNA or RNA,
enclosed in a protein coat, or capsid
Viruses are known to infect all cells, including microbial cells. Host-virus
interactions tend to be highly specific
Dr.T.V.Rao MD 41
Discovery of Virus
• Iwanovski
– a Russian chemist, 1892
– Tobacco Mosaic Disease
• Beijerinck confirmed
Dr.T.V.Rao MD 42
Viruses
• A virus is not a cell!
• Viruses are replicated
only when they are in a
living host cell
• Consist of DNA or RNA
core
• Core is surrounded by a
protein coat
• Coat may be enclosed in
a lipid envelope
Dr.T.V.Rao MD 43
What are Viruses
• Viruses Dependent on
Host cells for necessary
functions and
Multiplication
• Intracellular
parasites
• Contain either
DNA or RNA
never both.
Dr.T.V.Rao MD 44
Prion
A kind of infectious protein that can resist the digestion of proteinase
The cellular form of the prion protein (PrPc) is encoded by the host’s
chromosomal DNA
Dr.T.V.Rao MD 46
Koch’s Postulates
1 The bacterium should be constantly associated with
lesions of Disease
2 It should be possible to isolate the bacterium in pure
culture from the lesions
3 Inoculation of such pure culture into laboratory animal
should reproduce the lesions of the disease
4 It is possible to reisolate the bacterium in pure culture
from the lesions produced in the experimental animal
Dr.T.V.Rao MD 47
Koch’s postulates
Dr.T.V.Rao MD 48
Scientific era of Antibiotics
1928: Alexander
Fleming discovered
the first antibiotic.
He observed that
Penicillium fungus
made an antibiotic,
penicillin, that killed
S. aureus.
1940s: Penicillin was
tested clinically and
mass produced.
Dr.T.V.Rao MD 49
Discovery of Antibiotics
• Alexander Fleming (1881-1955)
Sir Alexander Fleming Ernst Boris Chain Sir Howard Walter Florey
Dr.T.V.Rao MD 50
Microbes are used to produce
Antibiotics
• Penicillin
• Mold
– Pencillium notatum
Dr.T.V.Rao MD 51
Modern Developments
• Bacteriology is the study of bacteria.
• Mycology is the study of fungi.
• Parasitology is the study of protozoa and
parasitic worms.
• Recent advances in genomics, the study of
an organism’s genes, have provided new
tools for classifying microorganisms.
Dr.T.V.Rao MD 52
Microbes and Human Disease
• Normal micro biota prevent growth of
pathogens.
• Normal micro biota produce growth factors
such as folic acid and vitamin K.
• Resistance is the ability of the body to
ward off disease.
• Resistance factors include skin, stomach
acid, and antimicrobial chemicals.
Dr.T.V.Rao MD 53
How to Study Medical Microbiology?
Fundamentals of Microbiology
•Biological Properties
Bacteriology •Morphology, identification,
•Antigenic structure
•Pathogenesis and Pathology
•Clinical findings
•Diagnostic Laboratory Tests
Virology •Immunity
•Treatment & Prevention
•Epidemiology & Control
Mycology
Dr.T.V.Rao MD 54
Bacteria - what comes to mind?
• Diseases
• Infections
• Epidemics
• Food Spoilage
• Only 1% of all known bacteria cause human
diseases
• About 4% of all known bacteria cause plant
diseases
• 95% of known bacteria are non-pathogens
Dr.T.V.Rao MD 55
• Staphylococcus aureus • Escherichia coli
• Staphylococcus • Bacillus anthrasis
epidermidis • Salmonella enteridis
• Streptococcus • Streptococcus pyogenes
pneumonia • Steptococcus lactis
• Streptococcus faecalis
• Vibrio cholera
• Erlichia canis
• Rhodospirillium rubrum • Campylobacter jujuni
• Bacillus subtilis • Helicobacter pylori
• Micrococcus luteus • Enterobacter aerogenes
Dr.T.V.Rao MD 56
Microbes Benefit Humans
1.Bacteria are primary decomposers - recycle
nutrients back into the environment (sewage
treatment plants)
2. Microbes produce various food products
– cheese, pickles, sauerkraut, green olives
– yogurt, soy sauce, vinegar, bread
– Beer, Wine, Alcohol
Dr.T.V.Rao MD 57
Microbes are also capable of
causing many diseases
Pneumonia Whooping Cough
Botulism Typhoid Fever Measles
Cholera Scarlet Fever Mumps
Syphilis Gonorrhea Herpes 1
Chlamydia Tuberculosis Herpes 2
Meningitis Tetanus RMSV
Strep Throat Lyme Disease AIDS
Black PlagueDiarrhea Dr.T.V.Rao MD Gangrene 58
Progress of Hepatitis Viruses
• 1947, concepts of hepatitis A and serum-
transmitted hepatitis
• 1970, Dane particle was observed
(hepatitis B virus)
• 1973, hepatitis A virus
• 1978, non-A, non-B hepatitis viruses
(NANBV)
• 1989, hepatitis C virus (HCV), hepatitis E
virus (HEV)
• 1990-1994, non A-E hepatitis viruses
• 1995, hepatitis G virus (HGV)
• 1997, TT virus (TTV)
Dr.T.V.Rao MD 59
Human Immunodeficiency Virus & AIDS
• 1981, the first cases report
about AIDS
• 1983, HIV was isolated
• 1990s, HAART (cocktail therapy)
was employed
• So far, no effective vaccine
available
Dr.T.V.Rao MD 60
HIV – AIDS
• Luc Montaigner and
Robert Gallo
announce their
discovery of the
immunodeficiency
virus (HIV) believed
to cause AIDS.
(American Society
for Microbiology
Archives)
Dr.T.V.Rao MD 61
Parasitology
• Parasitology is the study
of parasites .and their
interactions with their
hosts. The science of
parasitology has a long
history and has its roots
in zoology, with its
emphasis on the
identification and
classification of parasites
and of life cycles,
Dr.T.V.Rao MD 62
Taxonomic classification of parasitic organisms
Dr.T.V.Rao MD 66
How Humans Respond to Infections
Study of Immunology
• In spite of Infection
we survive with our
ability to protect
with a system
inherent in our Body
• Called the Immune
response comprises
the Medical
Immunology
Dr.T.V.Rao MD 67
Pathogenesis
Immunity
Dr.T.V.Rao MD 68
Immunity Protects the Living by
Complex Mechanisms
Dr.T.V.Rao MD 69
Why we should
Medical Microbiology
• We study the
Microbes which
infects and causes
Diseases
• We study their
Diagnosis
Prevention
Treatment
Dr.T.V.Rao MD 70
Modern Developments in
Microbiology
• Immunology is the study
of immunity. Vaccines and
interferons are being
investigated to prevent
and cure viral diseases.
• The use of immunology to
identify some bacteria
according to serotypes
(variants within a species)
was proposed by Rebecca
Lancefield in 1933.
Dr.T.V.Rao MD 71
Must learn
Dr.T.V.Rao MD 73
The Birth of Modern Chemotherapy
Dr.T.V.Rao MD 74
Commonly Used Antibiotics
• Penicillin
• Cephalosporins,
• Tetracycline's
• Quinolones
• Vancomycin
• Chloramphenicol
• Drugs for Tuberculosis eg Streptomycin
Dr.T.V.Rao MD 75
Vaccines Produce Immunity
and Prevents Several Infections
Dr.T.V.Rao MD 76
Commonly used Vaccines
• Small pox eradicated
• BCG,
• MMR
• Polio oral Vaccine
• Triple Antigen
• Hepatitis B Vaccine
Dr.T.V.Rao MD 77
What Skills You should
Develop
Dr.T.V.Rao MD 79
Working In the Hospital
Dr.T.V.Rao MD 80
Medical Microbiology advanced Beyond our
Imagination
Can we handle it ???
Dr.T.V.Rao MD 81
Major Selected Nobel Prizes in Physiology or
Medicine
1901* von Behring Diphtheria antitoxin
1902 Ross Malaria transmission
1905 Koch TB bacterium
1908 Metchnikoff Phagocytes
1945 Fleming, Chain, Florey Penicillin
1952 Waksman Streptomycin
1969 Delbrück, Hershey, Luria Viral replication
1987 Tonegawa Antibody genetics
1997 Prusiner Prions
* The first Nobel Prize in Physiology or Medicine.
Dr.T.V.Rao MD 82
Students requirement for the course
• Timetable
• Literature – books, etc
• Practical manual
• Laboratory coat
• Attendance and active participation
• Seek advice timely
Dr.T.V.Rao MD 83
• The Programme created by
Dr.T.V.Rao MD for Medical students
in the Developing world
• Email
• doctortvrao@gmail.com
Dr.T.V.Rao MD 84