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Overview of Microbiology

James D. Dick, PhDJohns Hopkins University

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James D. Dick, PhD

Director, Bacteriology Section, Division of Medical Microbiology�Associate Professor of Pathology, Molecular Microbiology and ImmunologyResearches biochemical and molecular techniques for the detection and identi-fication of bacterial pathogens and anti-biotic resistance mechanisms

Section A

Overview of Microbiology

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Classification of Infectious Disease

Clinical−

Major clinical manifestation

Epidemiological−

Transmission/reservoir

Microbiological−

Causative agent

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Microbiological Classification of Infectious Disease

ViralBacterialFungalParasiticPrions

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Diagnosis of Infectious Diseases

Infection versus colonizationDisease versus exposurePrevalence versus incidence

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Comparison of Eukaryotic and Prokaryotic Cells

Characteristic Eukaryotes Prokaryotes

Form Multicellular Single cells

Nucleus Nuclear membrane DNA in contact with cytoplasm

Organelles Membrane-bound organelles present No organelles

Sterols Always Only in Mycoplasma

Ribosomes 80s = 40s + 60s 70s = 30s + 50s

Cell wall Absent or cellulose/chitin Peptidoglycan

Mitosis Yes No

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Size Comparisons of Microorganisms

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Bacterial Cell Structure

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Bacterial Classification

Gram-positiveGram-negativeAcid-fast

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Bacterial Shapes

Cocci-round or spherical cellsBacilli-rod-shaped cellsCurved, spiral forms

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Biological Stains

Bacteria—gram stainFungi—KOH, lactophenol blue, India ink, silver stains in tissueMycobacteria—acid fast stainsParasites—trichrome stain, Wright’s stainViruses—antibody conjugated dyes

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Spherical, Rod-Shaped, and Spiral

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Bacterial Cell Walls

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Pappenheim Stain of Streptococcus pyogenes

Public Domain

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Dark Field Microscopy of Syphilis

Source: CDC

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Family Example Genome Size, Kilobases of Kilobase Pairs

Envelope

RNA VirusesSingle-stranded

Picornaviridae Poliovirus 7.2-8.4 NoTogaviridae Rubella virus 12 YesFlaviviridae Yellow fever virus 10 YesCoronaviridae SARS 16-21 YesRhabdoviridae Rabies virus 13-16 YesParamyxoviridae Measles virus 16-20 YesOrthomyxoviridae Influenza virus 14 YesBunyaviridae California encephalitis virus 13-21 YesArenaviridae Lymphocytic choriomeningitis virus 10-14 YesRetroviridae HIV 319 Yes

Double-strandedReoviridae Rotaviruses 16-27 No

DNA VirusesSingle-stranded

Parvoviridae Human parvovirus B-19 5 NoPartially double-stranded

Hepadnaviridae Hepatitis B 3 YesDouble-stranded

Polyomaviridae JC virus 8 NoAdenoviridae Human adenovirus 36-38 NoHerpesviridae Herpes simplex virus 120-220 YesPoxviridae Vaccinia, smallpox 130-280 Yes

Classification of Viruses

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Viruses

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Electron Micrograph of Viral Particle (Influenza)

Public Domain

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Fluorescent Antibody Stain (Meningoencephalitis)

Public Domain

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Characteristics of Fungi

Pathogenic fungi have two forms: yeasts (unicellular) and molds (multicellular)Some fungi are dimorphicMolds grow as filamentous, branching strands of connected cells known as hyphae

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Characteristics of Fungi

Fungi classified by type/method of reproductionAsexual—conidia; sexual—spores“Micro” or “macro” refers to size of spores

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Grouping of Fungi of Medical Importance

Superficial mycoses—outermost layers of skin and hairCutaneous mycoses—epidermisSubcutaneous mycoses—dermis and subcutaneous tissuesSystemic mycoses—internal organ systems

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Fungi of Medical ImportanceFungus Classification Disease

Malassezia furfur Yeast Superficial mycoses

Trichophyton rubrum Filamentous Tinea, cutaneous mycoses

Microsporum audouinii Filamentous Tinea, cutaneous mycoses

Epidermophyton floccosum Filamentous Tinea, cutaneous mycoses

Candida albicans Yeast Mucocutaneous and systemic mycoses

Sporothrix schenckii Dimorphic Subcutaneous mycoses

Histoplasma capsulatum Dimorphic Systemic mycoses, histoplasmosis

Blastomyces dermatitidis Dimorphic Systemic mycoses, blastomycosis

Coccidioides immitis Dimorphic Systemic mycoses, coccidioidomycosis

Paracoccidioides brasiliensis Dimorphic Systemic mycoses, paracoccidioidomycosis

Penicillium marneffei Dimorphic Systemic mycoses, penicilliosis

Cryptococcus neoformans Yeast Systemic mycoses, opportunistic cryptococcosis

Candida species Yeast Opportunistic infections

Aspergillus fumigatus Filamentous Opportunistic infections

Aspergillus flavus Filamentous Opportunistic infections

Fusarium species Filamentous Opportunistic infections

Rhizopus species Filamentous Opportunistic infections

Mucor species Filamentous Opportunistic infections

Absidia species Filamentous Opportunistic infections

Pseudallesheria species Filamentous Opportunistic infections

Pneumocystis carinii Dimorphic, cysts Opportunistic infections

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Histoplasma capsulatum

Public Domain

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Medical Parasitology

Protozoa−

Amebiasis

−

Leishmaniasis−

Trypanosomiasis

−

MalariaHelminths—adult stage in worm

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Hookworm in stool

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Section B

Diagnostic Microbiology

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Diagnostic Microbiology

MicroscopyCultureImmunologyMolecular methods

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Diagnostic Microbiology

Microscopy−

Light microscopy

−

Fluorescence microscopy−

Electron microscopy

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Bacteria

Staining characteristics−

Gram negative/gram positive

Shape−

Cocci-round or spherical cells

−

Bacilli-rod-shaped cells−

Curved, spiral forms

−

Coccobacilli−

Pleomorphic cells

Size

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Microscopy

Sensitivity−

Relatively poor, one bacterial cell per high-powered field is equivalent to 100,000–1,000,000 bacteria per ml

−

This can be improved through fluorescenceSpecificity−

Poor for bacteria, high for microorganisms exhibiting distinctive morphology—filamentous fungi, parasites, viruses by EM

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Diagnostic Microbiology

Culture−

Defined versus undefined media

−

Enrichment media−

Selective media

−

Specialized media

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Blood Agar (Corynebacterium haemolyticum)

Public Domain

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MacConkey's Agar (Proteus Vulgaris)

Public Domain

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Culture

Sensitivity—usually considered the gold standardSpecificity—excellent when used in conjunction with phenotypic, immunologic, and molecular techniques

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Diagnostic Immunology

Testing for specific microbial antigens−

Direct detection from clinical specimens

−

Characterization of a cultured organismTesting for antibody to specific microbial antigens−

Detection of a particular isotope, usually IgM or IgG

−

IgA and IgE not usually used

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Diagnostic Immunology

Complement fixationAgglutination assaysNeutralization/hemagglutination assaysEnzyme immunoassays (EIAs, ELISAs)Radioimmunoassays (RIA)Fluorescent antibody techniques

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Fluorescent Antibody Stain (Neisseria gonorrhoeae)

Public Domain

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Microbiology Tools for the Epidemiologist

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Molecular Diagnostics

Nucleic acid probesSignal amplification methods−

PCR

−

RT-PCR−

Nested PCR

−

Multiplex PCR

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Sensitivity Comparisons of Molecular Methods

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Probe Technology

Detection of fastidious, slow-growing, or nonculturableorganisms as well as antibiotic resistance genes and phenotypically difficult organisms

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Hybridization Techniques

Solid-phaseLiquid phaseIn situ

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Polymerase Chain Reaction (PCR)

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Gel and Hybridizations of PCR Reactions

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Limitations of Molecular Technology

False positive results−

Contamination

False negative results−

Presence of inhibitors

Narrow spectrum of detection−

Detection of a single pathogen

Cost