최신진단미생물학 7판 > Microbiology

제 7 판 머리말

제6판을 낸 것이 5년 전인 2017년이다. 제7판에는 특히 세 가지가 추가되었다. 사람 microbiome의 다양성 변화가 건강에 영향을 줄 수 있음이 알려지고 있다. 이 분야는 임상미생물 검사와는 관계가 적지만 꼭 필요한 지식이라 추가하였다.
2019년 중국에서 시작된 COVID-19가 전세계에서 단기간에 많은 희생자를 내었다. 이 세계적유행(pandemic)에 대처하기 위해 새로운 mRNA 백신을 1년만에 개발하였고, 국내외 회사들은 PCR 시약을 재빠르게 개발하였으며, 여러 나라의 진단검사자들은 수많은 검체를 날마다 단시간에 검사할 수 있는 능력을 보였다. 이에 관한 과학적 사실들을 추가하였다.
미생물의 분류명이 바뀌면 임상의사와 미생물검사자가 혼동을 일으킬 수 있다. 예를 들면, 아포생성 산소성 그람양성 막대균 모두가 Bacillus속이었으나 이제는 그 중 일부가 Paenibacillus 등으로 바뀌었다.
Staphylococcus속에는 산소성 세균뿐 아니라 무산소성인 Staphylococcus saccharolyticus가 들어 있게 되었다.
Brucella속 25종 중 24종은 브루셀라증의 원인균이 아니다. 분류명 변경으로 인한 혼동을 줄이기 위해 병원성 세균과 진균의 문부터 종까지의 분류표를 실었다.
이 책의 목표는 1988년 첫판이나 지금이나 같다. 외국어판 상세한 진단미생물학 서적이 많으나, 임상미생물학을 처음 배우거나 미생물 검사를 담당하는 이들에게 우리글로 요약된 길잡이가 되고, 필요하면 상세한 외국문헌을 이용할 수 있게 하기 위함이다.
제7판에서도 범위를 ~로 표시하고, 소괄호 ( )를 위 단어에 붙이고, 단위를 숫자에 붙이는 등의 우리말 맞춤법이나 문장부호의 사용을 따르지 않았다. 독자가 영문 문헌을 읽을 때 혼선을 피하도록 ~를 근사치 기호로 썼고, 소괄호 안의 대부분이 참고문헌이므로 떼어서 썼고, tetracycline 내성 유전자 tet(M)은 규칙대로
괄호를 붙여서 썼다. Aspergillus를 우리글로 아스페르길루스로 쓰지만 종명까지 우리글로 쓰는 것은 독해에 도움이 안 된다. 마찬가지로 영자 표기가 비슷한 여러가지 항균제를 발음에 따라서 우리글로 쓰는 것 역시 독해에 도움이 되지 않는다. 따라서 이들은 영자로 썼다. 그러나 우리말 세균명이나 병명은 포도알균, 장티푸스와 같이 한글로 썼다. 저자명, 잡지명, 권과 페이지를 알면 인터넷에서 참고문헌을 대개 찾을 수 있기에 본문이나 표의 각주에는 제목 없이 위와 같은 내용만 표시하였다. 반복 인용된 학술지인 Antimicrob Agents Chemother (AAC), Clin Infect Dis (CID), Clin Microbiol Rev (CMR), Emerg Infect Dis (EID), J
Antimicrob Chemother (JAC) 등은 익숙한 괄호 안의 약어를 썼다. 우리나라 연구자 중에는 같은 영자 성씨가 많아서 구별을 위해 성씨와 함께 이름의 약자도 썼고 가능하면 연구자명 모두를 실었다.
개정판을 위해, 제2장 사람의 microbiome을 담당한 염종화 교수, 제11장 Mycobacterium을 담당한 김명숙 박사, 제26장 바이러스를 담당한 이혁민 교수, 제26장 감염증 진단을 담당한 박윤희 교수를 새 저자로 모시었다.
순천향대학교 의료과학대학 임상병리학과 학과장 이학박사 엄용빈 교수님은 제6판에서 저자들이 못 찾은 오류를 많이 찾아 주셔서 좀 더 완벽한 제7판을 낼 수 있었기에 감사의 말씀을 드린다.
진단미생물학을 배우거나, 미생물 검사를 담당하는 분들께 이 책이 작은 도움이라도 되면 저자들에게 큰 보람이 되겠다. 제7 개정판은 많은 부분을 새로 썼기에 오류가 적지 않을 것이 염려된다. 작은 오류라도 지적해 주시면 감사하겠다.

2022년 9월
저자들 

제 1 장 진단미생물학 서론ㆍ11
1. 진단미생물학의 영역 ······························································································ 11
2. 미생물 검사에 따른 생물재해 ················································································ 12
3. 정도관리 ················································································································· 20
제 2 장 감염증 진단을 위한 기초미생물학ㆍ28
1. 미생물의 분류 ········································································································ 28
2. 세균의 유전, 물질대사 및 구조 ············································································· 30
3. 사람의 microbiome ······························································································ 40
제 3 장 병원성 세균과 비병원성 세균ㆍ47
1. 신체 각 부위에서 관찰되는 미생물 ······································································· 47
2. 숙주와 미생물의 관계 ···························································································· 49
제 4 장 미생물 검사의 진행ㆍ67
1. 검체의 채취와 처리 ································································································ 67
2. 검체의 직접 검사 ··································································································· 75
3. 미생물 배양 ············································································································ 85
4. 임상검체별 미생물 검사 ························································································· 89
제 5 장 미생물의 동정ㆍ130
1. 표현형에 의한 균종 동정 ····················································································· 130
2. 감염 진단을 위한 면역학적 시험 ········································································· 135
3. 분자생물학적 미생물 검사 ··················································································· 147

제 6 장 Staphylococcus , Micrococcus 및 그 밖의 catalase 양성 알균ㆍ171
1. 분 류 ···················································································································· 171
2. 감 염 ···················································································································· 172
3. 세균 검사 ············································································································· 175
4. 역학 조사를 위한 시험 ························································································ 179
5. 주요 균증 ············································································································· 179
6. 항균제 감수성 ······································································································ 180
제 7 장 Streptococcus , Enterococcus 및 그 밖의 catalase 음성 그람양성 알균ㆍ184
1. 분 류 ···················································································································· 184
2. 감 염 ···················································································································· 185
3. 세균 검사 ············································································································· 189
4. A군 사슬알균 혈청항체 시험 ··············································································· 203
5. 항균제 감수성 ······································································································ 204
제 8 장 Bacillus와 유관세균ㆍ207
1. 분 류 ···················································································································· 207
2. 산소성 그람양성 막대균의 균속 추정 ·································································· 209
3. 감 염 ···················································································································· 209
4. 세균 검사 ············································································································· 211
5. 항균제 감수성 ······································································································ 215
제 9 장 산소성 무아포 그람양성 막대균ㆍ217
1. Listeria ················································································································ 217
2. Erysipelothrix ····································································································· 221
3. Corynebacterium 및 유사 세균 ········································································ 224
제 10 장 Nocardia와 유사 세균ㆍ237
1. 분 류 ···················································································································· 237
2. 감 염 ···················································································································· 239
3. 세균 검사 ············································································································· 241
4. 항균제 감수성 ······································································································ 248

제 11 장 Mycobacteriumㆍ250
1. 분류와 성상 ········································································································· 250
2. 감 염 ···················································································································· 250
3. 실험실 안전 ········································································································· 256
4. 결핵균 검사 ········································································································· 256
5. 나균 검사 ············································································································· 274
제 12 장 Enterobacteralesㆍ278
1. 분 류 ···················································································································· 278
2. 감 염 ···················································································································· 281
3. 배 양 ···················································································································· 285
4. 생화학적 시험 ······································································································ 292
5. 균종 동정 ············································································································· 297
6. 주요 균종과 항균제 감수성 ················································································· 302
제 13 장 Vibrio 및 유관 세균ㆍ310
1. 분류와 성상 ········································································································· 310
2. 감 염 ···················································································································· 311
3. 검체 채취와 수송 ································································································· 314
4. 직접 검사 ············································································································· 314
5. 배 양 ···················································································································· 315
6. 균종 동정 ············································································································· 315
7. 항균제 감수성 ······································································································ 320
제 14 장 Aeromonasㆍ323
1. 분류와 성상 ········································································································· 323
2. 감 염 ···················································································································· 323
3. 세균 검사 ············································································································· 325
4. 항균제 감수성 ······································································································ 327
제 15 장 포도당 비발효 그람음성 막대균ㆍ330
1. 분 류 ···················································································································· 330
2. 감 염 ···················································································································· 331
3. 균종 동정 ············································································································· 332
4. 주요 균종 ············································································································· 341
제 16 장 Neisseriaㆍ354
1. 분 류 ···················································································································· 354
2. Neisseria gonorrhoeae ···················································································· 355
3. Neisseria meningitidis ····················································································· 363
4. 그 밖의 Neisseria 균종 ····················································································· 365
제 17 장 Haemophilusㆍ368
1. 분 류 ···················································································································· 368
2. 감 염 ···················································································································· 368
3. 세균 검사 ············································································································· 370
4. 항균제 감수성 ······································································································ 376
제 18 장 Legionellaㆍ379
1. 분 류 ···················································································································· 379
2. 감 염 ···················································································································· 380
3. 세균 검사 ············································································································· 381
4. 혈청학적 진단 ······································································································ 383
5. 항균제 감수성 ······································································································ 384
제 19 장 그 밖의 그람음성 막대균 및 짧은막대균ㆍ385
1. 분 류 ···················································································································· 385
2. Brucella ·············································································································· 386
3. Bordetella ··········································································································· 389
4. Eikenella corrodens ························································································· 393
5. Kingella ··············································································································· 394
6. Cardiobacterium hominis ················································································ 395
7. Suttonella ··········································································································· 396
8. Aggregatibacter ································································································· 396
9. Actinobacillus ···································································································· 398
10. Francisella tularensis ····················································································· 399
11. Pasteurella ······································································································· 401
12. Chromobacterium violaceum ······································································· 403
13. Capnocytophaga ····························································································· 404
14. Dysgonomonas ······························································································· 405
15. Streptobacillus ································································································ 405

제 20 장 Campylobacter 와 Helicobacterㆍ408
1. 분 류 ···················································································································· 408
2. Campylobacter ·································································································· 409
3. Helicobacter ······································································································ 414
제 21 장 나선균ㆍ421
1. Leptospira ·········································································································· 421
2. Treponema ········································································································· 425
3. Borrelia ··············································································································· 429
4. “Spirillum minus” ····························································································· 431
제 22 장 무산소성 세균의 분리와 동정ㆍ432
1. 산소와 세균 증식의 관계 ····················································································· 432
2. 무산소성 정상균 무리 ·························································································· 434
3. 무산소성 세균 감염 ····························································································· 434
4. 무산소성 세균 검사용 검체 ················································································· 435
5. 검체의 직접 검사 ································································································· 436
6. 무산소성 배양 ······································································································ 436
7. 무산소성 세균의 동정 ·························································································· 440
제 23 장 임상검체에서 분리되는 무산소성 세균ㆍ446
1. 그람양성 알균 ······································································································ 446
2. 그람음성 알균 ······································································································ 449
3. 그람음성 막대균 ··································································································· 450
4. Clostridium ········································································································ 460
5. 아포비형성 무산소성 그람양성 막대균 ································································ 473
제 24 장 Rickettsia , Chlamydia , Mycoplasma 및 기타 세포 내 증식 세균ㆍ482
1. 분 류 ···················································································································· 482
2. Rickettsia ··········································································································· 483
3. Coxiella burnetii ································································································ 488
4. Bartonella ··········································································································· 489
5. Ehrlichia와 Anaplasma ····················································································· 490
6. “Tropheryma whipplei ” ··················································································· 491
7. Chlamydia ·········································································································· 491

8. Mycoplasma 등 ································································································· 495
9. Ureaplasma ········································································································ 497
제 25 장 진균 검사ㆍ502



1. 분류와 형태 ········································································································· 502
2. 진균감염증의 진단 ······························································································· 505
3. 부위별 진균 감염증 ····························································································· 516
4. 효모형 진균 ········································································································· 519
5. 균사형 진균 ········································································································· 530
6. 폐포자충 ··············································································································· 552
제 26 장 바이러스 감염증의 진단과 전염성 해면뇌병증ㆍ558
1. 바이러스의 특징 ··································································································· 558
2. 바이러스 감염증 ··································································································· 563
3. 미생물학적 진단 ··································································································· 588
4. 전염성 해면뇌병증 ······························································································· 597
제 27 장 항균제 감수성 시험ㆍ605
1. 환자 치료에 흔히 쓰이는 주요 항세균제 ····························································· 605
2. 항균제에 대한 세균의 내성 기전 ········································································· 613
3. 항균제 감수성 시험의 원칙 ················································································· 620
4. 산소성 세균의 감수성시험 ··················································································· 630
5. 무산소성 세균의 감수성 시험 ·············································································· 651
6. Mycobocterium의 감수성 시험 ········································································· 654
7. 진균의 감수성 시험 ····························································································· 660
8. 내성 유전자의 검출 ····························································································· 665
9. 항균제 투여량 조절을 위한 시험 ········································································· 670
제 28 장 부록ㆍ673
1. 배 지 ···················································································································· 673
2. 염색액 ·················································································································· 688
3. 시 약 ···················································································································· 693
4. 용어 해설 ············································································································· 695
￭ 국문 찾아보기 ········································································································ 711
￭ 영문 찾아보기 ········································································································ 716