Microbiology is fundamental to understanding infectious diseases, a major component of medical practice worldwide. From diagnosing infections to selecting appropriate antimicrobial therapy, microbiological knowledge underpins clinical decision-making. This comprehensive guide covers essential bacterial and viral concepts that every medical student must master for both examinations and clinical practice.
Bacterial Classification
Gram Staining
The cornerstone of bacterial identification:
Gram Positive Bacteria:
- Thick peptidoglycan layer
- Stains purple/blue
- Examples: Staphylococcus, Streptococcus, Clostridium, Bacillus
Gram Negative Bacteria:
- Thin peptidoglycan layer with outer lipopolysaccharide membrane
- Stains pink/red
- Examples: E. coli, Pseudomonas, Salmonella, Neisseria
- More resistant to antibiotics due to outer membrane
Learn more about laboratory techniques at NCBI Microbiology.
Bacterial Shapes
- Cocci: Spherical (Staphylococcus, Streptococcus)
- Bacilli: Rod-shaped (E. coli, Bacillus)
- Spirilla: Spiral-shaped (Treponema pallidum)
- Vibrio: Comma-shaped (Vibrio cholerae)
Important Bacterial Pathogens
Staphylococcus aureus
- Gram-positive cocci in clusters
- Coagulase positive
- Causes: Skin infections, pneumonia, endocarditis, osteomyelitis
- MRSA: Methicillin-resistant S. aureus - major healthcare concern
- Treatment: Vancomycin for MRSA, beta-lactams for sensitive strains
Streptococcus pyogenes (Group A Strep)
- Gram-positive cocci in chains
- Beta-hemolytic
- Causes: Pharyngitis, cellulitis, rheumatic fever, glomerulonephritis
- Treatment: Penicillin (drug of choice)
Escherichia coli
- Gram-negative rod
- Part of normal gut flora
- Pathogenic strains: ETEC, EHEC (O157:H7), UPEC
- Causes: UTI, gastroenteritis, neonatal meningitis
- Treatment: Varies by strain and resistance pattern
Mycobacterium tuberculosis
- Acid-fast bacillus (Ziehl-Neelsen stain)
- Causes tuberculosis - major global health burden
- Transmission: Airborne droplets
- Diagnosis: Sputum AFB, chest X-ray, tuberculin test
- Treatment: RIPE therapy (Rifampin, Isoniazid, Pyrazinamide, Ethambutol)
For clinical examination of TB patients, see our Clinical Examination Guide.
Viral Infections
DNA Viruses
- Herpesviruses: HSV-1/2, VZV, EBV, CMV - latent infections
- Hepatitis B: Chronic hepatitis, cirrhosis, hepatocellular carcinoma
- HPV: Cervical cancer, genital warts
- Adenovirus: Respiratory infections, conjunctivitis
RNA Viruses
- Influenza: Seasonal epidemics, antigenic drift and shift
- HIV: AIDS, opportunistic infections
- Hepatitis C: Chronic hepatitis, cirrhosis
- SARS-CoV-2: COVID-19 pandemic
- Dengue, Chikungunya: Mosquito-borne viral fevers
Antimicrobial Therapy
Beta-lactam Antibiotics
- Penicillins: Benzylpenicillin, amoxicillin, flucloxacillin
- Cephalosporins: 1st to 5th generation - increasing Gram-negative coverage
- Carbapenems: Imipenem, meropenem - broad spectrum, reserved for severe infections
- Mechanism: Inhibit cell wall synthesis
- Resistance: Beta-lactamase production
Other Important Antibiotics
- Aminoglycosides: Gentamicin - Gram-negative coverage, nephrotoxic
- Macrolides: Azithromycin, clarithromycin - atypical pathogens
- Fluoroquinolones: Ciprofloxacin, levofloxacin - broad spectrum
- Glycopeptides: Vancomycin - MRSA, C. difficile
For drug interactions, review our Pharmacology Guide.
Antimicrobial Resistance
A growing global health crisis:
- MRSA: Methicillin-resistant Staphylococcus aureus
- VRE: Vancomycin-resistant Enterococcus
- ESBL: Extended-spectrum beta-lactamase producers
- CRE: Carbapenem-resistant Enterobacteriaceae
- MDR-TB: Multi-drug resistant tuberculosis
Prevention strategies include antibiotic stewardship, infection control, and appropriate prescribing. Learn more at CDC Antibiotic Use.
Diagnostic Microbiology
Culture Methods
- Blood agar, MacConkey agar, Chocolate agar
- Selective and differential media
- Aerobic vs anaerobic culture
Molecular Diagnostics
- PCR: Rapid detection of pathogens
- NAAT: Nucleic acid amplification tests
- Sequencing: Strain identification and resistance genes
Serology
- Antibody detection (IgM for acute, IgG for past infection)
- Antigen detection tests
Infection Control
- Hand hygiene: Single most important measure
- PPE: Gloves, gowns, masks, eye protection
- Isolation precautions: Contact, droplet, airborne
- Sterilization: Autoclaving, chemical disinfection
External Resources
- NCBI - Medical Microbiology
- CDC - Antibiotic Use and Resistance
- WHO - Antimicrobial Resistance
- AMBOSS Microbiology
Conclusion
Microbiology is essential for understanding infectious diseases and selecting appropriate treatment. Regular practice with culture identification, antibiotic selection, and resistance patterns will prepare you for clinical practice. Test your knowledge with our Question Bank and explore more topics in our blog section.