MIMS' Medical Microbiology and Immunology is loved internationally for its thorough yet easy-to-follow coverage of microbiology, infectious diseases, and immunology as a dynamic interplay between microbes and host. Covering the fundamentals of these closely linked disciplines, MIMS' takes a systems approach to elaborate on epidemiology, clinical presentation, pathogenesis, and diagnostic approaches, as well as treatment and infection control considerations, supplemented by case-based examples. Complex scientific and clinical concepts are explained clearly and simply with the help of illustrations and a range of accompanying online content. Students will come away with a deep understanding of topics and processes, and will return to this book for reference time and again.


Cover image
Title page
Copyright
Foreword 7th Edition
Foreword 6th Edition
Preface
Contributors
Introduction
Contents
Section 1 The Adversaries Pathogens
1 Pathogens as parasites
THE VARIETIES OF PATHOGENS
LIVING INSIDE OR OUTSIDE CELLS
SYSTEMS OF CLASSIFICATION
2 The bacteria
Structure
Nutrition
Growth and Division
Gene Expression
Survival Under Adverse Conditions
Mobile Genetic Elements
Mutation and Gene Transfer
The Genomics of Medically Important Bacteria
3 The viruses
MAJOR GROUPS OF VIRUSES
INFECTION OF HOST CELLS
REPLICATION
OUTCOME OF VIRAL INFECTION
4 The fungi
MAJOR GROUPS OF DISEASE-CAUSING FUNGI
5 The protozoa
Protozoa can infect all the major tissues and organs of the body
Protozoa have evolved many sophisticated strategies to avoid host responses
Protozoa use a variety of routes to infect humans
6 The helminths
LIFE CYCLES
HELMINTHS AND DISEASE
7 The arthropods
8 Prions
A SPECTRUM OF NEURODEGENERATIVE DISORDERS TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHY
ROGUE PROTEIN PATHOGENESIS
DEVELOPMENT, TRANSMISSION AND DIAGNOSIS OF PRION DISEASES
PREVENTION AND TREATMENT OF PRION DISEASES
9 The host parasite relationship
THE MICROBIOTA AND MICROBIOME
SYMBIOTIC ASSOCIATIONS
THE CHARACTERISTICS OF PARASITISM
THE EVOLUTION OF PARASITISM
Section 2 The adversaries host defences
10 The innate defences of the body
DEFENCES AGAINST ENTRY INTO THE BODY
DEFENCES ONCE THE MICROORGANISM PENETRATES THE BODY
11 Adaptive immune responses bring specificity
LYMPHOID TISSUES: PRIMARY AND SECONDARY
SECONDARY LYMPHOID ORGANS
SUBSETS OF T CELLS
ANTIBODY STRUCTURE AND FUNCTION
RECIRCULATION OF T AND B CELLS
12 Cooperation leads to effective immune responses
COOPERATION MEANS GREATER EFFICIENCY AND SPECIFICITY
OPSONIZATION BY ANTIBODY ENHANCES PHAGOCYTOSIS AND LEADS TO COMPLEMENT ACTIVATION
BENEFICIAL INFLAMMATORY REACTIONS CAN ALSO BE ENHANCED BY ANTIBODIES
ACTIVATION OF T CELLS INVOLVES ANTIGEN-PRESENTING CELLS AND ADDITIONAL COSTIMULATORY SIGNALS
B-CELL ACTIVATION
CLONAL EXPANSION
ANTIBODY PRODUCTION INVOLVES A SERIES OF STEPS WITHIN THE GERMINAL CENTRE
CYTOKINES PLAY AN IMPORTANT PART IN THESE CELL CELL INTERACTIONS
IMMUNOLOGIC MEMORY ENABLES A SECOND INFECTION WITH THE SAME MICROBE TO BE DEALT WITH MORE EFFECTIVELY
ARMIES MUST BE KEPT UNDER CONTROL
Section 3 The Conflicts
13 Background to the infectious diseases
HOST PARASITE RELATIONSHIPS
CAUSES OF INFECTIOUS DISEASES
THE BIOLOGIC RESPONSE GRADIENT
14 Entry, exit and transmission
SITES OF ENTRY
EXIT AND TRANSMISSION
TYPES OF TRANSMISSION BETWEEN HUMANS
TRANSMISSION FROM ANIMALS
15 Immune defences in action
COMPLEMENT
ACUTE PHASE PROTEINS AND PATTERN RECOGNITION RECEPTORS
FEVER
NATURAL KILLER CELLS
PHAGOCYTOSIS
CYTOKINES
ANTIBODY-MEDIATED IMMUNITY
CELL-MEDIATED IMMUNITY
RECOVERY FROM INFECTION
16 Spread and replication
FEATURES OF SURFACE AND SYSTEMIC INFECTIONS
MECHANISMS OF SPREAD THROUGH THE BODY
GENETIC DETERMINANTS OF SPREAD AND REPLICATION
OTHER FACTORS AFFECTING SPREAD AND REPLICATION
17 Parasite survival strategies and persistent infections
PARASITE SURVIVAL STRATEGIES
CONCEALMENT OF ANTIGENS
ANTIGENIC VARIATION
IMMUNOSUPPRESSION
PERSISTENT INFECTIONS
18 Pathologic consequences of infection
PATHOLOGY CAUSED DIRECTLY BY MICROORGANISMS
DIARRHOEA
PATHOLOGIC ACTIVATION OF NATURAL IMMUNE MECHANISMS
PATHOLOGIC CONSEQUENCES OF THE IMMUNE RESPONSE
SKIN RASHES
VIRUSES AND CANCER
Section 4 Clinical Manifestation and Diagnosis of Infections by Body System
19 Upper respiratory tract infections
RHINITIS
PHARYNGITIS AND TONSILLITIS
PAROTITIS
OTITIS AND SINUSITIS
ACUTE EPIGLOTTITIS
ORAL CAVITY INFECTIONS
20 Lower respiratory tract infections
LARYNGITIS AND TRACHEITIS
DIPHTHERIA
WHOOPING COUGH
ACUTE BRONCHITIS
ACUTE EXACERBATIONS OF CHRONIC BRONCHITIS
BRONCHIOLITIS
RESPIRATORY SYNCYTIAL VIRUS INFECTION
HANTAVIRUS PULMONARY SYNDROME
PNEUMONIA
BACTERIAL PNEUMONIA
VIRAL PNEUMONIA
HUMAN CORONAVIRUS INFECTIONS
PARAINFLUENZA VIRUS INFECTION
ADENOVIRUS INFECTION
HUMAN METAPNEUMOVIRUS INFECTION
HUMAN BOCAVIRUS INFECTION
INFLUENZA VIRUS INFECTION
MEASLES VIRUS INFECTION
CYTOMEGALOVIRUS INFECTION
TUBERCULOSIS
CYSTIC FIBROSIS
LUNG ABSCESS
FUNGAL INFECTIONS
PARASITIC INFECTIONS
21 Urinary tract infections
ACQUISITION AND AETIOLOGY
PATHOGENESIS
CLINICAL FEATURES AND COMPLICATIONS
LABORATORY DIAGNOSIS
TREATMENT
PREVENTION
22 Sexually transmitted infections
STIs AND SEXUAL BEHAVIOUR
SYPHILIS
Gonorrhoea
Chlamydial Infection
OTHER CAUSES OF INGUINAL LYMPHADENOPATHY
Mycoplasmas and Nongonococcal Urethritis
OTHER CAUSES OF VAGINITIS AND URETHRITIS
Genital Herpes
HUMAN PAPILLOMAVIRUS INFECTION
Monkeypox, previously a rare viral zoonosis, emerged in 2022 as aN STI
HUMAN IMMUNODEFICIENCY VIRUS
Opportunist STIs
Arthropod Infestations
23 Gastrointestinal tract infections
DIARRHOEAL DISEASES CAUSED BY BACTERIAL OR VIRAL INFECTION
FOOD POISONING BACTERIALTOXIN ASSOCIATED DIARRHOEA
VIRAL CAUSES OF DIARRHOEA
HELICOBACTER PYLORI AND GASTRIC ULCER DISEASE
PARASITES AND THE GASTROINTESTINAL TRACT
MICROSPORIDIA
OTHER INTESTINAL PROTOZOA
SYSTEMIC INFECTION INITIATED IN THE GASTROINTESTINAL TRACT
24 Obstetric and perinatal infections
INFECTIONS OCCURRING IN PREGNANCY
CONGENITAL INFECTIONS
INFECTIONS OCCURRING AROUND THE TIME OF BIRTH
25 Central nervous system infections
INVASION OF THE CENTRAL NERVOUS SYSTEM
THE BODY'S RESPONSE TO INVASION
MENINGITIS
ENCEPHALITIS
NEUROLOGIC DISEASES OF POSSIBLE VIRAL AETIOLOGY
SPONGIFORM ENCEPHALOPATHIES CAUSED BY SCRAPIE-TYPE AGENTS
CNS DISEASE CAUSED BY PARASITES
BRAIN ABSCESSES
TETANUS AND BOTULISM
26 Infections of the eye
CONJUNCTIVITIS
INFECTION OF THE DEEPER LAYERS OF THE EYE
27 Infections of the skin, soft tissue, muscle and associated systems
BACTERIAL INFECTIONS OF SKIN, SOFT TISSUE AND MUSCLE
MYCOBACTERIAL DISEASES OF THE SKIN
FUNGAL INFECTIONS OF THE SKIN
PARASITIC INFECTIONS OF THE SKIN
MUCOCUTANEOUS MANIFESTATIONS OF VIRAL INFECTIONS
MEASLES VIRUS INFECTION
RUBELLA VIRUS INFECTION
OTHER MACULOPAPULAR RASHES ASSOCIATED WITH VIRAL INFECTIONS
OTHER INFECTIONS PRODUCING SKIN LESIONS
KAWASAKI DISEASE
VIRAL INFECTIONS OF MUSCLE
POSTVIRAL FATIGUE SYNDROME
PARASITIC INFECTIONS OF MUSCLE
JOINT AND BONE INFECTIONS
INFECTIONS OF THE HAEMOPOIETIC SYSTEM
28 Vectorborne infections
ARBOVIRUS INFECTIONS
INFECTIONS CAUSED BY RICKETTSIAE
BORRELIA INFECTIONS
PROTOZOAL INFECTIONS
HELMINTH INFECTIONS
29 Multisystem zoonoses
Viral haemorrhagic fever is a multisystem syndrome triggered by a group of viruses that cause severe damage to the vascular system
ARENAVIRUS INFECTIONS
EBOLA AND MARBURG HAEMORRHAGIC FEVERS
Q FEVER
ANTHRAX
PLAGUE
YERSINIA ENTEROCOLITICA INFECTION
TULARAEMIA
PASTEURELLA MULTOCIDA INFECTION
LEPTOSPIROSIS
RAT-BITE FEVER
BRUCELLOSIS
HELMINTH INFECTIONS
30 Fever of unknown origin
DEFINITIONS OF FEVER OF UNKNOWN ORIGIN
CAUSES OF FUO
INVESTIGATION OF CLASSIC FUO
TREATMENT OF FUO
FUO IN SPECIFIC PATIENT GROUPS
INFECTIVE ENDOCARDITIS
31 Infections in the compromised host
THE COMPROMISED HOST
INFECTIONS OF THE HOST WITH DEFICIENT INNATE IMMUNITY DUE TO PHYSICAL FACTORS
INFECTIONS ASSOCIATED WITH SECONDARY ADAPTIVE IMMUNODEFICIENCY
OTHER IMPORTANT OPPORTUNIST PATHOGENS
Section 5 Diagnosis and Control
32 Diagnosis of infection and assessment of host defence mechanisms
AIMS OF THE CLINICAL MICROBIOLOGY LABORATORY
SPECIMEN PROCESSING
CULTIVATION (CULTURE) OF MICROORGANISMS
IDENTIFICATION OF MICROORGANISMS GROWN IN CULTURE
NONCULTURAL TECHNIQUES FOR THE LABORATORY DIAGNOSIS OF INFECTION
ANTIBODY DETECTION METHODS FOR THE DIAGNOSIS OF INFECTION
ASSESSMENT OF HOST DEFENCE SYSTEMS
PUTTING IT ALL TOGETHER: DETECTION, DIAGNOSIS, EPIDEMIOLOGY
33 Epidemiology and control of infectious diseases
WHAT IS EPIDEMIOLOGY?
OUTCOME MEASUREMENTS
TYPES OF EPIDEMIOLOGIC STUDIES
TRANSMISSION OF INFECTIOUS DISEASE
VACCINE EFFICACY
34 Attacking the enemy: antimicrobial agents and chemotherapy
SELECTIVE TOXICITY
DISCOVERY AND DESIGN OF ANTIMICROBIAL AGENTS
CLASSIFICATION OF ANTIBACTERIAL AGENTS
RESISTANCE TO ANTIBACTERIAL AGENTS
CLASSES OF ANTIBACTERIAL AGENTS
INHIBITORS OF CELL WALL SYNTHESIS
INHIBITORS OF PROTEIN SYNTHESIS
INHIBITORS OF NUCLEIC ACID SYNTHESIS
ANTIMETABOLITES AFFECTING NUCLEIC ACID SYNTHESIS
OTHER AGENTS THAT AFFECT DNA
INHIBITORS OF CYTOPLASMIC MEMBRANE FUNCTION
URINARY TRACT ANTISEPTICS
ANTITUBERCULOSIS AGENTS
ANTIBACTERIAL AGENTS IN PRACTICE
ANTIBIOTIC ASSAYS
ANTIVIRAL THERAPY
ANTIFUNGAL AGENTS
ANTIPARASITIC AGENTS
CONTROL BY CHEMOTHERAPY VERSUS VACCINATION
CONTROL VERSUS ERADICATION
USE AND MISUSE OF ANTIMICROBIAL AGENTS
35 Protecting the host: vaccination
VACCINATION A 400-YEAR HISTORY
Edward Jenner (1749 1823)
AIMS OF VACCINATION
VACCINES CAN BE OF DIFFERENT TYPES
Live attenuated vaccines
Nonliving vaccines
Genetically engineered vaccines
NONSPECIFIC BENEFICIAL EFFECTS OF VACCINES
Vaccines in current use
New vaccines in development
36 Specific and nonspecific immunotherapy
ADOPTIVE IMMUNOTHERAPY WITH T CELLS
PASSIVE IMMUNOTHERAPY WITH ANTIBODIES
NONSPECIFIC CELLULAR MODULATION
CORRECTION OF HOST IMMUNODEFICIENCY
37 Infection control
COMMON HOSPITAL INFECTIONS
IMPORTANT CAUSES OF HOSPITAL INFECTION
Urinary tract infections
Surgical wound infections
Pneumonia
Bloodstream infections
Gastrointestinal infections
SOURCES AND ROUTES OF SPREAD OF HOSPITAL INFECTION
HOST FACTORS AND HOSPITAL INFECTION
CONSEQUENCES OF HOSPITAL INFECTION
PREVENTION OF HOSPITAL INFECTION
INVESTIGATING HAI
STERILIZATION AND DISINFECTION
Index
Pathogen parade
Viruses
Hepatitis Viruses
Bacteria
Beta-Haemolytic Streptococci
Alpha-Haemolytic Streptococci
Gram-Positive Rods
Gram-Negative Rods
Other Bacteria
Fungi
Helminths
Vaccine parade
Section 1: The Adversaries Pathogens
Section 2: The Adversaries Host Defences
Section 3: The Conflicts
Section 4: Clinical Manifestation and Diagnosis of Infections by Body System
Section 5: Diagnosis and Control
Online Cases
Bibliography list of useful websites