Murray - Medical Microbiology 8th Edition c2016
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Murray - Medical Microbiology 8th Edition c2016


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MEDICAL MICROBIOLOGY
NOTE TO INSTRUCTORS:
Contact your Elsevier Sales Representative for teaching 
resources, including slides and image banks, for Medical 
Microbiology, 8e, or request these supporting materials at: 
http://evolve.elsevier.com/Murray/microbiology/
http://evolve.elsevier.com/Murray/microbiology/
MEDICAL MICROBIOLOGY
8TH EDITION
PATRICK R. MURRAY, PhD
Senior Worldwide Director, Scientific Affairs
BD Diagnostics Systems
Sparks, Maryland;
Adjunct Professor, Department of Pathology
University of Maryland School of Medicine
Baltimore, Maryland
KEN S. ROSENTHAL, PhD
Professor of Biomedical Sciences
Director of Microbiology and Immunology
Roseman University of Health Sciences College of Medicine
Las Vegas, Nevada;
Emeritus Professor
Northeastern Ohio Medical University
Rootstown, Ohio
MICHAEL A. PFALLER, MD
Chief Medical Officer
T2 Biosystems
Lexington, Massachusetts;
Professor Emeritus
University of Iowa College of Medicine and College of Public Health
Iowa City, Iowa
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
MEDICAL MICROBIOLOGY, EIGHTH EDITION ISBN: 978-0-323-29956-5
Copyright © 2016, Elsevier Inc. All rights reserved.
Previous editions copyrighted 2013, 2009, 2005, 2002, 1998, 1994, 1990.
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Publisher\u2019s permissions policies and our arrangements with organizations such as the Copyright Clearance 
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This book and the individual contributions contained in it are protected under copyright by the Publisher 
(other than as may be noted herein).
Notices
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our understanding, changes in research methods, professional practices, or medical treatment may become 
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Library of Congress Cataloging-in-Publication Data
Murray, Patrick R., author.
 Medical microbiology / Patrick R. Murray, Ken S. Rosenthal, Michael A. Pfaller ; consultant, JMI 
Laboratories.\u20148th edition.
 p. ; cm.
 Includes bibliographical references and index.
 ISBN 978-0-323-29956-5 (pbk. : alk. paper)
 I. Rosenthal, Ken S., author. II. Pfaller, Michael A., author. III. Title.
 [DNLM: 1. Microbiology. 2. Microbiological Techniques. 3. Parasitology. QW 4]
 QR46
 616.9\u2032041\u2014dc23
 2015030867
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Content Development Manager: Kathryn DeFrancesco
Publishing Services Manager: Catherine Jackson
Project Manager: Rhoda Howell
Design Direction: Brian Salisbury
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
http://www.elsevier.com/permissions
\u2022 	To all who use this textbook, that they may benefit from its 
use as much as we did in its preparation
vii
Our knowledge about microbiology and immunology is constantly growing, and by building a good foundation 
of understanding in the beginning, it will be much easier to 
understand the advances of the future.
Medical microbiology can be a bewildering field for the 
novice. We are faced with many questions when learning 
microbiology: How do I learn all the names? Which infec-
tious agents cause which diseases? Why? When? Who is at 
risk? Is there a treatment? However, all these concerns can 
be reduced to one essential question: What information do 
I need to know that will help me understand how to diag-
nose and treat an infected patient?
Certainly, there are a number of theories about what a 
student needs to know and how to teach it, which supposedly 
validates the plethora of microbiology textbooks that have 
flooded the bookstores in recent years. Although we do not 
claim to have the one right approach to teaching medical 
microbiology (there is truly no one perfect approach to 
medical education), we have founded the revisions of this 
textbook on our experience gained through years of teaching 
medical students, residents, and infectious disease fellows, as 
well as on the work devoted to the seven previous editions. 
We have tried to present the basic concepts of medical 
microbiology clearly and succinctly in a manner that 
addresses different types of learners. The text is written in a 
straightforward manner with, it is hoped, uncomplicated 
explanations of difficult concepts. In this edition, we chal-
lenged ourselves to improve the learning experience even 
more. We are using the new technology on StudentConsult.
com (e-version) to enhance access to the material. New to 
this edition, chapter summaries and learning aids are placed 
at the beginning of each of the microbe chapters, and on the 
e-version these are keyed to the appropriate sections in the 
chapter. In addition, many of the figures are enhanced to 
assist learning. Details are summarized in tabular format 
rather than in lengthy text, and there are colorful illustra-
tions for the visual learner. Clinical Cases provide the rele-
vance that puts reality into the basic science. Important 
points are emphasized in boxes to aid students, especially in 
their review, and the study questions, including Clinical 
Cases, address relevant aspects of each chapter. Each section 
(bacteria, viruses, fungi, parasites) begins with a chapter that 
summarizes microbial diseases, and this also provides review 
material.
Our understanding of microbiology and immunology is 
rapidly expanding, with new and exciting discoveries in all 
areas. We used our experience as authors and teachers to 
choose the most important information and explanations for 
inclusion in this textbook. Each chapter has been carefully 
updated and expanded to include new, medically relevant 
discoveries. In each of these chapters, we have attempted to 
present the material that we believe will help the student gain 
an interest in as well as a clear understanding of the signifi-
cance of the individual microbes and their diseases.
With each edition of Medical Microbiology we refine and 
update our presentation. There are many changes to the 
eighth edition, both in the print and e-versions of the book. 
The book starts with a general introduction to microbiology 
and new chapters on the human microbiome and epidemiol-
ogy of infectious diseases. The human microbiome (that is, 
the normal population of organisms that populate our 
bodies) can now be considered as another organ system with 
10 times as many cells as human cells. This microbiota edu-
cates the