Infection and microbiology followed different strands of development for centuries (Fig. 1.1).

We
tend to map this story against the recorded efforts of prominent individuals, though many others
doubtless contributed. Ideas of infection and epidemics were recorded by Hippocrates, but it was
nearly 2000 years before Girolamo Fracastoro (1478-1553) proposed in his classic tome 'De
Contagione' that 'seeds of contagion' (as opposed to spirits in the ether) might be responsible. Quite
separately, the early microscopists began to make observations on objects too small to be seen by
the naked eye. Foremost among these was the Dutchman Antonie van Leeuwenhoek (1632-1723).
With his remarlcable homemade and handheld microscope, he found many microorganisms in
materials such as water, mud, saliva and the intestinal contents of healthy subjects and recognised
them as living creatures ('animalcules') because they swam about actively. That he saw bacteria as
well as the larger microbes is known from his measurements of their
Bacteria are deceptively simple in structure. They are pro karyotic organisms, which are simple
unicellular organ isms with no nuclear membrane, mitochondria, Golgi bodies, or endoplasmic
reticulum, that reproduce by asex ual division. Most bacteria have either a gram-positive cell wall
with a thick peptidoglycan layer, or a gram-negative cell wall with a thin peptidoglycan layer and an
overlying outer membrane. Bacteria, such as Mycobacterium tubercu losis have more complex cell
walls and others lack this cell wall structure and compensate by surviving only inside host cells or in a
hypertonic environment. The size (1 to 20 µm or larger), shape (spheres, rods, and spirals), and spa
tial arrangement (single cells, chains, and clusters) of the cells are used for the preliminary
classification of bacteria, and the phenotypic and genotypic properties of the bacteria form the basis
for the definitive classification
The unique properties of viruses set them apart from liv ing creatures. Viruses lack many of the
attributes of cells, including the ability to self-replicate. Only when it infects a cell does a virus
acquire the key attribute of a living system— reproduction. Viruses are known to infect a wide
variety of plant and animal hosts as well as protists, fungi, and bacteria. However, most viruses are
restricted to infecting specific types of cells of only one host species, a property known as “tropism”.
Recently, viruses called virophages have been discovered that infect other viruses. Host–virus
interactions tend to be highly specific, and the biologic range of viruses mirrors the diversity of
potential host cells. Further diversity of viruses is exhibited by their broad array of strategies for
replication and survival.

Many algae (al′je; singular: alga) are single-celled micro scopic organisms, but some marine algae are
large, rela tively complex, multicellular organisms. Unlike bacteria, algae have a clearly defined cell
nucleus and numerous membrane-enclosed intracellular structures. All algae photosynthesize their
own food as plants do, and many can move about. Algae are widely distributed in both fresh water
and oceans. Because they are so numerous and because they capture energy from sunlight in the
food they make, algae are an important source of food for other organisms. Algae are of little
medical importance; only one species, Prototheca, has been found to cause disease in humans.
Having lost its chlorophyll, and there fore the ability to produce its own food, it now makes meals of
humans.

The process of making a microbiological diagnosis has many component steps. All of these must be
understood and optimized if the laboratory is to collaborate fully with the clini cian in achieving the
best outcome for the patient. The process begins when the clinician meets the patient, takes a
history and performs a clinical examination. The clinician forms a hypothesis about the cause of the
patient's complaint: the differential diagnosis. With this hypothesis a diagnostic plan must be
constructed which will include laboratory, radiological and other investigations. At this point the
clinical microbiologist may be contacted and discussions may lead to the development of the
differential diagnosis. The clinical microbiologist can also advise on the most appropriate
investigations, how the speci mens should be sent and may also give advice on empirical therapy.