BASIC MEDICAL MICROBIOLOGY

SECTION I Introduction
Overview of Medical Microbiology

Microbiology can certainly be overwhelming for the student confronted with the daunting task of
learning about hundreds of medically important microbes. I remember well the irst day in my
introductory graduate course in medical microbiology; the course instructor handed each student a
1000-page syllabus consisting of lecture outlines, notes, and literature references. hat became known
not so lovingly as the book of pain. However, microbiology is not so challenging if the subject matter—
the microbes—are subdivided into groups and further subdivided into related units. Let me illustrate
this in this introductory chapter. Microbes are subdivided into one of four groups:
• Viruses
• Bacteria
• Fungi
• Parasites
he structural complexity of these groups increases
from viruses (the most simple structure) to parasites
(the most complex). Here is generally no confusion
about which group a microbe should be placed in,
although a few fungi were formerly classified with
the parasites. Each group of microbes is then further
subdivided, generally based on a key feature of the
group.

VIRUSES AND BACTERIA

Viruses
Viruses are very simple microbes, consisting of nucleic acid, a few proteins, and (in some) a lipid
envelope. These microbes are completely dependent on the cells they infect for their survival and
replication. Medically important viruses are subdivided into 20 families defined by the structural
properties of the members. The most important feature is the nucleic acid. Viruses contain either DNA
or RNA but not both the families of DNA viruses and RNA viruses are further subdivided into viruses with
either single-stranded or double-stranded nucleic acids. Lastly, these viral families are further
subdivided into viruses with an outer envelope, or naked non enveloped viruses. Now the perceptive
student would say that this gives us 8 families of viruses and not 20. Well, the viruses are further
subdivided by their shape (spherical or rodlike) and size (big or small [“pico”]). Thus the key to
understanding viruses is to place them into their respective families based on their structural features.

Bacteria
Bacteria are a bit more complex, with both RNA and DNA, metabolic machinery for self-replication, and
a complex cell wall structure. Bacteria are prokaryotic organisms; that is, simple unicellular organisms
with no nuclear membrane, mitochondria, Golgi bodies, or endoplasmic reticulum and they reproduce
by asexual division. The key feature that is used to separate most bacteria is their staining property, with
the Gram stain and acid-fast stain the most important. Most bacteria are either gram-positive (retain the
blue dye) or gram-negative (lose the blue stain and stain with the red dye). These bacteria are then
subdivided by their shape (either spherical [cocci] or rod-shaped), whether they grow aerobically or
anaerobically (many bacteria grow in both atmospheres and are called facultative anaerobes), and
whether they form resilient spores or not (only gram-positive rods are spore-formers). The other
important bacterial stain is the acid-fast stain that is retained only by a few bacteria that have a
characteristic lipid-rich cell wall. This group is further subdivided by how difficult it is to remove the acid-
fast stain (the stain is named because an acid solution removes the stain from most other bacteria).
Finally, there are groups of organisms that do not stain with these procedures so they are separated by
other features, such as shape (spiral-shaped bacteria) or their need to grow inside a host cell (e.g.,
leukocyte) or cell cultures in the laboratory. 

FUNGI AND PARASITES

Fungi and parasites are more complex eukaryotic organisms that contain a well-defined nucleus,
mitochondria, Golgi bodies, and endoplasmic reticulum. Single-celled and multi-celled organisms are
members of both groups. As can be seen, the line separating these two groups is not as well defined as
that separating these organisms from the bacteria or viruses, but the classification is still well recognized

Fungi
Fungi are subdivided into single-celled organisms (yeasts) or multi-celled organisms (molds), with a few
medically important members existing in both forms (dimorphic fungi). Molds are complex organisms
with the cells organized into threadlike tubular structures (hyphae) and specialized asexual reproductive
forms (conidia). The molds are then further subdivided by the structure of the hyphae (pigmented or
non-pigmented, separated into individual cells [separated molds] or not) and the arrangement of the
conidia

Parasites
Parasites are also subdivided into single-celled organisms (protozoa) or multi-celled organisms (worms
and bugs). Members of the family Protozoa are then further divided into amebae, flagellates (think of
them as hairy protozoa), and coccidia (some are spherical - shaped but many are not). he worms
(technically called helminthes) are nicely classified by their shape: roundworms, flatworms, and
tapeworms. Pretty simple, although many have very complex lifecycles that unfortunately are important
for understanding how they cause disease. he bugs are simply “bugs.” These include mosquitos, ticks,
leas, lice, mites, and lies. hey are important because they are vectors of a number of viruses and
bacteria (not fungi) that are responsible for diseases. Other bugs obviously exist (such as spiders), but
these generally are not vectors for other pathogenic microbes.