Table Of ContentCH19 11/28/2012 13:31:2 Page196
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Essential Microbiology
for Pharmacy and
Pharmaceutical
Science
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Companion website
This book is accompanied by a companion website at:
www.wiley.com/go/hanlon/essentialmicrobiology
Visit the website for:
(cid:129) Figures and tables from the book
(cid:129) Interactive multiple choice questions
(cid:129) Links to more detailed reference sources, both printed
and electronic
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Essential Microbiology
for Pharmacy and
Pharmaceutical
Science
Geoffrey Hanlon and Norman Hodges
School of Pharmacy and Biomolecular Sciences,
University of Brighton, UK
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LibraryofCongressCataloging-in-PublicationData
Hanlon,Geoff.
EssentialMicrobiologyforPharmacyandPharmaceuticalScience/GeoffHanlonandNormanHodges.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-470-66532-9(cloth)–ISBN978-0-470-66534-3(pbk.)
I. Hodges,NormanA. II. Title.
[DNLM: 1. MicrobiologicalPhenomena. 2. Anti-InfectiveAgents–pharmacology. 3. Infection–drugtherapy.
4. Infection–microbiology. 5. PharmaceuticalPreparations. 6. PharmacologicalPhenomena.QW4]
615.7092–dc23
2012027340
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Contents
Preface vii
Part I Characteristics of microorganisms
Chapter 1 Themicrobialworld 3
Chapter 2 Handlingandgrowingmicroorganisms 11
Chapter 3 Bacterialstructureandfunction 21
Chapter 4 Mycology:thestudyoffungi 33
Chapter 5 Protozoa 43
Chapter 6 Virusesandviralinfections 49
Chapter 7 Characteristicsofothermicroorganismsandinfectiousagents 57
Part II Microorganisms and the treatment of infections
Chapter 8 Infectionandimmunity 65
Chapter 9 Theselectionanduseofantibiotics 79
Chapter 10 Antibacterialantibiotics 87
Chapter 11 Antifungalagents 95
Chapter 12 Antiviralagents 103
Chapter 13 Antibioticresistance 117
Chapter 14 Antibioticstewardship 127
Part III Microorganisms and the manufacture of medicines
Chapter 15 Bioburdens:counting,detectingandidentifyingmicroorganisms 137
Chapter 16 Antiseptics,disinfectantsandpreservatives 149
Chapter 17 Themanufactureofmedicines:productcontaminationandpreservation 161
Chapter 18 Thedesignofsterilizationprocesses 175
Chapter 19 Sterilizationmethods 183
Chapter 20 Theuseofmicroorganismsinthemanufactureofmedicines 197
Index 209
v
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Preface
Asapharmaceuticalscientist
or practicing pharmacist,
what do we need to know
about microbiology?
Whetheryouarestudyingforadegreeinpharmacyor
arelateddisciplinesuchaspharmaceuticalandchemi-
calsciences,youare, firstandforemost, pharmaceuti-
calscientistsandneedtounderstandthemainfunction
ofprofessionalsworkinginthisfield.Thepharmaceu-
ticalsciencesareaverybroaddisciplineencompassing
The diagram above illustrates that pharmaceutical
everything from the basic sciences to the social sci-
microbiology touches on a number of major aspects in
ences; however, the bottom line is that pharma-
theproductionanduseofmedicinesandwewillbriefly
ceutical scientists are the only professionals with an
deal with each of these in turn.
intimate knowledge of the production and use of
medicines. They are involved at every stage in the
productionofmedicines–fromdrugdiscovery,prod- Production of medicines
uctformulationandmanufacturetoregulatorycontrol
and quality assurance, while pharmacists are specifi- A large number of medicines and medical devices are
callyinvolvedinoverseeingthesafeandeffectiveuseof manufactured as sterile products – for example, injec-
medicinesinthecommunityandinhospital.However, tionsandinfusions,eyedropsandeyeointments,some
regardlessofwhereyourspecificexpertiseresides,itis dressings, catheters and cannulas. Going back in time,
important to have a good knowledge of all stages in therewereanumberofhorrificincidentswhereproducts
the process. that had not been properly sterilized were given to
Withthisinmindwenowneedtounderstandwhere patients, some of whom subsequently died. It is our
pharmaceutical microbiology fits into the picture. responsibilityaspharmaceuticalscientiststounderstand
vii
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viii Preface
theprocessesofsterilizationandasepticmanufactureso theenvironment.Fromapatientperspectiveprobablythe
that patients’ lives are not put at risk. mostimportantroleofthepharmacististounderstandthe
Evenifamedicineisnotasterileproduct,therearestill useofantibiotics–whattheycandoandwhattheycan’t.
requirementsforittobemanufacturedinsuchawayasto Forinstance,anantibioticsuchasamoxicillinwouldbeof
restrictmicrobialcontamination,andqualitycontrolpro- no use in treating a patient with a viral sore throat or a
cedures including bioburden determination and environ- fungal lung infection. Indeed we need to gofurther and
mental monitoring are pivotal to achieve this. Many understand why an antibacterial antibiotic such as ben-
products,suchascreams,lotionsandliquidoralproducts, zylpenicillinwouldbeineffectiveintreatingapatientwith
areopenedandusedonanumberofseparateoccasions.In aGram-negativebacteraemia.Anincreasinglyimportant
order to protect the product and the patient we need to issueandonethatwillplayamajorpartinthecareerofany
incorporateantimicrobialpreservativesintothesemedicines pharmacistorpharmaceuticalscientististhatofantibiotic
andunderstandwhatinfluencestheirefficacy. resistance.Manyoftheantibioticsthatwehavecometo
While we spend a lot of time trying to eliminate relyuponarelosingtheirusefulnessascertainpathogens
microorganismsfromourenvironmentandtheproducts developmechanisms to resist their effects. Some clinical
we make, it should not be forgotten that they are also isolates of Pseudomonas aeruginosa, Acinetobacter bau-
responsiblefortheproductionofanumberofveryuseful mannii and Mycobacterium tuberculosis havebeen found
materials.Theseincludeantibiotics,steroids,insulinand whichareresistanttovirtuallyallofthestandardantibiotic
otherrecombinantproteins,aminoacids,organicacids, therapies. How these infections can be managed in the
enzymes and polysaccharides. future requires a clear understanding of the basics of
microbiology.
Understanding infection Controlling microorganisms in the environment by
the use of disinfectants and antiseptics has become
increasingly crucial as we understand more about the
Itisnottheroleofapharmaceuticalscientisttodiagnose
role of microbes in infection. The use ofalcohol gelsin
infections; that is the job of the clinician, but it is
hospitals has become the norm and the public has
important that we have a clear understanding of viral,
become more aware of the importance of disinfection
fungalandbacterialdiseases.Thereasonthisisimportant
aroundthehome.Disinfectantsarethemaintoolindeep
isbecauseitcriticallyinfluencesthechoiceofmedication
cleaningproceduresappliedfollowingoutbreaksofinfec-
tobeusedinthemanagementofthedisease.Knowingthe
tionssuchasMRSAandClostridiumdifficileinhospitals.
characteristics of different pathogens, the diseases they
Pharmacistswillplayaroleinimplementingthesestrat-
cause and the most suitable management protocols is
egiesandwillneedtobeinapositiontoprovideadvice
criticalforourroleintheinfectioncontrolteam.Partof
on all of these scenarios.
our daily professional routine may be to discuss treat-
mentoptionswithclinicalcolleaguesandwehavetobe
able to speak their language. The scope of this book
We also need to understand how the body reacts to
infectiousagentssothatwecanadvisepatientsonhowto
ThisbookcoversthemicrobiologycontentoftheRoyal
dealwiththeirsymptoms.Manypatientswillpresentwith
Pharmaceutical Society’s syllabus for Pharmacy degrees
minorconditionssuchascoughsandcolds,skininfections,
intheUKwhichisequallyrelevanttothosestudyingthe
gastro-intestinalproblemssuchasdiarrhoeaandvomiting
pharmaceuticalandchemicalsciences.Itisnotintended
andweneedtounderstandwhatisgoingoninordertogive
togiveacomprehensivecoverageofthewholesubjectbut
them the best advice. Moreover, we are seeing increasing
instead to be an easily digestible outline of the most
numbers of patients with compromised immune systems
important features. If the reader requires further infor-
and so it is necessary to understand why these are more
mationonanyofthesubjects,thewebsiteassociatedwith
susceptibletoinfectionandhowthismightbemanaged.
thisbookgivesexamplesofwherethismaybefound,and
in addition it contains a range of multiple choice ques-
Control of microbes
tionstoallowareadertochecktheirunderstandingofthe
material.
Anunderstandingofthecontrolofmicrobesisrelevantin
termsofpatienttreatmentandalsocontrolofmicrobesin Geoffrey Hanlon and Norman Hodges
