Koneman's Color Atlas and Textbook of Diagnostic Microbiology

by Winn, Washington C.; Allen, Stephen D.; Janda, William M.; Koneman, Elmer W.; Schreckenberger, Paul C.; Procop, Gary W.; Woods, Gail L.

• ISBN13: 9780781730143
• ISBN10: 0781730147
• Edition: 6th
• Format: Hardcover
• Copyright: 2005-11-10
• Publisher: LWW

Summary

Long considered the definitive work in its field, this new edition presents all the principles and practices readers need for a solid grounding in all aspects of clinical microbiology--bacteriology, mycology, parasitology, and virology. Tests are presented according to the Clinical and Laboratory Standards Institute (formerly NCCLS) format. This extensively revised edition includes practical guidelines for cost-effective, clinically relevant evaluation of clinical specimens including extent of workup and abbreviated identification schemes. New chapters cover the increasingly important areas of immunologic and molecular diagnosis. Clinical correlations link microorganisms to specific disease states. Over 600 color plates depict salient identification features of organisms.

Table of Contents

Introduction to Microbiology
Part I: The Role of the Microbiology Laboratory in the Diagnosis of Infectious Diseases: Guidelines to Practice and Management
Introduction	2	(1)
Outline of the Book	2	(1)
The World of Infectious Disease	2	(1)
The Triad of Infectious Disease	2	(7)
The Infectious Agent	3	(1)
Classes of Infectious Agents	3	(1)
Interactions Between Hosts and Infectious Agents	4	(1)
Purpose of Infectious Agents in Nature	4	(1)
Virulence	4	(1)
The Environment	5	(1)
The Infected Host	5	(1)
Innate Humoral (Noncellular) Defenses	6	(1)
Innate Cellular Defenses	7	(1)
Types of Inflammation	7	(1)
Adaptive Immunologic Cellular Defenses	7	(1)
Adaptive Immunologic Noncellular (Humoral) Defenses	8	(1)
Clinical Signs and Symptoms of Infection	8	(1)
Indirect Effects of Infectious Agents on Humans	9	(1)
Phases of the Diagnostic Cycle	9	(36)
Preanalytic Phase	10	(1)
Specimen Collection	10	(4)
Specimen Transport	14	(1)
Specimen Receipt and Preliminary Observations	14	(1)
Criteria for Rejection of Specimens	14	(1)
Cost-Effective Approaches in the Preanalytic Phase	15	(1)
Analytic Phase	15	(1)
Microscopic Examination	15	(12)
Processing Specimens	27	(6)
Interpretation of Cultures	33	(5)
Procedures for Preliminary Identification of Bacterial Isolates	38	(1)
Identification of Organisms Other Than Bacteria	39	(1)
Testing of Susceptibility to Antimicrobial Agents	39	(1)
Cost-Effective Approaches in the Analytic Phase	39	(4)
Postanalytic Phase	43	(1)
Reporting Results	43	(1)
Interactions With Epidemiologists	44	(1)
Analysis of Results	44	(1)
Maintenance of Samples and Records	44	(1)
Administrative Aspects of the Microbiology Laboratory	45	(23)
Government Regulations	45	(2)
Risk Management	47	(1)
Laboratory Safety	47	(1)
General Safety Rules and Regulations	47	(1)
Routine Safety Precautions	48	(2)
Biologic Agents	50	(1)
Universal Precautions	51	(4)
Shipping of Specimens and Etiologic Agents	55	(1)
Nonbiologic Hazards	56	(2)
Bioterrorism	58	(1)
Quality Assurance	58	(1)
Quality Control	59	(1)
Components of a Quality Control Program	60	(1)
Monitoring Laboratory Equipment	60	(1)
Monitoring Culture Media, Reagents, and Supplies	61	(7)
Introduction to Microbiology
Part II: Guidelines for the Collection, Transport, Processing, Analysis, and Reporting of Cultures from Specific Specimen Sources
Infections of the Respiratory Tract	68	(11)
Infections of the Upper Respiratory Tract	71	(1)
Indigenous Flora	71	(1)
Pharyngitis	72	(1)
Infections of the Oral Cavity Other Than Pharyngitis	73	(1)
Infections of the Nasopharynx and Nasopharyngeal Cultures	74	(1)
Otitis Media and Sinusitis	74	(1)
Epiglottitis	74	(1)
Laryngitis	74	(1)
Other Infections of the Upper Respiratory Tract	74	(1)
Infections of the Lower Respiratory Tract	75	(1)
Tracheobronchitis	75	(1)
Bronchiolitis	75	(1)
Pneumonia	75	(1)
Chronic Pneumonia	76	(1)
Empyema	76	(1)
Pneumonia in Special Populations	76	(1)
Collection of Specimens for the Diagnosis of Lower Respiratory Infection	76	(2)
Laboratory Diagnosis of Pneumonia	78	(1)
Infections of the Gastrointestinal Tract	79	(3)
Lower Intestinal Infections	79	(1)
Clinical Symptoms	79	(2)
Collection of Fecal Specimens	81	(1)
Epidemiologic Considerations in the Evaluation of Patients With Gastroenteritis	81	(1)
Upper Intestinal Infections	81	(1)
Clinical Symptoms	81	(1)
Obtaining Specimens From the Upper Gastrointestinal Tract	82	(1)
Urinary Tract Infections	82	(5)
Clinical Signs and Symptoms	82	(1)
Host Factors	83	(1)
Collection of Urine Samples for Culture	83	(1)
Midstream Urine Specimens	83	(1)
Other Voided Urine Specimens	84	(1)
Catheter Collections	85	(1)
Suprapubic Aspiration	85	(1)
Culture of Urine Specimens	85	(1)
Screening Tests for Urinary Tract Infection	86	(1)
Screening Tests for Bacteriuria	86	(1)
Screening Tests for Pyuria	86	(1)
Infections of the Genital Tract	87	(4)
Sexually Transmitted Infections	87	(1)
Urethritis and Cervicitis	87	(1)
Genital Ulcer Disease	88	(1)
Genital Infections Transmitted by Nonsexual Means	88	(1)
Vaginitis and Vaginosis	88	(1)
Infections of the Upper Female Genital Tract	89	(1)
Systemic Complications of Genital Infections	89	(1)
Diagnosis of Genital Tract Infections	89	(1)
Diagnosis of Urethritis, Cervicitis, and Vaginitis	89	(1)
Diagnosis of Genital Ulcer Disease and Venereal Warts	90	(1)
Collection of Genital Specimens	90	(1)
Infections of the Bones and Joints	91	(1)
Clinical Presentation	91	(1)
Diagnosis of Infections of the Bones and Joints	91	(1)
Infections of the Central Nervous System	92	(3)
Meningitis	92	(1)
Encephalitis and Brain Abscess	93	(1)
Diagnosis of Central Nervous System Infections	93	(1)
Collection of Specimens	93	(1)
Assessing the Inflammatory Response and Microscopic Techniques	93	(1)
Direct Detection of Antigen and Nucleic Acid	94	(1)
Serologic Diagnosis	95	(1)
Diagnosis by Culture	95	(1)
Wounds, Abscesses, and Cellulitis	95	(1)
Clinical Presentation	95	(1)
Diagnosis of Wound Infections, Abscesses, and Cellulitis	95	(1)
Collection of Specimens	95	(1)
Microscopic Examination of Specimens	96	(1)
Culture	96	(1)
Eye Infections	96	(1)
Clinical Presentation	96	(1)
Conjunctivitis	96	(1)
Keratitis	97	(1)
Uveitis and Endophthalmitis	97	(1)
Diagnosis of Eye Infections	97	(1)
Collection of Specimens	97	(1)
Microscopic Examination	97	(1)
Culture	97	(1)
Infections of the Blood	97	(15)
Clinical Presentation and Pathogenesis	97	(1)
Bacteremia and Septicemia	97	(1)
Types of Bacteremia	97	(1)
Intravascular Infection	98	(2)
Catheter-Associated Bacteremia and Sepsis	100	(1)
Collection of Blood Cultures	100	(1)
Contamination With Skin Flora	100	(1)
Number and Timing of Cultures	101	(1)
Culture Media	101	(1)
Systems for Processing Blood Cultures	102	(1)
Manual Blood Culture Systems	102	(1)
Lysis-Centrifugation Blood Culture System	103	(1)
Automated and Computerized Blood Culture Systems	103	(1)
Comparative Studies	104	(1)
Special Considerations	105	(1)
Fastidious Organisms and Endocarditis	105	(1)
Catheter-Associated Bacteremia and Sepsis	105	(1)
Tissues and Biopsies	105	(7)
Laboratory Diagnosis by Immunologic Methods
Antigens and Antibodies: Basic Definitions	112	(1)
Monoclonal Antibodies	113	(1)
Types of Antigen-Antibody Reactions Used in Diagnostic Serology	114	(5)
Precipitin Reactions	114	(2)
Complement Fixation and Hemagglutination Inhibition	116	(1)
Agglutination Reactions	116	(3)
Solid-Phase Immunoassay Methods	119	(6)
Enzyme Immunoassays for Antibody Detection	119	(3)
Enzyme Immunoassay Antibody Capture Methods for IgM Detection	122	(1)
Enzyme Immunoassays for Antigen Detection	122	(3)
Immunofluorescence Techniques	125	(8)
Immunofluorescence Techniques for Antigen Detection	125	(1)
Immunofluorescence Techniques for Antibody Detection	125	(8)
Molecular Microbiology
Nucleic Acids---The Basics of DNA and RNA	133	(4)
Structure of DNA	133	(1)
Structure of RNA	134	(1)
Function of DNA---Information Storage	135	(1)
Function of RNA---Information Transfer	135	(1)
Reading (Transcription) and Interpretation (Translation) of the Genetic Code	135	(2)
Signal-Amplification Methods	137	(4)
Nucleic-Acid Probes	137	(1)
Clinical Applications	137	(1)
Hybrid Capture	137	(1)
Clinical Applications	138	(1)
Branched DNA	139	(1)
Clinical Applications	139	(1)
In Situ Hybridization	139	(1)
Clinical Applications	140	(1)
Nucleic-Acid Amplification	141	(6)
Basics of the Polymerase Chain Reaction	141	(2)
Clinical Applications	143	(1)
Other Methods of Nucleic-Acid Amplification	143	(1)
Clinical Applications	144	(1)
Modifications of PCR	144	(1)
RT-PCR	144	(1)
Clinical Applications	145	(1)
Broad-Range PCR	145	(1)
Clinical Applications	145	(1)
Multiplex PCR	146	(1)
Clinical Applications	146	(1)
Nested PCR	146	(1)
Clinical Applications	146	(1)
Postamplification Analysis	147	(4)
Traditional Methods of Detection	147	(1)
Gel Electrophoresis/Southern Blot Analysis	147	(1)
Enzymatic Detection of Amplified Products	147	(1)
Clinical Applications	148	(1)
Reverse Hybridization	148	(1)
Clinical Applications	148	(1)
DNA Sequencing	148	(1)
Traditional DNA Sequencing	149	(1)
Clinical Applications	149	(1)
Sequencing by Synthesis (Pyrosequencing)	149	(1)
Clinical Applications	150	(1)
Microarray Analysis	150	(1)
Clinical Applications	151	(1)
Real-Time Nucleic-Acid Amplification	151	(5)
Methods of Detecting the Products of Real-Time Amplification	151	(1)
SYBR Green	151	(1)
Hybridization Probes	151	(3)
Clinical Applications	154	(2)
Strain Typing	156	(2)
Non-Amplification-Based Typing	156	(1)
Pulsed-Field Gel Electrophoresis	156	(1)
Amplification-Based Typing	157	(1)
PCR-RFLP	157	(1)
Rep-PCR	158	(1)
Clinical Applications of Microbial Typing	158	(1)
Conclusion	158	(9)
Medical Bacteriology: Taxonomy, Morphology, Physiology, and Virulence
Taxonomy: Classification, Nomenclature, and Identification of Bacteria	167	(10)
The Naming of Bacteria	167	(1)
Phenotypic Identification of Bacteria	168	(1)
Phylogenetic Criteria for Classification of Bacteria	168	(9)
Basic Bacterial Anatomy and Physiology	177	(23)
Bacterial Size and Shape	177	(1)
Nuclear Structure, DNA Replication, Transcription, and Translation	178	(3)
Cytoplasm	181	(1)
Cytoplasmic Membrane	182	(1)
Bacterial Cell Wall Structure	182	(2)
Gram-Positive Bacterial Cell Walls	184	(1)
Gram-Negative Bacterial Cell Walls	185	(3)
``Acid-Fast'' Bacterial Cell Walls	188	(1)
Bacterial Endospores	189	(1)
Bacterial Surface Structures	190	(1)
Capsules	190	(1)
Flagella	190	(1)
Fimbriae (Pili)	191	(1)
Genetic Exchange and Recombination in Bacteria	192	(3)
Requirements for Bacterial Growth and Metabolism	195	(1)
Carbon	195	(1)
Carbon Dioxide	195	(1)
Oxygen	195	(1)
Nitrogen	195	(1)
Growth Factors	196	(1)
Kinetics of Bacterial Cell Growth	196	(1)
General Bacterial Metabolism and Energy Generation	196	(1)
Fermentation	196	(2)
Utilization of Pyruvate	198	(2)
Bacterial Virulence Factors and Pathogenicity	200	(13)
Definitions and Concepts	200	(3)
Requirements for Pathogenicity	203	(1)
Virulence Factors of Microorganisms	204	(1)
Adhesins	204	(1)
Aggressins	204	(1)
Exotoxins and Endotoxins	205	(2)
Bacterial Superantigens	207	(6)
The Enterobacteriaceae
Characteristics for Presumptive Identification	213	(3)
Screening Characteristics	213	(1)
Carbohydrate Utilization	213	(2)
Cytochrome Oxidase Activity	215	(1)
Nitrate Reduction	216	(1)
Culture Media Used for Detection of Carbohydrate Fermentation	216	(2)
Use of Kligler Iron Agar and Triple Sugar Iron Agar	216	(1)
Biochemical Principles	217	(1)
Selection of Primary Isolation Media	218	(5)
Chemicals and Compounds Used in Selective Media	219	(2)
Selective Isolation Media	221	(1)
Highly Selective Isolation Media Used Primarily for Gastrointestinal Specimens	222	(1)
Enrichment Media	222	(1)
Guidelines for Choosing Selective Isolation Media	222	(1)
Differential Identification Characteristics	223	(5)
Indole Production	224	(1)
Methyl Red Test	224	(1)
Voges-Proskauer Test	225	(1)
Citrate Utilization	225	(1)
Urease Production	225	(1)
Decarboxylation of Lysine, Ornithine, and Arginine	225	(1)
Phenylalanine Deaminase Production	226	(1)
Hydrogen Sulfide Production	226	(1)
Motility	227	(1)
Taxonomy of the Enterobacteriaceae	228	(54)
Classification of Enterobacteriaceae by Tribes	228	(1)
Key Identification Characteristics for the Most Common Species	228	(7)
Tribe Escherichieae	235	(15)
Tribe Edwardsielleae	250	(1)
Tribe Salmonelleae	251	(7)
Tribe Citrobactereae	258	(1)
Tribe Klebsielleae	259	(8)
Tribe Proteeae	267	(2)
Tribe Yersinieae	269	(5)
Tribe Erwinieae	274	(1)
Miscellaneous New Genera of Enterobacteriaceae	274	(3)
Identification Characteristics of Newer Enterobacteriaceae	277	(1)
Clinical Significance of Newer Enterobacteriaceae	277	(5)
Quick Screening Methods for Rapid Identification	282	(2)
Commercial Screening Kits	282	(1)
Chromogenic Agar Media	283	(1)
Classic Identification Systems	284	(1)
Checkerboard Matrix	284	(1)
Branching Flow Diagrams	284	(1)
Computer-Aided Schemes	285	(1)
Numeric Coding Systems	285	(2)
Reading Octal Codes in Numeric Code Registers	286	(1)
Estimated Frequency of Occurrence	287	(1)
Calculation of Likelihood	287	(1)
Resolving Discrepancies	287	(1)
Packaged Kit Identification Systems	287	(5)
Overview of Packaged Systems	287	(2)
Specific Identification Systems	289	(1)
API 20E	289	(1)
BBL Crystal Enteric/Nonfermenter ID System	289	(1)
RapID onE System	289	(1)
Enterotube II	290	(1)
Micro-ID	291	(1)
Biology GN2 Microplate	291	(1)
MicroScan System	291	(1)
Sensititre System	291	(1)
Semiautomated and Automated Identification Systems	292	(17)
MicroScan Walkaway	292	(1)
Vitek System	292	(1)
Sensititre Gram-Negative Autoldentification System	293	(1)
The Phoenix System	293	(1)
The OmniLog ID System	293	(16)
The Nonfermentative Gram-Negative Bacilli
Part I: Metabolism of the Nonfermenters
Fermentative and Oxidative Metabolism	309	(3)
The Embden-Meyerhof-Parnas Pathway	309	(2)
The Entner-Doudoroff Pathway	311	(1)
The Warburg-Dickens Hexose Monophosphate Pathway	312	(1)
Initial Clues That an Unknown Isolate is a Nonfermenter	312	(1)
Lack of Evidence for Glucose Fermentation	312	(1)
Positive Cytochrome Oxidase Reaction	312	(1)
Failure to Grow on MacConkey Agar	313	(1)
Tests Used in the Identification of Nonfermenters	313	(3)
Utilization of Glucose	313	(1)
Motility	313	(1)
Pigment Production	314	(1)
Hydrolysis of Urea	314	(1)
Nitrate Reduction	315	(1)
Denitrification of Nitrates and Nitrites	315	(1)
Indole Production	315	(1)
Decarboxylation	315	(1)
Esculin Hydrolysis	315	(1)
Flagella Stains	315	(1)
Leifson Method	315	(1)
Ryu Method	316	(1)
Wet-Mount Technique	316	(1)
Flagellar Morphology	316	(1)
Part II: Taxonomy, Biochemical Characteristics, and Clinical Significance of Medically Important Genera of Nonfermenters
Organisms That Are Motile With Polar Flagella	316	(24)
Pseudomonads	316	(1)
Family Pseudomonadaceae	317	(1)
Genus Pseudomonas---rRNA Group I	317	(6)
Family Burkholderiaceae	323	(1)
rRNA Group II	323	(1)
Genus Burkholderia---Pseudomallei Group	323	(5)
Genus Ralstonia and Genus Cupriavidus	328	(1)
Genus Pandoraea	329	(2)
Genus Inquilinus	331	(1)
Genua Lautropia	331	(1)
Family Comamonadaceae	331	(1)
rRNA Group III	331	(1)
Acidovorans Group	331	(1)
Facilis-Delafieldii Group	332	(1)
Family Caulobacteraceae	332	(1)
rRNA Group IV	332	(1)
Brevundimonas-Diminuta Group	332	(1)
Family Xanthomonadaceae	332	(1)
rRNA Group V	332	(1)
Genus Stenotrophomonas	332	(2)
Family Sphingomonadaceae	334	(1)
Genus Sphingomonas	334	(1)
Family Oceanospirillaceae	334	(1)
Genus Balneatrix	334	(1)
Family Oxalobacteraceae	334	(1)
Genus Massilia	334	(1)
Genus Herbaspirillum	334	(2)
Family Alteromonadaceae	336	(1)
Genus Shewanella---Hydrogen Sulfide-Producing Group	336	(1)
Genus Alishewanella---Halophilic Group	337	(1)
Family Halomonadaceae	337	(1)
Genus Halomonas	337	(1)
Family Methylobacteriaceae	337	(1)
Genus Methylobacterium	337	(1)
Genus Roseomonas	338	(1)
Unnamed Species	339	(1)
Laribacter hongkongensis	339	(1)
Organisms That Are Motile With Peritrichous Flagella	340	(5)
Family Alcaligenaceae	340	(1)
Genus Alcaligenes	340	(1)
Genus Achromobacter	340	(3)
Genus Bordetella	343	(1)
Genus Kerstersia	344	(1)
Genus Oligella	344	(1)
Family Rhizobiaceae	344	(1)
Genus Rhizobium (Formerly Agrobacterium)	344	(1)
Family Brucellaceae	345	(1)
Genus Ochrobactrum	345	(1)
Organisms That Are Nonmotile and Oxidase-Positive	345	(8)
Family Flavobacteriaceae	345	(1)
Chryseobacterium, Empedobacter, and Unnamed CDC Groups	346	(2)
Weeksella and Bergeyella	348	(1)
Genus Myroides	348	(1)
Family Sphingobacteriaceae	348	(1)
Sphingobacterium and Pedobacter	348	(1)
Family Moraxellaceae	349	(1)
Genus Moraxella	349	(1)
Genus Psychrobacter and CDC EO Groups	350	(3)
Family Neisseriaceae	353	(1)
Genus Neisseria	353	(1)
Gilardi Rod Group 1	353	(1)
Organisms That Are Nonmotile and Oxidase-Negative	353	(2)
Genus Acinetobacter	353	(2)
CDC Group NO-1	355	(1)
Bordetella holmesii (CDC Group NO-2)	355	(1)
CDC Group EO-5	355	(1)
Part III: Approach to Recovery and Identification of Nonfermenters
Levels of Service in Identification of Nonfermenters	355	(1)
Guidelines for Recovery of Nonfermenters	356	(1)
Identification of Most Common Species	356	(1)
Pseudomonas aeruginosa	356	(1)
Acinetobacter baumannii	357	(1)
Stenotrophomonas maltophilia	357	(1)
Methods for Identification Using Conventional Tests	357	(2)
Weyant (CDC), Gilardi, and Pickett Identification Schemes	358	(1)
Practical Approach to Identification of Nonfermenters	358	(1)
Computer-Aided Schemes	359	(1)
Commercial Kit Systems	359	(14)
The Oxi/Ferm Tube	359	(3)
The API 20E System	362	(1)
The API 20NE System	362	(1)
The Remel N/F System	362	(5)
The Crystal Enteric/Nonfermenter System	367	(1)
The RapID NF Plus System	367	(6)
The Biolog System	373	(1)
Automated Identification Systems	373	(2)
The Vitek Legacy System	373	(1)
The Vitek 2 System	374	(1)
The Microscan Walkaway-96, Walkaway-40, and Autoscan-4 Systems	375	(1)
The Sensititre AP80 System	375	(1)
The Phoenix System	375	(1)
Selection of a System	375	(18)
Curved Gram-Negative Bacilli and Oxidase-Positive Fermenters: Campylobacteraceae and Vibrionaceae
Part I: Curved Rods: Campylobacter, Wolinella, Arcobacter Helicobacter, and Related Bacteria
Historical Background	393	(1)
Classification of Campylobacter and Related Taxa	393	(13)
Campylobacter Species	395	(1)
Campylobacter jejuni Subsp. jejuni	395	(3)
Other Campylobacter Species	398	(4)
Former Wolinella and Bacteroides Species Included in the Family Campylobacteraceae	402	(1)
Genus Arcobacter	403	(1)
Genus Helicobacter	403	(1)
H. pylori	404	(1)
Other Medically Important Helicobacter Species	404	(1)
Nonhuman Helicobacter Species	405	(1)
Other Microaerophilic Gram-Negative Bacilli	405	(1)
Definitive Identification of Campylobacters and Related Bacteria	406	(2)
Rapid Identification of Campylobacters From Colonies and From Stool Specimens	406	(1)
Nonculture Tests	406	(1)
Direct Detection Methods	407	(1)
Culture and Isolation of Helicobacter pylori	407	(1)
Specimens for Recovery of H. pylori	407	(1)
Isolation Procedure	407	(1)
Identification of H. pylori	407	(1)
Biopsy Urease Test (CLO Test)	408	(1)
Noninvasive Tests To Diagnose H. pylori Infection	408	(1)
Accuracy of Invasive and Noninvasive Tests To Diagnose H. pylori Infection	408	(1)
Enterohepatic Helicobacters	408	(1)
Part II: The Families Vibrionaceae and Aeromonadaceae
Phylogeny of the Vibrionaceae	408	(9)
Genus Vibrio	408	(1)
Taxonomy	409	(1)
Description and Associated Clinical Syndromes of Vibrio Species of Human Importance	409	(5)
Methods for Laboratory Isolation of Vibrios	414	(2)
Biochemical Characterization and Laboratory Identification of Vibrio Species	416	(1)
Genera Listonella, Photobacterium and Shewanella	417	(1)
Aeromonas and Plesiomonas	417	(5)
Genus Aeromonas	417	(2)
Taxonomy	419	(1)
Clinical Significance	419	(1)
Aeromonas Species in Medicinal Leeches	420	(1)
Laboratory Recovery of Aeromonas Species From Clinical Specimens	420	(1)
Laboratory Identification of Aeromonas Species	420	(2)
Genus Plesiomonas	422	(1)
Laboratory Isolation and Identification	422	(1)
Genus Chromobacterium	422	(9)
Miscellaneous Fastidious Gram-Negative Bacilli
Haemophilus Species	431	(21)
Taxonomy of Haemophilus and Related Organisms	431	(2)
Haemophilus influenzae	433	(1)
Haemophilus influenzae Type B Vaccines	433	(2)
Infections Caused by Haemophilus Species	435	(1)
Meningitis	435	(4)
Epiglottitis	439	(1)
Otitis Media	439	(1)
Sinusitis	440	(1)
Bronchitis and Chronic Obstructive Pulmonary Disease	440	(1)
Pneumonia	440	(1)
Bacteremia and Infectious Complications of Bacteremia	441	(1)
Endocarditis	441	(1)
Urogenital, Maternal, and Perinatal Infections	441	(1)
Ocular Infections	442	(1)
Brazilian Purpuric Fever	442	(1)
Miscellaneous Haemophilus influenzae Infections	443	(1)
Haemophilus parainfluenzae	443	(1)
Haemophilus aphrophilus and Haemophilus paraphrophilus	444	(1)
Other Haemophilus Species	444	(1)
Haemophilus ducreyi	444	(1)
Laboratory Diagnosis of Haemophilus Infections	444	(1)
Direct Examination of Clinical Specimens	444	(1)
Culture of Haemophilus Species	445	(1)
Identification of Haemophilus Species	446	(3)
Laboratory Diagnosis of Haemophilus ducreyi Infection	449	(2)
Antimicrobial Susceptibility of Haemophilus Species	451	(1)
Actinobacillus Species	452	(6)
Actinobacillus actinomycetemcomitans	452	(1)
Clinical Significance	452	(1)
Cultural Characteristics and Identification	453	(2)
Antimicrobial Susceptibility	455	(1)
Actinobacillus ureae	455	(3)
Actinobacillus hominis	458	(1)
Animal Species in the Genus Actinobacillus	458	(1)
Pasteurella and Mannheimia Species	458	(9)
Taxonomy and Characteristics of the Genus Pasteurella	458	(1)
Pasteurella multocida	459	(1)
Clinical Significance and Virulence	459	(3)
Cultural Characteristics and Identification	462	(2)
Antimicrobial Susceptibility	464	(1)
Other Pasteurella Species Isolated From Human Infections	465	(1)
Pasteurella pneumotropica (``Actinobacillus pneumotropica'')	465	(1)
Pasteurella aerogenes (``Actinobacillus aerogenes'')	465	(1)
Pasteurella dagmatis	465	(1)
Pasteurella canis and Pasteurella stomatis	466	(1)
Pasteurella bettyae	466	(1)
Pasteurella caballi	466	(1)
Pasteurella gallinarum	466	(1)
Mannheimia Species (Formerly the ``Pasteurella haemolytical Pasteurella granulomatis'' Complex)	467	(1)
Cardiobacterium Hominis	467	(3)
Taxonomy	467	(1)
Clinical Significance	468	(1)
Cultural Characteristics and Identification	468	(1)
Antimicrobial Susceptibility	468	(2)
Elkenella Corrodens	470	(2)
Taxonomy and Virulence	470	(1)
Clinical Significance	470	(1)
Cultural Characteristics and Identification	471	(1)
Antimicrobial Susceptibility	471	(1)
Kingella and Suttonella Species	472	(2)
Taxonomy	472	(1)
Clinical Significance	472	(1)
Cultural Characteristics and Identification	473	(1)
Antimicrobial Susceptibility	474	(1)
Human Capnocytophaga Species	474	(3)
Taxonomy	474	(1)
Clinical Significance	474	(1)
Cultural Characteristics and Identification	475	(1)
Antimicrobial Susceptibility	475	(2)
Canine Capnocytophaga Species	477	(2)
Taxonomy	477	(1)
Clinical Significance	477	(1)
Cultural Characteristics and Identification	477	(1)
Antimicrobial Susceptibility	478	(1)
Dysgonomonas Species	479	(1)
CDC Groups EF-4A and EF-4B	479	(2)
Simonsiella Species	481	(1)
Streptobacillus Moniliformis	481	(1)
Taxonomy	481	(1)
Clinical Significance	481	(1)
Cultural Characteristics and Identification	481	(1)
Antimicrobial Susceptibility	482	(1)
Brucella Species	482	(9)
Epidemiology of Brucellosis	482	(2)
Taxonomy of Brucella Species	484	(1)
Virulence of Brucella Species	484	(2)
Clinical Spectrum of Brucellosis	486	(1)
Serologic Diagnosis of Brucellosis	486	(2)
Isolation and Cultural Characteristics	488	(1)
Identification of Brucella Species	488	(2)
Treatment of Brucellosis	490	(1)
Francisella Tularensis	491	(6)
Epidemiology of Tularemia	491	(1)
History and Taxonomy	491	(1)
Virulence of F. tularensis	492	(1)
Clinical Spectrum of Tularemia	493	(1)
Isolation and Cultural Characteristics	494	(1)
Serologic Diagnosis of Tularemia	495	(1)
Treatment of Tularemia	495	(2)
Bartonella Species	497	(13)
Taxonomy and Epidemiology of Bartonella Species	497	(2)
Clinical Significance of Bartonella Species	499	(1)
Oroya Fever and Verruga Peruana	500	(1)
``Classical'' and ``Urban'' Trench Fever	500	(1)
Bacillary Angiomatosis	501	(1)
Peliosis	501	(1)
Fever and Bacteremia	502	(1)
Endocarditis	502	(1)
Cat-Scratch Disease (CSD)	503	(1)
Miscellaneous Infections	504	(1)
Detection, Isolation, and Identification of Bartonella Species	505	(1)
Specimen Types	505	(1)
Culture	505	(1)
Gram Stain and Colony Morphology	505	(1)
Identification Methods	505	(2)
Serologic Diagnosis of Bartonella Infections	507	(2)
In Vitro Antimicrobial Susceptibility	509	(1)
Afipia Species	510	(1)
Taxonomy and Clinical Significance	510	(1)
Isolation and Identification	510	(1)
Antimicrobial Susceptibility	510	(1)
Bordetella Species	510	(40)
Background and Taxonomy of Bordetella Species	510	(2)
Epidemiology of Pertussis	512	(1)
Clinical Significance of Bordetella pertussis	512	(1)
Pertussis Vaccines	513	(3)
Clinical Significance of Other Bordetella Species	516	(1)
Bordetella parapertussis	516	(1)
Bordetella bronchiseptica	516	(1)
Bordetella hinzii	517	(1)
Bordetella holmesii	517	(1)
Bordetella trematum	517	(1)
Isolation and Identification of Bordetella Species	517	(1)
Specimens and Culture Media	517	(1)
Direct Fluorescent Antibody Test	518	(1)
Cultural Characteristics and Identification	519	(1)
New Technologies for Detection and Identification of Bordetella pertussis	519	(2)
Serologic Tests for Diagnosis of Pertussis	521	(1)
Treatment of Pertussis	522	(1)
Antimicrobial Susceptibility Testing of Bordetella Species	522	(28)
Legionella
Taxonomy and Characteristics of the Genus Legionella	550	(1)
Clinical and Pathologic Spectrum of Legionellosis	551	(2)
Predisposing Factors	552	(1)
Pathology and Pathogenesis	552	(1)
Epidemiologic and Ecologic Aspects of Legionellosis	553	(2)
Incidence	553	(1)
Legionellaceae in the Environment	553	(1)
Natural Habitats	553	(1)
Man-Made (Artificial) Aquatic Habitats	554	(1)
Legionellosis in Travelers	554	(1)
Nosocomial Outbreaks of Legionellosis	555	(1)
Laboratory Diagnosis	555	(2)
Selection, Collection, and Transport of Clinical Specimens	555	(1)
Direct Examination of Clinical Specimens	556	(1)
Gross Examination and Microscopic Examination of Stained Materials	556	(1)
Microscopic Examination of Stained Materials	556	(1)
Direct Fluorescent Antibody (DFA) Procedure	556	(1)
Antigen Detection in Urine and Body Fluids	557	(1)
Detection of Legionella in Clinical Specimens	557	(4)
Isolation of Legionella Species From Clinical Specimens	557	(1)
Biopsy, Surgical Removal, and Autopsy Tissue	557	(1)
Pleural Fluid and Transtracheal Aspirates	557	(1)
Acid-Wash Decontamination Procedure for Sputum and Other Contaminated Specimens	557	(1)
Blood Cultures	557	(1)
Identification of Legionella Species	558	(1)
Antimicrobial Susceptibility and Treatment	558	(2)
Serum Indirect Immunofluorescent Antibody Test	560	(1)
Molecular Diagnosis	560	(1)
Environmental Microbiology Studies	561	(7)
Isolation of Legionella From Environmental Samples	561	(1)
Typing of Legionella Isolates	561	(7)
Neisseria Species and Moraxella catarrhalis
Taxonomy of the Family Neisseriaceae and the Family Moraxellaceae	568	(1)
General Characteristics of the Genus Neisseria	569	(1)
Clinical Significance of Neisseria Species	570	(15)
Neisseria gonorrhoeae	570	(1)
Epidemiology	570	(3)
Infections Caused by N. gonorrhoeae	573	(5)
Neisseria meningitidis	578	(1)
Epidemiology	578	(2)
Infections Caused by N. meningitidis	580	(2)
Meningococcal Prophylaxis and Meningococcal Vaccines	582	(2)
Other Neisseria Species	584	(1)
Clinical Significance of Moraxella Catarrhalis	585	(3)
Isolation of Neisseria Species	588	(4)
Neisseria gonorrhoeae	588	(1)
Direct Gram-Stained Smears	588	(1)
Specimen Collection	588	(1)
Specimen Transport	589	(1)
Selective Culture Media: Inoculation and Incubation	590	(1)
Neisseria meningitidis	591	(1)
Laboratory Safety	591	(1)
Direct Gram-Stained Smears and Direct Capsular Antigen Tests	591	(1)
Specimen Collection and Transport	591	(1)
Isolation and Incubation	591	(1)
Identification of Neisseria Species	592	(8)
Colony Morphology	592	(1)
Gram Stain and Oxidase Test	593	(1)
Superoxol Test	593	(1)
Differentiation of Other Organisms on Selective Media	593	(1)
Presumptive Criteria for Identification of N. gonorrhoeae	593	(1)
Identification Tests for Neisseria Species	593	(1)
Carbohydrate-Utilization Tests	594	(1)
Conventional CTA Carbohydrates	594	(1)
Rapid Carbohydrate-Utilization Test	594	(1)
RIM-Neisseria Test (Rapid Identification Method-Neisseria)	594	(1)
Other Carbohydrate-Utilization Methods	594	(1)
Chromogenic Enzyme Substrate Tests	594	(1)
Gonochek II	595	(1)
BactiCard Neisseria	595	(1)
Immunologic Methods for Culture Confirmation of N. gonorrhoeae	596	(1)
Direct Fluorescent Monoclonal Antibody Test	596	(1)
Coagglutination Tests	596	(1)
GonoGen II Test	596	(1)
Multitest Identification Systems	597	(1)
DNA Probe Test for Culture Confirmation of N. gonorrhoeae	597	(1)
Nucleic Acid Hybridization and Amplification Tests for N. gonorrhoeae	597	(2)
Molecular Methods for Detection of N. meningitidis	599	(1)
Cultural Characteristics of Neisseria Species	600	(4)
Neisseria gonorrhoeae	600	(2)
Neisseria meningitidis	602	(1)
Other Neisseria Species	603	(1)
Neisseria lactamica	603	(1)
Neisseria cinerea	603	(1)
Neisseria flavescens	603	(1)
Neisseria subflava Biovars, Neisseria mucosa, and Neisseria sicca	603	(1)
Neisseria polysaccharea	604	(1)
Neisseria elongata Subspecies	604	(1)
Neisseria gonorrhoeae Subspecies kochii (``Neisseria kochii'')	604	(1)
Atypical and Non-Human Neisseria Species	604	(1)
Cultural Characteristics and Identification of Moraxella Catarrhalis	604	(1)
Antimicrobial Susceptibility of Neisseria Species	605	(3)
Neisseria gonorrhoeae	605	(2)
Neisseria meningitidis	607	(1)
Antimicrobial Susceptibility of Moraxella Catarrhalis	608	(16)
Gram-Positive Cocci
Part I: Staphylococci and Related Gram-Positive Cocci
Taxonomy of Staphylococci and Related Gram-Positive Cocci	624	(1)
Clinical Significance of Staphylococci and Related Gram-Positive Cocci	625	(18)
Staphylococcus aureus Subsp. aureus	625	(13)
Coagulase-Negative Staphylococci	638	(1)
Staphylococcus epidermidis	638	(3)
Staphylococcus saprophyticus Subsp. saprophyticus	641	(1)
Other Coagulase-Negative Staphylococci	642	(1)
Micrococcus Species and Related Genera	642	(1)
Rothia mucilaginosa	642	(1)
Isolation and Preliminary Differentiation of Staphylococci and Related Gram-Positive Cocci	643	(2)
Direct Gram-Stained Smears	643	(1)
Isolation From Clinical Specimens	643	(1)
Colony Morphology	643	(1)
The Catalase Test	644	(1)
Methods for Differentiating Micrococci and Staphylococci	644	(1)
Fermentation of Glucose	644	(1)
Susceptibility to Lysostaphin	645	(1)
Production of Acid From Glycerol in the Presence of Erythromycin	645	(1)
Susceptibility to Furazolidone	645	(1)
Modified Oxidase Test	645	(1)
Susceptibility to Bacitracin	645	(1)
Identification of Staphylococcus Aureus	645	(4)
Slide Coagulase Test	645	(1)
Tube Coagulase Test	646	(1)
Alternative Coagulase Test Procedures	646	(1)
Latex Agglutination	646	(1)
Passive Hemagglutination	646	(1)
Additional Confirmatory Tests	647	(1)
Deoxyribonuclease (DNase) Test	647	(1)
Thermostable Endonuclease Test	648	(1)
Mannitol Fermentation	648	(1)
Other Methods for Identification of Staphylococcus aureus	648	(1)
Rapid Tests for Detection of Methicillin Resistance	648	(1)
Differentiation of Coagulase-Positive Staphylococci of Veterinary Origin	648	(1)
Identification of Coagulase-Negative Staphylococci	649	(12)
Conventional Identification Methods	649	(1)
Production of Phosphatase for Identification of Staphylococcus epidermidis	650	(1)
Pyrrolidonyl Arylamidase Activity	650	(2)
Susceptibility to Polymyxin B	652	(1)
Ornithine Decarboxylase Test (ODC)	652	(3)
Urease Production	655	(1)
Acetoin Production	655	(1)
Susceptibility to Deferoxamine	655	(1)
Susceptibility to Novobiocin for Identification of Staphylococcus saprophyticus	655	(1)
Commercial Identification Systems	655	(1)
RapiDEC Staph	656	(1)
API Staph-IDENT	656	(1)
API Staph	656	(1)
API ID32 Staph	656	(1)
Vitek Gram-Positive Identification (GPI) Card	657	(1)
MicroScan Rapid Pos Combo Panel	657	(1)
MicroScan Pos ID Panel	657	(1)
BBL Crystal Gram-Positive (GP) Identification System	657	(1)
Staf-Sistem 18-R	658	(1)
Staph-Zym	658	(1)
Microbact Staphylococcal 12S	658	(1)
Microbial Identification System	658	(1)
Biolog Microplate Identification System	658	(1)
Molecular Identification and Typing Methods for Staphylococci	658	(3)
Identification of Micrococcus and Related Species	661	(1)
Identification of Rothia mucilaginosa	661	(1)
Laboratory Approach to the Identification of Staphylococci	661	(13)
Gram-Positive Cocci
Part II: Streptococci, Enterococci, and the ``Streptococcus-Like'' Bacteria
General Characteristics of the Streptococci	674	(2)
Group A β-Hemolytic Streptococci (Streptococcus Pyogenes)	676	(7)
Virulence Factors	676	(3)
Clinical Significance	679	(4)
Group B β-Hemolytic Streptococci (Streptococcus Agalactiae)	683	(5)
Virulence Factors	683	(1)
Clinical Significance	684	(4)
Group C and Group G β-Hemolytic Streptococci	688	(1)
Group F β-Hemolytic Streptococci	689	(1)
Other Streptococci in the ``Pyogenic Cocci'' Group	689	(1)
Streptococcus Pneumoniae	689	(4)
Virulence Factors	689	(1)
Pneumococcal Vaccines	690	(1)
Clinical Significance	691	(2)
Viridans Streptococci	693	(2)
The Anginosus Group: Streptococcus Anginosus, Streptococcus Constellatus, and Streptococcus Intermedius	695	(2)
Group D Streptococci: The ``Streptococcus Bovis/Streptococcus Equinus Complex'' and Related Species	697	(1)
Streptococcus Suis	698	(2)
Other Viridans Streptococci Isolated From Animals	700	(1)
Miscellaneous Streptococci	700	(1)
Enterococcus Species	700	(4)
Taxonomy	700	(1)
Virulence Factors	701	(1)
Clinical Significance	701	(3)
Genus Melissococcus	704	(1)
The ``Streptococcus-Like'' Bacteria	704	(5)
Abiotrophia and Granulicatella Species	704	(1)
Aerococcus and Helcococcus Species	705	(1)
Leuconostoc Species	706	(1)
Pediococcus and Tetragenococcus Species	706	(1)
Gemella Species	707	(1)
Vagococcus Species	707	(1)
Alloiococcus Species	708	(1)
Globicatella Species	708	(1)
Facklamia Species	708	(1)
Dolosigranulum, Ignavigranum, and Dolosicoccus Species	709	(1)
Eremococcus Species	709	(1)
Genus Lactococcus	709	(1)
Isolation and Identification of Streptococci and ``Streptococcus-Like'' Bacteria	709	(57)
Direct Gram-Stained Smears	709	(1)
Culture Media	710	(1)
Hemolysis on Blood Agar	710	(1)
Nonculture, Direct Detection Techniques for Group A β-Hemolytic Streptococci in Pharyngeal Specimens	711	(1)
Nonculture, Direct Detection Techniques for Group B β-Hemolytic Streptococci and Streptococcus pneumoniae	712	(1)
Colony Morphology and Catalase Testing	713	(1)
Recognition and Preliminary Characterization of Streptococci and the ``Streptococcus-Like'' Bacteria	713	(2)
Presumptive Identification of Streptococci	715	(1)
Susceptibility to Bacitracin	715	(1)
Susceptibility to Sulfamethoxazole-Trimethoprim (SXT)	715	(2)
CAMP Test and Pigment Production	717	(1)
Hydrolysis of Sodium Hippurate	717	(1)
Bile-Esculin Test	717	(1)
Salt-Tolerance Test (6.5% NaCl Broth)	717	(1)
Leucine Aminopeptidase (LAP) Test	718	(1)
Pyrrolidonyl Arylamidase (PYR) Test	718	(1)
Susceptibility to Optochin	718	(1)
Bile-Solubility Test	718	(1)
Commercial Presumptive Identification Tests	718	(1)
Serologic Identification of β-Hemolytic Streptococci	718	(1)
Capillary Precipitin Test	718	(1)
Coagglutination	718	(1)
Latex Agglutination	719	(1)
Serologic Identification of Streptococcus pneumoniae	719	(1)
Biochemical Characteristics for Identification of Groupable Streptococci	719	(1)
Identification of the Viridans Streptococci	719	(3)
Sanguis Group	722	(1)
Mitis Group	722	(1)
Mutans Group	722	(1)
Salivarius Group	722	(3)
Anginosus Group	725	(1)
Bovis Group	726	(1)
Identification of Streptococcus suis and Other Streptococci Isolated From Animals	726	(1)
Identification of Enterococcus Species	726	(5)
Identification of Abiotrophia and Granulicatella Species	731	(1)
Identification of Aerococcus and Helcococcus Species	731	(3)
Identification of Leuconostoc, Pediococcus, and Tetragenococcus Species	734	(2)
Identification of Gemella Species	736	(1)
Identification of Vagococcus Species	736	(2)
Identification of Alloiococcus, Globicatella, Facklamia, Dolosigranulum, Ignavigranum, and Dolosicoccus Species	738	(4)
Identification of Lactococcus Species	742	(1)
Commercially Available Systems for Identification of Streptococci, Enterococci, and Selected ``Streptococcus-Like'' Bacteria	742	(1)
API Rapid Strep	743	(1)
BBL Crystal Gram-Positive Identification System	743	(1)
Rapid ID 32 Strep	744	(1)
RapID STR	744	(1)
Vitek Gram-Positive Identification (GPI) Card	744	(1)
Microscan Gram-Positive Breakpoint Combo Panel	745	(21)
Aerobic and Facultative Gram-Positive Bacilli
Listeria Species and Listeria Monocytogenes	766	(7)
Taxonomy of the Genus Listeria	766	(2)
Virulence Factors of L. monocytogenes	768	(1)
Epidemiology of L. monocytogenes	768	(1)
Clinical Significance of L. monocytogenes	768	(2)
Isolation of L. monocytogenes From Clinical Specimens	770	(1)
Identification of Listeria Species	770	(3)
Antimicrobial Susceptibility and Treatment of Listeria Infections	773	(1)
Pathogenicity of Other Listeria Species	773	(1)
Erysipelothrix Species: Erysipelothrix Rhusiopathiae and Erysipelothrix Tonsillarum	773	(2)
Taxonomy of the Genus Erysipelothrix	773	(1)
Virulence Factors of E. rhusiopathiae	774	(1)
Clinical Significance of E. rhusiopathiae	774	(1)
Isolation and Identification of E. rhusiopathiae	775	(1)
Antimicrobial Susceptibility of E. rhusiopathiae	775	(1)
Bacillus Species and Related Genera	775	(8)
Taxonomy and the Taxonomic Dissection of the Genus Bacillus	775	(1)
Bacillus anthracis	776	(1)
Epidemiology of Anthrax	776	(1)
Virulence Factors of B. anthracis	777	(1)
Clinical Presentations of Anthrax	777	(1)
Treatment of Anthrax	778	(1)
Prevention of Anthrax	778	(1)
Bacillus cereus	778	(1)
Virulence Factors of B. cereus	778	(1)
B. cereus Gastroenteritis	779	(1)
Opportunistic Bacillus Species Infections	779	(1)
Bacteremia and Endocarditis	779	(1)
Infections in Compromised Hosts	780	(1)
Ocular Infections	780	(1)
Musculoskeletal Infections	780	(1)
Nosocomial Infections	780	(1)
Laboratory Safety, Specimen Collection, and Processing	781	(1)
Isolation and Identification of Bacillus Species: The ``Bacillus cereus Group'': B. anthracis, B. cereus, B. thuringiensis, and B. mycoides	781	(2)
Antimicrobial Susceptibility of Bacillus Species	783	(1)
Corynebacterium Species	783	(27)
Introduction and Taxonomy	783	(2)
Identification of Corynebacterium Species and the Coryneform Bacteria	785	(12)
Antimicrobial Susceptibility Testing of Corynebacterium Species and the Coryneform Bacteria	797	(1)
Members of the Genus Corynebacterium Isolated From Humans	797	(1)
Corynebacterium amycolatum	798	(5)
Corynebacterium diphtheriae	803	(4)
Corynebacterium jeikeium	807	(1)
Corynebacterium pseudodiphtheriticum	808	(1)
Corynebacterium striatum	808	(1)
Corynebacterium urealyticum	808	(1)
Corynebacterium Species Associated With Animals	809	(1)
Corynebacterium Species Isolated From Foods and the Environment	810	(1)
Other Coryneform Bacteria	810	(24)
Actinobaculum Species	810	(1)
Actinomyces Species Isolated From Humans	811	(6)
Actinomyces Species Isolated From Animals	817	(1)
Arcanobacterium Species	817	(6)
Arthrobacter Species	823	(1)
Brevibacterium Species	823	(3)
Cellulomonas, Cellulosimicrobium, and Oerskovia Species	826	(2)
Dermabacter Species	828	(1)
Exiguobacterium Species	828	(2)
Leifsonia Species	830	(1)
Microbacterium (Aureobacterium) Species	830	(2)
Rothia and ``Rothia-Like'' Species (CDC Group 4)	832	(2)
Turicella Species	834	(1)
Gardnerella Vaginalis	834	(4)
Taxonomy and Cellular Morphology	834	(1)
Virulence Factors of G. vaginalis	835	(1)
Clinical Significance of G. vaginalis	835	(1)
Isolation and Identification	836	(2)
Antimicrobial Susceptibility	838	(1)
Lactobacillus Species	838	(20)
Taxonomy and Epidemiology	838	(1)
Clinical Significance	839	(1)
Isolation and Identification	840	(1)
Antimicrobial Susceptibility	840	(18)
Aerobic Actinomycetes
Introduction, Classification, and Taxonomy	858	(2)
The Nocardioform Group	860	(4)
Nocardia	860	(1)
Epidemiology, Pathology, and Pathogenesis	861	(1)
Clinical Disease	862	(1)
Rhodococcus	863	(1)
Epidemiology, Pathology, and Pathogenesis	863	(1)
Clinical Disease	863	(1)
Other Nocardioform Bacteria	863	(1)
The Maduromycetes and Thermomonosporas	864	(1)
Actinomadura	864	(1)
Epidemiology	864	(1)
Clinical Disease and Pathology	864	(1)
Nocardiopsis	864	(1)
The Streptomycetes	865	(1)
Streptomyces	865	(1)
Thermophilic Actinomycetes	865	(1)
Miscellaneous Actinomycetes	865	(1)
Oerskovia	865	(1)
Dermatophilus	865	(1)
Tropheryma whipplei	865	(1)
History and Taxonomy	865	(1)
Ecology	866	(1)
Clinical Disease and Pathology	866	(1)
Laboratory Diagnosis of Infections Caused by Aerobic Actinomycetes	866	(12)
Primary Isolation	866	(1)
Differentiation of Nocardia From Other Genera of Aerobic Actinomycetes	867	(4)
Identification of Thermophilic Actinomycetes	871	(1)
Identification of Tropheryma whipplei	871	(1)
In Vitro Susceptibility of Nocardia and Related Bacteria to Antimicrobial Agents and Therapy of Infections	871	(7)
The Anaerobic Bacteria
Relationships of Bacteria to Oxygen	878	(2)
Oxygen Tolerance	879	(1)
Oxidation-Reduction Potential	879	(1)
Habitats	880	(1)
Taxonomic Classification and Nomenclature	880	(7)
Human Infections	887	(3)
Isolation of Anaerobic Bacteria	890	(5)
Selection of Specimens for Culture	890	(1)
Collection and Transport of Specimens	891	(1)
Anaerobic Blood Culture (Summary of Guidelines for Traditional Broth and Instrumented Systems)	891	(1)
Direct Examination of Clinical Materials	892	(1)
Selection and Use of Media	893	(2)
Anaerobic Systems for the Cultivation of Anaerobic Bacteria	895	(3)
Anaerobic Jar Techniques	895	(2)
Use of the Anaerobic Glove Box	897	(1)
The Roll-Streak System	897	(1)
Anaerobic Disposable Plastic Bags	898	(1)
Use of the Anaerobic Holding Jar	898	(1)
Incubation of Cultures	898	(2)
Inspection and Subculture of Colonies	900	(1)
Aerotolerance Tests	900	(1)
Preliminary Reporting of Results	901	(1)
Determination of Cultural and Biochemical Characteristics for Differentiation of Anaerobic Isolates	901	(5)
Presumptive Identification	901	(1)
Use of Differential Agar Media	901	(1)
Presumpto Plates	902	(2)
Antimicrobial Susceptibility Plates	904	(1)
Characterization of Anaerobes Using Conventional Biochemical Tests in Large Tubes	904	(1)
Alternative Procedures	905	(1)
The Nagler Test and the CAMP Test for C. perfringens	905	(1)
Packaged Microsystems	905	(1)
Commercial Packaged Kits for Identification of Anaerobes After 4 Hours of Incubation	905	(1)
Determination of Metabolic Products by Gas-Liquid Chromatography	906	(3)
Identification of Volatile Fatty Acids	906	(2)
Analysis of Nonvolatile Acids	908	(1)
Gas-Liquid Chromatography Controls	909	(1)
Identification of Anaerobic Bacteria	909	(30)
Anaerobic Gram-Negative Non--Spore-Forming Bacilli	912	(1)
Classification and Nomenclature	912	(1)
Presumptive or Preliminary Group Identification of Bacteroides, Prevotella, Porphyromonas, and Fusobacterium	913	(11)
Identification of the Anaerobic Cocci	924	(3)
Identification of the Anaerobic Non--Spore-Forming Gram-Positive Bacilli	927	(1)
Propionibacterium Species	927	(1)
Bifidobacterium Species	927	(3)
Lactobacillus Species	930	(1)
Actinomyces Species	930	(1)
Eubacterium Species	930	(1)
Mobiluncus and Bacterial Vaginosis	931	(1)
Additional Genera and Species of Anaerobic Non--Spore-Forming Gram-Positive Bacilli	931	(1)
Identification of Clostridium Species	931	(1)
Histotoxic Clostridia Involved in Clostridial Myonecrosis or Gas Gangrene	932	(3)
Miscellaneous Clostridia in Other Clinical Settings	935	(1)
Clostridium difficile--Associated Intestinal Disease	936	(1)
Botulism	937	(1)
Tetanus	938	(1)
Antimicrobial Susceptibility Testing of Anaerobic Bacteria	939	(7)
Methods for Antimicrobial Susceptibility Testing of Anaerobes	939	(7)
Antimicrobial Susceptibility Testing
Historical Introduction	946	(1)
Bacterial Resistance to Antimicrobial Agents	947	(16)
Mechanistic Variables	947	(2)
Mechanisms of Resistance	949	(1)
Transport of Antimicrobial Agents Across the Cell Wall and Cell Membranes	949	(6)
Antibiotics That Interfere With Formation of Bacterial Cell Walls: The β-Lactam and Glycopeptide Antibiotics	955	(6)
Antimicrobial Agents That Do Not Exert Their Effect on Cell Walls	961	(2)
Interactions Among Resistance Mechanisms	963	(1)
Laboratory Guidance of Antimicrobial Therapy	963	(5)
Tests for Determining Inhibitory Activity of Antimicrobial Agents	968	(28)
Indications	968	(1)
Choice of Test	968	(2)
Selection of Antimicrobial Agents	970	(1)
Standardization	970	(1)
Growth Medium	970	(1)
pH	970	(1)
Serum	970	(5)
Cation Concentration	975	(1)
Atmosphere	975	(1)
Temperature	975	(1)
Inoculum	975	(1)
Antimicrobial Agents	975	(1)
Quality Control	976	(1)
Quality Assurance	977	(1)
Interpretation of Results	977	(4)
Selection of Antimicrobial Agents to Be Reported	981	(1)
Macrodilution Broth Susceptibility Test	982	(1)
Agar Dilution Susceptibility Test	982	(1)
Disk Diffusion Susceptibility Test	983	(3)
Development of a Standardized Disk Diffusion Procedure	986	(1)
Interpretation of Results	987	(2)
Quality Control	989	(1)
Limitations	989	(1)
Microbroth Dilution Susceptibility Test	989	(4)
Commercial Systems	993	(1)
Vitek (BioMerieuxVitek, Hazelwood, MO) and MicroScan (Dade International, West Sacramento, CA)	993	(3)
Epsilometer Test (Etest; AB Biodisk, Sweden)	996	(1)
Special Issues in Susceptibility Testing	996	(27)
β-Lactamases	996	(5)
Staphylococcus Species	1001	(1)
Haemophilus Species	1002	(1)
Neisseria gonorrhoeae	1002	(1)
Moraxella (Branhamella) catarrhalis	1002	(1)
Enterococcus Species	1002	(1)
Extended-Spectrum β-Lactamases	1003	(1)
Staphylococcus Species	1004	(1)
β-Lactam Antibiotics (Oxacillin-Resistant Staphylococcus Species)	1004	(3)
Vancomycin	1007	(1)
Macrolides, Lincosamides, and Streptogramins	1008	(1)
Fluoroquinolones	1008	(1)
Haemophilus Species	1008	(1)
Penicillin Antibiotics	1009	(1)
Chloramphenicol	1009	(1)
Cephalosporins	1009	(1)
Trimethoprim-Sulfamethoxazole	1009	(1)
Streptococcus pneumoniae	1009	(1)
Penicillin and Other β-Lactam Antibiotics	1009	(1)
Multiple Resistance	1010	(1)
Macrolides and Lincosamides	1010	(1)
Neisseria gonorrhoeae	1011	(1)
Neisseria meningitidis	1011	(1)
Enterococcus Species	1011	(1)
Aminoglycoside Antibiotics	1012	(1)
β-Lactam Antibiotics	1012	(1)
Vancomycin	1012	(1)
Listeria monocytogenes	1013	(1)
Streptococcus pyogenes (Group A β-Hemolytic Streptococcus)	1013	(1)
Penicillin	1013	(1)
Erythromycin	1013	(1)
Fluoroquinolones	1013	(1)
Streptococcus agalactiae (Group B β-Hemolytic Streptococcus)	1014	(1)
Viridans Streptococci	1014	(1)
Other Gram-Positive Bacteria	1014	(1)
Pseudomonas aeruginosa, Burkholderia cepacia, and Stenotrophomonas maltophilia in Patients With Cystic Fibrosis	1014	(1)
Direct Susceptibility Testing	1014	(9)
Mycoplasmas and Ureaplasmas
Taxonomy of Mycoplasmas and Ureaplasmas	1023	(3)
Virulence Factors of Human Mycoplasmas	1026	(1)
Clinical Significance of the Human Mycoplasmas	1027	(13)
Mycoplasma pneumoniae	1027	(1)
Mycoplasma hominis and Ureaplasma urealyticum	1028	(5)
Mycoplasma genitalium	1033	(1)
Mycoplasma fermentans	1034	(3)
Mycoplasma penetrans	1037	(1)
Mycoplasma pirum	1038	(1)
Mycoplasma primatum	1039	(1)
Mycoplasma spermatophilum	1039	(1)
Human Infections Due to Mycoplasma Species of Animal Origin	1039	(1)
Hemotrophic Mycoplasma Species	1039	(1)
Culture of Human Mycoplasmas From Clinical Specimens	1040	(8)
General Considerations	1040	(1)
Specimen Collection	1041	(1)
Transport Media	1041	(1)
Media for Culture of Mycoplasmas	1041	(1)
Isolation and Identification of Mycoplasma pneumoniae	1042	(1)
Noncultural Detection of Mycoplasma pneumoniae	1043	(1)
Isolation and Identification of the Genital Mycoplasmas	1044	(1)
Noncultural Detection of the Genital Mycoplasmas	1045	(2)
Commercial Mycoplasma Culture Systems	1047	(1)
Isolation of Mycoplasmas on Routine Culture Media	1048	(1)
Serologic Tests for Diagnosis of Mycoplasma Pneumoniae Infections	1048	(2)
Serologic Tests for Genital Mycoplasmas	1050	(1)
Antimicrobial Susceptibility and Treatment of Mycoplasma Infections	1051	(3)
Diagnosis and Treatment of Hemotrophic Mycoplasma Infections in Animals	1054	(11)
Mycobacteria
Trends in Clinical Tuberculosis	1065	(2)
Worldwide Increase in the Incidence of Tuberculosis	1065	(1)
Impact of Coinfection With HIV and Mycobacterium tuberculosis	1066	(1)
Persons at Risk for Tuberculosis	1066	(1)
Rapidly Progressive Disease	1066	(1)
Implementation of More Aggressive Infection Control and Epidemiologic Measures	1067	(1)
Trends in the Laboratory Diagnosis of Tuberculosis	1067	(1)
Use of Molecular Techniques	1067	(1)
Use of Automated Instruments	1067	(1)
Use of Broth Culture Media	1067	(1)
Inoculation of Clinical Specimens to Agar-Based Culture Media	1067	(1)
Use of p-nitro-acetylamino-hydroxypropiophenone (NAP)	1068	(1)
Applications of Gas-Liquid Chromatography, High-Performance Liquid Chromatography, and Mass Spectrometry	1068	(1)
Use of the Lysis-Centrifugation System Blood Culture Tube	1068	(1)
The Clinical Laboratory	1068	(1)
Optimizing the Detection and Identification of Mycobacteria	1068	(1)
Laboratory Safety	1068	(1)
Specimen Collection	1069	(2)
Respiratory Specimens	1069	(1)
Blood Cultures	1069	(1)
Stool Specimens	1070	(1)
Miscellaneous ``Sterile'' Specimens	1070	(1)
Laboratory Approach to the Recovery and Identification of Mycobacteria	1071	(6)
Specimen Preparation	1072	(1)
Digestion and Decontamination	1072	(2)
Centrifugation	1074	(1)
Bone Marrow and Biopsy Specimens	1074	(1)
Miscellaneous Liquid Specimens	1075	(1)
Staining of Acid-Fast Bacilli	1075	(2)
Culture of Specimens for Recovery of Mycobacteria	1077	(2)
Culture Media	1077	(1)
Nonselective Culture Media for Recovery of Mycobacteria	1077	(1)
Media of Cohen and Middlebrook	1078	(1)
Selective Media	1078	(1)
Incubation	1079	(1)
Rapid Methods for Establishing a Diagnosis	1079	(1)
Sensitivity of Acid-Fast Smears	1079	(1)
Gas-Liquid and High-Performance Liquid Chromatography	1080	(1)
Use of Broth Culture Medium	1080	(1)
Automated Detection Systems	1080	(3)
BACTEC AFB System	1081	(1)
Mycobacteria Growth Indicator Tube (MGIT) and MGIT 960	1081	(1)
MB/BacT Mycobacteria Detection System	1082	(1)
The ESP Culture System II	1082	(1)
The BACTEC MYCO/F Lytic	1083	(1)
Manual Detection Systems	1083	(2)
Septi-Chek AFB System	1083	(2)
Identification of Mycobacteria Using Conventional Methods	1085	(5)
Optimal Temperature for Isolation and Rates of Growth	1085	(1)
Pigment Production	1086	(1)
Niacin Accumulation	1086	(1)
Reduction of Nitrates to Nitrites	1086	(1)
Tween 80 Hydrolysis	1087	(1)
Catalase Activity	1087	(1)
Arylsulfatase Activity	1087	(1)
Urease Activity	1087	(1)
Pyrazinamidase	1087	(1)
Iron Uptake	1087	(1)
Growth Inhibition by Thiophene-2-carboxylic Acid Hydrazide	1087	(1)
Growth in 5% Sodium Chloride	1087	(3)
Growth on MacConkey Agar	1090	(1)
Classification of Mycobacteria	1090	(16)
Laboratory Identification of Mycobacteria and Related Clinical Syndromes	1091	(1)
Review of Mycobacterium Species: Laboratory Aspects and Clinical Correlations	1091	(1)
Mycobacterium tuberculosis Complex	1091	(2)
Photochromogens	1093	(2)
Scotochromogens	1095	(4)
Nonphotochromogens	1099	(5)
Rapid Growers	1104	(1)
Other Mycobacteria	1104	(2)
The Detection and Identification of Mycobacteria by Molecuar Methods	1106	(7)
Signal-Amplification Methods	1107	(1)
Nucleic-Acid Probes	1107	(1)
In Situ Hybridization	1107	(1)
Nucleic-Acid Amplification Methods	1108	(1)
Commercially Available Applications	1108	(1)
Home-Brew PCR Assays, Including Real-Time PCR	1109	(1)
Postamplification Analysis	1110	(1)
Reverse Hybridization	1110	(1)
DNA Sequencing	1111	(1)
Microarray Analysis	1111	(1)
Strain Typing and DNA Fingerprinting	1111	(2)
Susceptibility Testing	1113	(2)
Short-Course Therapy	1115	(2)
American Thoracic Society Recommendations	1117	(1)
Summary	1117	(9)
Spirochetal Infections
Taxonomy	1126	(1)
Treponema	1126	(8)
Treponema pallidum Subspecies pallidum	1126	(1)
Incubation Period	1127	(1)
Primary Syphilis	1127	(1)
Secondary Syphilis	1127	(1)
Latent Syphilis	1127	(1)
Late Syphilis	1127	(1)
Epidemiology	1128	(1)
Immunity	1129	(1)
Treponema pallidum Subspecies pertenue	1129	(1)
Treponema pallidum Subspecies endemicum	1130	(1)
Treponema carateum	1130	(1)
Laboratory Diagnosis of Treponemal Infections	1130	(1)
Serologic Tests	1131	(2)
Innovations: Provisional and Investigative Tests	1133	(1)
Borrelia	1134	(9)
Relapsing Fever	1134	(1)
Epidemiology	1134	(1)
Clinical Disease	1135	(1)
Laboratory Diagnosis	1135	(1)
Lyme Disease	1135	(2)
Epidemiology	1137	(2)
Clinical Disease	1139	(1)
Laboratory Diagnosis	1140	(3)
Leptospira	1143	(3)
Leptospirosis	1144	(1)
Epidemiology	1144	(1)
Clinical Disease	1144	(1)
Laboratory Diagnosis	1144	(2)
Spirillum Minor (Rat-Bite Fever)	1146	(7)
Mycology
Patients at Risk for Fungal Infections	1153	(1)
General Signs and Symptoms Suggesting Fungal Infection	1153	(1)
Clinical Categorization of Fungal Infections	1153	(3)
Common Mycologic Terms	1155	(1)
Laboratory Approach to the Diagnosis of Fungal Infections	1156	(10)
Specimen Collection and Transport	1158	(2)
Specimen Processing	1160	(1)
Direct Examination	1160	(2)
Preparation of Mounts for Study	1162	(1)
Selection and Inoculation of Culture Media	1162	(3)
Incubation of Fungal Cultures	1165	(1)
Laboratory Approach to the Presumptive Identification of Fungal Isolates	1166	(6)
Extent of Laboratory Genus/Species Identification	1166	(2)
Genus and Species Identification of the Major Groups of Fungi	1168	(1)
Zygomyces Species and Zygomycosis	1168	(3)
Histopathology of Infections Caused by the Zygomycetes	1171	(1)
Hyaline Molds and Hyalohyphomycosis	1172	(15)
Aspergillus Species and Aspergillosis	1174	(1)
Laboratory Presentation	1174	(1)
Colony Morphology	1174	(1)
Microscopic Features	1174	(1)
Aspergillus fumigatus	1175	(1)
Aspergillus flavus	1175	(1)
Aspergillus niger	1175	(1)
Aspergillus terreus	1176	(1)
Aspergillus nidulans	1177	(1)
Histopathology	1177	(2)
Diagnosis Using Nonculture Techniques	1179	(2)
Additional Rapidly Growing Hyaline Molds	1181	(1)
Colony Characteristics	1181	(1)
Genera of Hyaline Filamentous Molds Producing Conidia in Chains	1181	(1)
Penicillium Species	1181	(1)
Paeciliomyces Species	1182	(1)
Scopulariopsis Species	1182	(1)
Identification of Hyaline Molds Producing Conidia in Clusters	1182	(1)
Acremonium Species	1182	(1)
Fusarium species	1183	(1)
Gliocladium Species	1183	(1)
Trichoderma Species	1184	(1)
Identification of the Genera of Hyalohyphomycetes Producing Conidia Singly	1184	(1)
Scedosporium Species	1185	(1)
Chrysosporium Species	1186	(1)
Sepedonium Species	1186	(1)
Beauveria Species	1187	(1)
Identification of the Dermatophytes	1187	(5)
Identification of Microsporum Species	1189	(1)
Microsporum canis	1189	(1)
Microsporum gypseum	1190	(1)
Microsporum nanum	1190	(1)
Identification of Trichophyton Species	1190	(1)
Trichophyton mentagrophytes	1190	(1)
Trichophyton rubrum	1190	(1)
Trichophyton tonsurans	1191	(1)
Trichophyton verrucosum	1191	(1)
Epidermophyton floccosum	1192	(1)
Diagnosis by Nonculture Techniques	1192	(1)
The Dimorphic Fungi	1192	(16)
Blastomyces dermatitidis and Blastomycosis	1194	(2)
Laboratory Presentation	1196	(1)
Diagnosis Using Nonculture Techniques	1197	(2)
Coccidioides immitis and Coccidioidomycosis	1199	(1)
Laboratory Presentation	1199	(1)
Histoplasma capsulatum and Histoplasmosis	1199	(1)
Laboratory Presentation	1200	(2)
Diagnosis Using Nonculture Techniques	1202	(1)
Sporothrix schenckii and Sporotrichosis	1203	(1)
Laboratory Presentation	1203	(1)
Diagnosis Using Nonculture Techniques	1203	(1)
Paracoccidioides immitis and Paracoccidioidomycosis	1203	(3)
Laboratory Presentation	1206	(1)
Diagnosis Using Nonculture Techniques	1206	(2)
Dematiaceous Fungi	1208	(3)
Agents of Phaeohyphomycosis	1208	(1)
Laboratory Presentation	1208	(1)
Macroconidia With Transverse and Longitudinal Septa (Muriform)	1208	(1)
Alternaria Species	1209	(1)
Ulocladium Species	1209	(1)
Stemphylium Species	1210	(1)
Epicoccum Species	1210	(1)
Macroconidia With Transverse Septa	1210	(1)
Bipolaris Species	1210	(1)
Drechslera Species	1210	(1)
Curvularia Species	1210	(1)
Exserohilum Species	1210	(1)
Macroconidia Borne Singly or Via Special Conidiation	1210	(1)
Nigrospora Species	1211	(1)
Phoma Species	1211	(1)
Chaetomium Species	1211	(1)
Agents of Chromomycosis and Mycetoma	1211	(5)
Cladophialophora (Cladosporium) carrionii	1214	(1)
Phialophora verrucosum	1215	(1)
Phialophora richardsiae	1215	(1)
Fonsecaea pedrosoi	1215	(1)
Exophiala jeanselmei	1216	(1)
The Laboratory Identification of Yeasts	1216	(16)
Germ Tube	1216	(2)
Cornmeal Agar Preparations	1218	(1)
Growth Patterns of Yeasts on Cornmeal Agar	1219	(1)
CHROMagar	1219	(1)
Candida albicans	1219	(1)
Candida tropicalis	1220	(1)
Candida parapsilosis	1220	(1)
Candida kefyr (pseudotropicalis)	1220	(1)
Other Emerging Pathogenic Candida Species	1220	(1)
Candida Species and Candidiasis	1221	(1)
Species That Produce True Hyphae	1221	(3)
Species That Fall to Produce True Hyphae	1224	(1)
Cryptococcosis and Cryptococcus neoformans	1224	(2)
Diagnosis by Nonculture Methods	1226	(1)
Miscellaneous Non-Hyphae-Forming Yeasts of Medical Importance	1226	(1)
Candida (Torulopsis) glabrata	1226	(1)
Rhodotorula Species	1226	(1)
Saccharomyces Species	1226	(2)
Hansenula anomala	1228	(1)
Malassezia furfur	1228	(1)
Laboratory Identification of ``Black Yeasts''	1229	(1)
Aureobasidium pullulans	1229	(1)
Phaeoannellomyces werneckii	1229	(1)
Packaged Yeast-Identification Systems	1230	(1)
Antifungal Susceptibility Testing	1230	(2)
Serologic Diagnosis of Fungal Diseases	1232	(15)
Parasitology
Risk and Prevention of Parasitic Infections	1247	(1)
Clinical Manifestations of Parasitic Disease	1247	(1)
Collection, Transport, and Processing of Specimens	1248	(7)
Fecal Specimens	1248	(1)
Preservation of Clinical Specimens	1249	(1)
Visual Examination	1249	(1)
Processing Fresh Stool Specimens for Ova and Parasite Examination	1249	(4)
Examination of Intestinal Specimens Other Than Stool	1253	(1)
Examination of Extraintestinal Specimens	1254	(1)
Sputum	1254	(1)
Urine and Body Fluids	1254	(1)
Tissue Biopsies and Aspirates	1254	(1)
Corneal Scrapings or Biopsy	1254	(1)
Muscle Biopsy	1254	(1)
Blood	1254	(1)
Identification and Differentiation of Parasites	1255	(1)
Life Cycles of Human Parasites	1256	(1)
Intestinal Protozoa	1256	(17)
The Intestinal Amoebae	1258	(1)
Amebiasis and Entamoeba histolytica	1258	(2)
Entamoeba histolytica versus Entamoeba coli	1260	(1)
Serologic Diagnosis of Amebiasis	1260	(1)
Nonpathogenic Entamoeba histolytica: Entamoeba dispar	1261	(1)
Other Intestinal Amoebae	1262	(1)
Protozoa of Uncertain Classification	1262	(1)
Intestinal Flagellates	1263	(1)
Giardia lamblia	1263	(3)
Other Intestinal Flagellates	1266	(1)
Ciliates: Balantidium coli	1267	(1)
Coccidia	1267	(1)
Cryptosporidium parvum	1267	(3)
Cyclospora cayetanensis	1270	(1)
Isospora belli	1271	(1)
Sarcocystis Species	1271	(1)
Phylum Microsporum: Microsporidium Species	1272	(1)
Nematodes	1273	(8)
Ascariasis and Ascaris lumbricoides	1274	(1)
Trichuriasis and Trichuris trichiura (Whipworm)	1274	(1)
Enterobius vermicularis	1275	(1)
Hookworms	1276	(3)
Strongyloidiasis and Strongyloides stercoralis	1279	(1)
Trichostrongylus Species	1279	(1)
Capillaria philippinensis	1280	(1)
Cestodes	1281	(5)
Taenia solium and Taenia saginata	1282	(2)
Diphyllobothrium laturr. The Giant Fish Tapeworm	1284	(1)
Hymenolepis Species	1285	(1)
Dipylidium caninum	1286	(1)
Trematodes	1286	(6)
Schistosomes	1287	(1)
Fasciola hepatica and Fasciolopsis buski	1288	(2)
Clonorchis sinensis	1290	(2)
Paragonimus westermani	1292	(1)
Blood and Tissue Parasites	1292	(26)
Malaria	1294	(4)
Babesia	1298	(1)
Hemoflagellates; Leishmania Species and Trypanosoma Species	1298	(1)
Leishmaniasis and Leishmania Species	1299	(1)
Trypanosomiasis	1299	(4)
Filarial Nematodes and Filariasis	1303	(2)
Onchocerciasis and Onchocerca volvulus	1305	(1)
Dracunculiasis	1306	(1)
Dirofilariasis	1306	(1)
Tissue Protozoan Infections	1306	(1)
Toxoplasma gondii	1306	(5)
Pneumocystis carinii	1311	(1)
Miscellaneous Larval Tissue Parasite Infections	1311	(1)
Trichinosis	1312	(1)
Visceral Larval Migrans	1312	(2)
Cutaneous Larva Migrans---Toxocara	1314	(1)
Anisakiasis	1314	(1)
Gnathostomiasis	1315	(1)
Angiostrongyliasis	1315	(1)
Echinococcosis (Hydatid Disease)	1315	(1)
Multiceps Species---Coenurosis	1316	(1)
Sparganosis: Spirometra mansonoides	1316	(2)
Serologic Diagnosis of Parasitic Infections	1318	(3)
Drugs Commonly Used in the Treatment of Parasitic Diseases	1321	(8)
Diagnosis of Infections Caused by Viruses, Chlamydia, Rickettsia, and Related Organisms
Introduction	1329	(1)
Historical Review	1329	(1)
Evolution of Cell-Culture Techniques	1329	(1)
Evolution of Diagnostic Virology Services	1329	(1)
Levels of Service	1330	(1)
Taxonomy and Nomenclature	1330	(3)
Clinical Manifestations of Viral Infections	1333	(34)
Orthomyxoviruses	1335	(7)
Paramyxoviruses	1342	(1)
Parainfluenza Viruses	1342	(2)
Mumps Virus	1344	(1)
Measles Virus	1344	(1)
Respiratory Syncytial Virus	1344	(1)
Other Paramyxoviruses	1344	(1)
Picornaviruses	1344	(1)
Rhabdoviruses	1345	(1)
Arenaviruses	1346	(1)
Filoviruses	1346	(1)
Togaviruses	1347	(1)
Bunyaviruses	1348	(1)
California Encephalitis Viruses	1348	(1)
Hantaviruses	1348	(1)
Human Gastroenteritis Viruses	1349	(1)
Rotaviruses	1350	(1)
Caliciviruses	1350	(1)
Astroviruses	1350	(1)
Enteric Adenoviruses	1350	(1)
Coronaviruses	1350	(1)
Coltiviruses	1351	(1)
Retroviruses	1351	(5)
Herpesviruses	1356	(1)
Herpes Simplex Virus	1356	(2)
Cytomegalovirus	1358	(1)
Epstein-Barr Virus	1359	(1)
Varicella-Zoster Virus	1359	(1)
Human Herpesviruses-6 and -7	1359	(1)
Human Herpesvirus-8	1360	(1)
B Virus	1360	(1)
Adenoviruses	1360	(1)
Poxviruses	1361	(1)
Papovaviruses	1361	(1)
Papillomaviruses	1362	(2)
Polyomaviruses	1364	(1)
Parvoviruses	1364	(1)
Hepatitis Viruses	1364	(1)
Hepatitis A Virus	1365	(1)
Hepatitis B Virus	1365	(1)
Hepatitis C Virus	1365	(1)
Hepatitis D Virus	1366	(1)
Hepatitis E Virus	1366	(1)
Prion Diseases (Transmissible Spongiform Encephalopathies)	1366	(1)
Clinical Classification of Viral Infections	1367	(1)
Diagnosis of Viral Infections	1367	(25)
Collection of Specimens for Diagnosis	1369	(4)
Transportation and Storage of Specimens	1373	(1)
Isolation of Viruses in Culture	1373	(1)
Preparation and Maintenance of Cell Cultures	1373	(2)
Contamination of Cell Cultures	1375	(2)
Technical Aspects of Cell Culture	1377	(3)
Selection of Cell Cultures for Isolation of Viruses	1380	(1)
Inoculation and Incubation of Cell Cultures	1380	(1)
Detection of Virus and Provisional Identification	1381	(1)
Cytopathic Effect	1381	(2)
Hemagglutination and Hemadsorption	1383	(4)
Light Microscopy	1387	(1)
Electron Microscopy	1387	(1)
Biochemical Differentiation	1387	(2)
Cell Association	1389	(1)
Detection of Viral Antigens	1389	(1)
Artifacts and Non-Virus-Induced Changes	1389	(1)
Definitive Identification of Isolates	1390	(1)
Storage of Viral Isolates	1391	(1)
Summary of Detection and Identification of Viruses in Culture	1391	(1)
Direct Detection of Viruses in Clinical Specimens	1392	(5)
Light Microscopic Detection of Inclusions	1392	(1)
Electron Microscopic Detection of Viral Particles	1393	(1)
Immunologic Detection of Viral Antigen	1393	(1)
Respiratory Viruses	1393	(1)
Herpes Group Viruses	1393	(1)
Other Viruses	1394	(1)
Molecular Techniques	1394	(1)
Human Immunodeficiency Virus	1394	(1)
Hepatitis C Virus	1395	(1)
Hepatitis B Virus	1396	(1)
Human Papillomaviruses	1396	(1)
Parvovirus B19	1396	(1)
West Nile Virus	1396	(1)
Herpes Simplex Virus	1396	(1)
Cytomegalovirus	1397	(1)
Enteroviruses	1397	(1)
SARS Coronavirus	1397	(1)
Other Viral Infections	1397	(1)
Selection of Tests for Rapid Diagnosis	1397	(1)
Serologic Diagnosis of Viral Infections	1397	(6)
Human Immunodeficiency Virus	1398	(1)
Hepatitis B Virus and Epstein-Barr Virus	1399	(2)
Hepatitis A Virus	1401	(1)
Hepatitis C Virus	1401	(1)
Parvovirus	1402	(1)
Herpes Simplex Virus	1402	(1)
Varicella-Zoster Virus	1402	(1)
Cytomegalovirus	1402	(1)
West Nile Virus	1402	(1)
Rubella	1402	(1)
SARS Coronavirus	1402	(1)
Anti-IgM Antibodies	1402	(1)
Miscellaneous Serologic Procedures	1403	(1)
Diagnosis of Other Viral Infections	1403	(1)
Antiviral Susceptibility Testing	1403	(1)
Infections with Chlamydia Species	1403	(4)
Chlamydia trachomatis	1403	(1)
Clinical Features and Epidemiology	1403	(1)
Collection of Specimens	1403	(2)
Isolation of Chlamydia trachomatis in Cell Culture	1405	(1)
Direct Detection of Chlamydia trachomatis in Clinical Specimens	1405	(1)
Serologic Diagnosis	1406	(1)
Other Methods for Diagnosis	1406	(1)
Diagnosis of Sexual Abuse	1406	(1)
Chlamydia psittaci	1406	(1)
Chlamydia pneumoniae	1406	(1)
Infections With Rickettsia, Coxiella, Ehrlichia, and Anaplasma	1407	(13)
Rickettsia and Coxiella	1407	(1)
Clinical Features and Epidemiology	1407	(1)
Collection of Specimens	1408	(1)
Isolation of Rickettsia and Coxiella in Culture	1408	(1)
Direct Detection of Antigen and Nucleic Acid in Clinical Specimens	1409	(1)
Serologic Diagnosis	1409	(1)
Ehrlichia and Anaplasma Species	1409	(11)
Appendix I	1420	(17)
Appendix II	1437
Charts
Chart 1-1 Catalase	1443	(1)
Chart 1-2 Bile-Solubility Test	1443	(1)
Chart 1-3 The Slide Coagulase Test	1444	(1)
Chart 1-4 Indole Test	1445	(2)
Chart 1-5 Cytochrome Oxidase Test	1447	(1)