00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page i N I N T H E D I T I O N Burton’s MICROBIOLOGY FOR THE HEALTH SCIENCES Paul G. Engelkirk, PhD, MT(ASCP), SM(AAM) Biomedical Educational Services (Biomed Ed) Belton, Texas Adjunct Faculty, Biology Department Temple College, Temple, TX Janet Duben-Engelkirk, EdD, MT(ASCP) Biomedical Educational Services (Biomed Ed) Belton, Texas Adjunct Faculty, Biotechnology Department Temple College, Temple, TX 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page ii Acquisitions Editor:David B. Troy Product Manager:John Larkin Managing Editor:Laura S. Horowitz, Hearthside Publishing Services Marketing Manager:Allison Powell Designer:Steve Druding Compositor:Maryland Composition/Absolute Service Inc. 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To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via web site at http://www.lww.com (products and services). Not authorized for sale in North America and the Caribbean. 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Engelkirk, Paul G. Burton’s microbiology for the health sciences / Paul G. Engelkirk, Janet Duben-Engelkirk. — 9th ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-60913-321-4 1. Microbiology. 2. Medical microbiology. 3. Allied health personnel. I. Burton, Gwendolyn R. W. (Gwendolyn R. Wilson) II. Duben-Engelkirk, Janet L. III. Title. IV. Title: Microbiology for the health sciences. [DNLM: 1. Microbiological Processes. 2. Communicable Diseases—microbiology. 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Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com.Lippincott Williams & Wilkins customer service representatives are available from 8:30 AMto 6:00 PM, EST. 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page iii Dedicated to the original author of this book, Dr. Gwendolyn R.W. Burton, whose spirit lives on within its pages. Gwen, we will remember you, think of you, pray for you. And when another day is through, we’ll still be friends with you. (paraphrased lyrics of a song by the late and much loved John Denver) AND To our parents, without whose love and support, we could have never fulfilled our dreams. 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page iv ABOUT THE AUTHORS Paul G. Engelkirk, PhD, MT(ASCP), SM(AAM), is a retired professor of biological sciences in the Science Department at Central Texas College in Killeen, Texas, where he taught introductory microbiology for 12 years. Before joining Central Texas College, he was an associate profes- sor at the University of Texas Health Science Center in Houston, Texas, where he taught diagnostic microbiol- ogy to medical technology students for 8 years. Prior to his teaching career, Dr. Engelkirk served 22 years as an officer in the U.S. Army Medical Department, supervis- ing various immunology, clinical pathology, and microbi- ology laboratories in Germany, Vietnam, and the United States. He retired from the Army with the rank of Lieutenant Colonel. Dr. Engelkirk received his bachelor’s degree in biol- ogy from New York University and his master’s and doc- torate degree (both in microbiology and public health) from Michigan State University. He received additional medical technology and tropical medicine training at Walter Reed Army Hospital in Washington, D.C., and clinical chemistry and related subjects for 12 years. In specialized training in anaerobic bacteriology, myco- 1992, Dr. Duben-Engelkirk assumed the position of bacteriology, and virology at the Centers for Disease Director of Allied Health and Clinical Laboratory Control and Prevention in Atlanta, Georgia. Science Education at Scott and White Hospital in Dr. Engelkirk is the author or coauthor of four mi- Temple, Texas, wherein her responsibilities included crobiology textbooks, 10 additional book chapters, five teaching microbiology and clinical chemistry. She also medical laboratory-oriented self-study courses, and many served as Interim Program Director for the Medical scientific articles. He also served for 14 years as coeditor Laboratory Technician program at Temple College. In of four separate newsletters for clinical microbiology lab- 2006, Dr. Duben-Engelkirk assumed the position of oratory personnel. Dr. Engelkirk has been engaged in chair of the biotechnology department at the Texas various aspects of clinical microbiology for more than Bioscience Institute and Temple College, where she was 45 years and is a past president of the Rocky Mountain responsible for curriculum development and administra- Branch of the American Society for Microbiology. He tion of the biotechnology degree programs. She is now and his wife, Janet, currently provide biomedical educa- semiretired and teaching online biotechnology courses tional services through their consulting business (Biomed for the Temple College Biotechnology Department. She Ed), located in Belton, Texas. Dr. Engelkirk’s hobbies in- and her husband, Paul, are also co-owners of a biomed- clude RVing, hiking, kayaking, nature photography, writ- ical education consulting business. ing, and working in his yard. Dr. Duben-Engelkirk was coeditor of a widely used clinical chemistry textbook and coauthored a clinical Janet Duben-Engelkirk, EdD, MT(ASCP),has over 30 years anaerobic bacteriology textbook with Paul. She has au- of experience in clinical laboratory science and higher ed- thored or coauthored numerous book chapters, journal ucation. She received her bachelor’s degrees in biology and articles, self-study courses, newsletters, and other educa- medical technology and her master’s degree in technical tional materials over the course of her career. education from the University of Akron, and her doctorate Dr. Duben-Engelkirk has received many awards dur- in allied health education and administration from a com- ing her career, including Outstanding Young Leader in bined program through the University of Houston and Allied Health, the American Society for Clinical Baylor College of Medicine in Houston, Texas. Laboratory Science’s Omicron Sigma Award for out- Dr. Duben-Engelkirk began her career in clinical standing service, and Teaching Excellence Awards. Her laboratory science education teaching students “on the professional interests include instructional technology, bench” in a community hospital in Akron, Ohio. She computer-based instruction, and distance education. then became Education Coordinator for the Clinical Outside of the office and classroom, Dr. Duben- Laboratory Science Program at the University of Texas Engelkirk enjoys taking cruises, reading, music, yoga, Health Science Center at Houston, where she taught movies, hiking, and camping. iv 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page v PREFACE Microbiology—the study of microbes—is a fascinating make it more useful and more appealing. Color illustra- subject that impacts our daily lives in numerous ways. tions appear throughout the book, rather than being Microbes live on us and in us. They are vital in many grouped together in one location. The book is divided industries. Microbes are essential for the cycling and into eight major sections, containing a total of 21 chap- recycling of elements such as carbon, oxygen, and nitro- ters. Each chapter contains a Chapter Outline, Learning gen, and provide most of the oxygen in our atmosphere. Objectives, Self-Assessment Exercises, and information They are used to clean up toxic wastes. Microbes are about the contents of the Student CD-ROM. Interesting used in genetic engineering and gene therapy. And, of historical information, in the form of “Historical Notes,” course, many microbes cause disease. In recent years, is spread throughout the book and is presented in appro- the public has been bombarded with news reports about priate chapters. microbe-associated medical problems such as swine flu, bird flu, severe acute respiratory syndrome (SARS), STUDENT-FRIENDLY FEATURES flesh-eating bacteria, mad cow disease, superbugs, black mould in buildings, West Nile virus, bioterrorism, an- The authors have made every attempt to create a stu- thrax, smallpox, food recalls as a result of Escherichia coli dent-friendly book. The book can be used by all types of and Salmonella contamination, and epidemics of students, including those with little or no science back- meningitis, hepatitis, influenza, tuberculosis, and diar- ground and mature students returning to school after an rheal diseases. absence of several years. It is written in a clear and con- cise manner. It contains more than 30 Study Aid boxes, WRITTEN FOR HEALTHCARE which summarize important information and explain dif- PROFESSIONALS ficult concepts and similar-sounding terms. New terms are highlighted and defined in the text, and are included Burton’s Microbiology for the Health Scienceshas been writ- in a Glossary at the back of the book. ten primarily for nurses and other healthcare profession- Answers to Self-Assessment Exercises contained in als. This book provides students of these professions with the book can be found in Appendix A. Appendix B con- vital microbiology information that will enable them to tains a summary of key points about the most important carry out their duties in an informed, safe, and efficient bacterial pathogens discussed in the book. In the past, manner. It is appropriate for use in any one-semester in- students have found this appendix to be especially help- troductory microbiology course, whether for students of ful. Appendix C contains useful formulas for conversion the healthcare professions or for science or biology ma- of one type of unit to another (e.g., Fahrenheit to Celsius jors. Unlike many of the other introductory microbiol- and vice versa). Because Greek letters are commonly used ogy texts on the market, all of the material in this book in microbiology, the Greek alphabet can be found in can be covered in a single semester. Appendix D. Chapters of special importance to students of the healthcare professions include those dealing with antibi- STUDENT CD-ROM otics and other antimicrobial agents, epidemiology and public health, healthcare-associated infections, infection The Student CD-ROM included with the book provides control, how microbes cause disease, how our bodies a vast amount of supplemental information. protect us from pathogens and infectious diseases, and Each section of the CD-ROM includes the primary the major viral, bacterial, fungal, and parasitic diseases objectives of the chapter, a list of new terms introduced ofhumans. in the chapter, a review of key points, and sections enti- tled “Insight,” “Increase Your Knowledge,” and “Critical NEW TO THE NINTH EDITION Thinking.” Case Studies are provided for the chapters on infectious diseases. The Student CD-ROM also contains The most obvious changes in the ninth edition are an in- answers to the Self-Assessment Exercises found in the creased number of color illustrations and the redistribu- book, and additional Self-Assessment Exercises with an- tion of information about infectious diseases. The eighth swers. Instructor information on “thePoint” includes edition’s lengthy and somewhat cumbersome chapter on suggested laboratory exercises, suggested audiovisual infectious diseases (Chapter 17) has been divided into aids, an image bank, a test generator, and answers to the five chapters (Chapters 17 through 21 in the ninth edi- various Case Studies and Self-Assessment Exercises in tion). The artwork has been expanded and updated to the book and on the Student CD-ROM. v 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page vi vi Preface TO OUR READERS thanks to our extremely efficient Managing Editor, Ms. Laura Horowitz, who was an absolute delight to As you will discover, the concise nature of this book makes work with; to Gregory Bond, MSN, for his thorough each sentence significant. Thus, you will be intellectually review of the previous edition; to the authors of other challenged to learn each new concept as it is presented. It Lippincott Williams & Wilkins textbooks, whose illus- is our hope that you will enjoy your study of microbiology trations appear throughout the book; to Dr. Patrick and be motivated to further explore this exciting field, es- Hidy, RN, and Christine Vernon, for providing many of pecially as it relates to your occupation. Many students the drawings; and to David B. Troy, Acquisitions Editor; who have used this textbook in their introductory micro- Allison Powell, Marketing Manager; and Meredith biology course have gone on to become infection control Brittain and John Larkin, Product Managers from nurses, epidemiologists, clinical laboratory scientists (med- Lippincott Williams & Wilkins. ical technologists), and microbiologists. Paul G. Engelkirk, PhD, MT(ASCP), SM(AAM) OUR THANKS Janet Duben-Engelkirk, EdD, MT(ASCP) We are deeply indebted to all of the people who helped with the editing and publication of this book. Special 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page vii USER’S GUIDE In today’s health careers, a thorough understanding of Something To Think About microbiology is more important than ever. Burton’s These boxes contain information that will stimu- Microbiology for the Health Sciences, Ninth Edition, not only late students to ponder interesting possibilities. provides the conceptual knowledge you will need but also Test Preparation Features teaches you how to apply it. This User’s Guide intro- duces you to the features and tools of this innovative text- These features help you review chapter content and test book. Each feature is specifically designed to enhance yourself before exams. your learning experience, preparing you for a successful Highlighted Key Points career as a health professional. Help you pinpoint the main ideas of the text. CHAPTER OPENER FEATURES Self-Assessment Exercises The features that open each chapter are an introduction Help you gauge your understanding of what you have to guide you through the remainder of the lesson. learned. Chapter Outline On the CD-ROM Box Serves as a “roadmap” to the material ahead. Directs you to additional content and exercises for Learning Objectives review on the companion CD-ROM. Highlight important concepts—helping you to organize and prioritize learning. BONUS CD-ROM Introduction Packaged with this textbook, the CD-ROM is a powerful Familiarizes you with the material covered in the chapter. learning tool. It includes the following features that help reinforce and review the material covered in the book: CHAPTER FEATURES Chapter Learning Tools The following features appear throughout the body of • Primary Objectives of Each Chapter the chapter. They are designed to hone critical thinking • Lists of New Terms Introduced in Each Chapter skills and judgment, build clinical proficiency, and pro- • Review of Key Points mote comprehension and retention of the material. • Answers to Text-Based Exercises • Additional Self-Assessment Exercises with Answers Also included are special “Insight,” “Increase Your Historical Note Boxes Knowledge,” “Critical Thinking,” and “Case Study” sec- Provide insight into the history and development tions that provide additional information and exercises as of microbiology and healthcare. well as fun facts on selected topics from the text. Additional Appendices Spotlighting Boxes A new feature spotlighting healthcare careers. 1. Microbial Intoxications 2. Phyla and Medically Significant Genera within the Domain Bacteria Study Aid Boxes 3. Basic Chemistry Concepts Summarize key information, explain difficult con- 4. Responsibilities of the Clinical Microbiology cepts, and differentiate similar-sounding terms. Laboratory 5. Clinical Microbiology Laboratory Procedures 6. Preparing Solutions and Dilutions Clinical Procedure Boxes Set forth step-by-step instructions for common procedures. vii 00i-00x_18283_FM-IE.qxd 10/13/09 7:28 PM Page viii CONTENTS Preface v SECTION III Chemical and Genetic Aspects of SECTION I Microorganisms Introduction to Microbiology Chapter 6 Biochemistry: The Chemistry of Life . . . . . . . . 84 Chapter 1 Microbiology—The Science . . . . . . . . . . . . . . . 1 Introduction 84 Organic Chemistry 85 Introduction 1 Biochemistry 86 What is Microbiology? 1 Why Study Microbiology? 2 Chapter 7 First Microorganisms on Earth 6 Microbial Physiology and Genetics . . . . . . . . 102 Earliest Known Infectious Diseases 6 Microbial Physiology 102 Pioneers in the Science of Microbiology 6 Metabolic Enzymes 104 Careers in Microbiology 11 Metabolism 106 Chapter 2 Bacterial Genetics 111 Viewing the Microbial World . . . . . . . . . . . . . 13 Genetic Engineering 118 Gene Therapy 118 Introduction 13 Using the Metric System to Express the Sizes of Microbes 13 SECTION IV Microscopes 14 Controlling the Growth of Microbes Chapter 8 SECTION II Controlling Microbial Growth In Vitro . . . . . . 121 Introduction to Microbes and Cellular Biology Introduction 122 Factors that Affect Microbial Growth 122 Chapter 3 Encouraging the Growth of Microbes In Vitro 124 Cell Structure and Taxonomy . . . . . . . . . . . . . 24 Inhibiting the Growth of Microbes In Vitro 131 Introduction 24 Chapter 9 Eucaryotic Cell Structure 25 Controlling Microbial Growth In Vivo Using Procaryotic Cell Structure 28 Summary of Structural Differences Between Procaryotic and Antimicrobial Agents . . . . . . . . . . . . . . . . . 140 Eucaryotic Cells 34 Introduction 140 Reproduction of Organisms and Their Cells 35 Characteristics of an Ideal Antimicrobial Agent 142 Taxonomy 35 How Antimicrobial Agents Work 142 Determining Relatedness Among Organisms 38 Antibacterial Agents 142 Antifungal Agents 148 Chapter 4 Antiprotozoal Agents 148 Microbial Diversity . . . . . . . . . . . . . . . . . . . . 40 Antiviral Agents 148 Part 1 Acellular and Procaryotic Microbes 40 Drug Resistance 149 Introduction 40 Some Stategies in the War Against Drug Resistance 154 Acellular Microbes 41 Empiric Therapy 154 The Domain Bacteria 52 Undesirable Effects of Antimicrobial Agents 156 The Domain Archaea 66 Concluding Remarks 156 Chapter 5 SECTION V Microbial Diversity . . . . . . . . . . . . . . . . . . . . 69 Environmental and Applied Microbiology Part 2 Eucaryotic Microbes 69 Introduction 69 Chapter 10 Algae 69 Microbial Ecology and Microbial Protozoa 72 Biotechnology . . . . . . . . . . . . . . . . . . . . . . 158 Fungi 74 Lichens 82 Introduction 158 Slime Moulds 82 Symbiotic Relationships Involving Microorganisms 159 viii