Microbiology: The Human Experience

Book Preface

When we began writing this textbook, we asked ourselves whether a new introductory microbiology textbook was needed at all. Could we create a book with a fresh look and more vibrant appeal for the allied health and non–science major students taking the course? We studied the approaches taken by other textbooks and reflected on how we, ourselves, teach micro-biology to health career students. Our conclusion was that the cur-rently available textbooks do not fully realize a truly human-centric approach. We believe that this is a missed opportunity, for what could be more captivating than learning how tiny, unseen, living things can so greatly influence human life and death? As a result, we decided to write our book so that human experiences drive all discussions, from basic microbiological concepts to infectious diseases.
Learning the basic concepts of microbiology from a human health perspective is something we find allied health students really enjoy. After all, microbiology as a science was forged largely from a desire to ease human suffering, so why not embrace that theme while teaching microbiology to students who share that desire? From the death of a small child with measles to the pneumonia that killed an elderly grandparent, infectious diseases have been a driv-ing force in our biological and intellectual evolution for millions of years. Even today, infectious diseases kill two-thirds of the nearly 9 million children who die each year. Understanding how microbes live, grow, and die is a good way to gain some control over our own mortality.
We find that students interested in pursuing health careers become energized when aspects of medicine are injected early and often. In Chapter 2, for instance, we quickly introduce the basics of infectious disease and then employ multiple case histories to illustrate those concepts. This strategy, pairing the explanation of core microbiology concepts with applications to medicine and human health, is maintained throughout the book. More than 100 clinical case histories propel coverage of basic microbiological con-cepts such as microbial growth, metabolism, genetics, differentia-tion, ecology, and immunology. The chapters on immunology, for instance, take the novel approach of using patient case histories to highlight what happens when one part of the immune system fails and then build a discussion of the immune system around those fail-ures. Cases in every chapter provide a window through which stu-dents can unravel the mystery of infections: how they happen, how they are diagnosed, and how they are treated. Sections of several chapters also reveal important connections between the environ ment, climate change, and emerging infections, a growing concern among national and world health organizations.
Many features of our book lend themselves to new as well as tra-ditional teaching paradigms. The writing style is engaging and con-versational and includes a touch of humor to drive learning. Clearly written explanations and a lavish art program support the “flipped” classroom approach in which students learn independently through reading before attending interactive classroom sessions. The case histories themselves can be used to design innovative, team-based, active-learning exercises. We also know that health career stu-dents learn microbiology most easily when it relates to their own infectious disease experiences. Toward that end, frequent thought exercises embedded in each chapter revolve around infections that students may have had or may wonder about. These exercises link concepts from earlier chapters while developing a student’s critical thinking skills. For these and many other reasons, we think you will find the pedagogical tools included in this book superior to those of other undergraduate allied health textbooks.
Over the years, we have taught microbiology to a wide vari-ety of undergraduate, graduate, and health career students. But beyond that, we’ve listened to dozens of colleagues and thousands of students over the past decade while we wrote. Each comment and criticism helped us create a textbook of microbiology that truly embraces the human experience.

John W. Foster Zarrintaj (Zari) Aliabadi Joan L. Slonczewski

Major Features
CHAPTER-OPENING CASE HISTORIES Each chapter opens with an elegantly illustrated case history that sets the theme. For exam-ple, the chapter on biochemistry (Chapter 4) begins with a small boy stricken with cholera; our chapter on bacterial growth (Chapter 6) starts with a newborn suffering from meningitis; and the bacterial metabolism chapter (Chapter 7) begins with a college student vaca-tioning in Mexico who contracts shigellosis. Later, we explain how these cases connect to the basic concepts presented in the chapter.
CHAPTER AND SECTION OBJECTIVES Every chapter begins with a set of objectives that outline the major concepts that will be cov-ered in the following pages. The chapter objectives are followed by individual section objectives and section summaries that alert stu-dents about what they should be able to explain, discuss, and com-pare after reading each section.
CONCEPTUAL LEARNING THROUGH EMBEDDED CASE HIS-TORIES In addition to the chapter-opening cases, there are more than 100 patient cases integrated into this textbook. Some are real, some are embellished, but all of them convey the human toll of infectious disease and why we as a species chose to explore the hid-den world of microbes in the first place. Each story provides a focal point for discussing:

• Basic concepts of microbiology (Chapters 1–13) such as microbe structure, genetics, biochemistry, biotechnology, antibiotics, and disinfectants
• The human microbiome and our immune responses
to infection (Chapters 14–17). Topics include innate immunity, adaptive immunity, immunological diseases, and immunological tools
• Microbial pathogenesis and infectious diseases by organ system (Chapters 18–24), including skin, respiratory, systemic, gastrointestinal, urinary, reproductive, and central nervous systems
• Clinical microbiology and epidemiology (Chapters 25 and 26)
• Environmental and food microbiology (Chapter 27)

The cases not only provide a framework for concept building, but repeatedly outline how diseases are diagnosed and how they are tracked and treated. Some cases explore the intimate connections between evolution and emerging diseases; between climate change and epidemiology; and between the immune system and the sever-ity of disease.
BACKWARD AND FORWARD LINKS An important part of learn-ing is to connect new concepts to earlier ones. Toward that end we have placed a series of links within each chapter that recap rele-vant concepts presented in earlier chapters and sometimes foretell important concepts. The links redirect students to relevant sections of the book if they need to refresh their knowledge.
END-OF-CHAPTER ASSESSMENT QUESTIONS Questions at the end of each chapter are tied to learning outcomes for each section and allow students to quickly evaluate their mastery of the material.
THOUGHT QUESTIONS Opportunities for critical thinking are central to student learning. Scattered throughout every chapter are eight to ten thought questions that help students think about the concepts they just read and connect them to concepts in other chap-ters. Answers to these questions are sometimes difficult but always insightful; and if students get stumped, the answers can be found at the end of the chapter.

CLINICAL CORRELATION QUESTIONS Because this textbook was designed in large part for students interested in health sci-ence careers, each chapter ends with clinical correlation questions. These questions are designed around clinical scenarios that stu-dents must evaluate by explaining how they would diagnose, treat, or track a pathogen.
THE ORGAN SYSTEM APPROACH TOWARD TEACHING INFEC-TIOUS DISEASE There are two basic ways infectious diseases are taught: the taxonomic approach, in which all the diseases a single microbe can cause are presented together, and the organ system approach, which focuses on an individual organ system and the array of pathogens that infect it. From the health care provider’s stand-point, the organ system approach is the most useful way in which information on infectious disease is compiled because it reflects how a clinician interacts with a patient. Sick patients visiting a clinician will describe their symptoms (“I have a fever, cough, and chest pain”). This tells the clinician which organ system is principally involved (the respiratory system in this case). Then the clinician, knowing what pathogens can infect that organ system, will collect appro-priate clinical samples to scientifically confirm the microbiological cause and, while waiting for that result, prescribe an antibiotic, if called for, that can stop the growth of the most likely pathogens. In this textbook, we use the organ system approach in a way that does not require the instructor to learn medicine, yet hooks the student on learning microbiology through real-world medical examples.
Art Program
The vast majority of concepts introduced in our book take place at a scale not visible to the naked eye. Yet, one of the most important skills introductory students can master is the ability to visualize key microbial processes and structures. As a result, we focused consid-erable effort on making sure that the images selected and developed for our book achieve the highest level of visual engagement and ped-agogical value.

• Figures depicting processes and structures are colorful and engaging and include helpful bubble captions that provide essential information students need to learn from the figure.
• Meticulously designed life cycle figures combine drawn art, photographs, and a system of helpful schematic arrows that convey the key steps in the progression of important diseases.
• Carefully chosen micrographs include scale bars with size information and an acronym indicating the kind of microscope used to capture the image.
• Ample images of the physical manifestations of disease on the human body draw students in and help future clinicians become comfortable recognizing the outward signs of import-ant diseases.