- Email: [email protected]
The microbiology and epidemiology of infection for health science students
journal
of Hospital
Infection
(1995) 31, 157-l 58
Book reviews The Microbiology and Epidemiology of Infection for Health Science Students. Meet-s P, Sedgwick J, Worsley M. London: Chapman & Hall 1995. E14.99. 330~~. ISBN 0 412 59900 7. The broad subject of infection, encompassing microbiology, infectious diseases and epidemiology is vast. Health care professionals in every field frequently encounter patients suffering from the results of infection. The names of microorganisms and the infections that they cause appear to be designed specifically to confuse, and the mechanisms of the spread of infection are a mystery to the uninitiated. Consequently, a clear understanding of the processes that lead to infection and a grounding in the subject of infection control is necessary for all health care professionals and should be provided at an early stage in their training. This book provides an introduction to these diverse, yet linked topics and, in my view, has tackled the task successfully. The first section of the book describes the interactions between the defences of the host, the pathogenic characteristics of microorganisms, and the routes of transmission that lead to infection. This is followed by a systematic consideration of each major genus and species of bacterium, virus, fungus and parasite in turn. An overview of the pathogenesis of each important microbe, diagnosis and treatment of infections caused and, when relevant, the epidemiology and appropriate control measures are given. Appropriately, no attempt is made to give details of the laboratory identification of individual organisms. The third section deals with some of the commoner clinical infective syndromes and with general principles of disease diagnosis and treatment. While accepting that increased detail in this section would lead to some repetition, I feel that the opportunity to give an indication of the relative frequencies of causative organisms for the commoner infections was missed. For instance, it was not clear that sore throat is predominantly a viral disease and that diptheria and Haemophilus influenzae are very rare causes of upper respiratory tract infection in developed countries. Finally, the principles of the prevention of infection in the community and in medical settings are described. A pragmatic and logical approach to a subject prone to rituals and unvalidated procedures is taken. The book is very readable and succeeds in keeping the reader’s attention through the liberal use of boxes containing a delightful selection of historical and background information. Clear and precise descriptions of commonly used terms are given in the text. Additionally, a useful glossary of terms used and an introduction to the confusing subject of microbial taxonomy are provided. The degree of detail given is, in my view, just right for the in tended readership of students on health science and biomedical degree courses. In addition, I believe that it is also particularly suited to the requirements of
158
Book reviews
trainees in most of the health care and related professions at an early stage of their training, particularly to nurses, environmental health officers and medical laboratory scientific officers. I highly commend this book.
A. J. Mifsud
Laboratory of Hospital Infection, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK
Guidelines for Standards in Laboratory Practice in Medical Microbiology. S. Mehtar, Ed. Publication Number 3, Association of Medical Microbiologists 1994. ElO.00. ISBN 09525044 05. ‘The aim of this document is to provide guidelines or checklists for the purchasers and providers to ensure quality and standards continue to be maintained’. With such an opening statement, medical microbiologists responsible for the management of laboratory services will welcome this publication. It should prove particularly useful when read in conjunction with the Clinical Pathology Accreditation Scheme Handbook. The guidelines are divided into six sections: (1) General; (2) Bacteriology; (3) Virology; (4) N on - viral serology; antibiotic susceptibility testing and antibiotic assays; (5) Mycology; and (6) Quality education and training. Within the first five sections, standards are stated and the criteria to attain them listed. In the last section, though standards and criteria are not given, they are due to be published in a subsequent supplement. None of the standards are controversial and should be endorsed by all. However, the chosen criteria may occasionally cause disagreement amongst medical microbiologists. For instance, the standard for the detection of clinically relevant enteric pathogens includes the following criterion: ‘toxin production and culture for Clostridium difficile should be performed on samples where there is a history of antibiotic therapy, hospitalization or pseudomembranous colitis’. This is contrary to the advice of a recent Department of Health and Public Health Laboratory Service report which recommends C. dif$cile toxin detection alone for sporadic cases. However, the main thrust of this publication will be to promote further discussion and a review of laboratory protocols. Individual medical microbiology laboratories may then wish to modify the guidelines to make them more applicable to their own local needs and population. With the rapidly changing developments in medical microbiology, the Association of Medical Microbiologists may wish to consider a second edition within a few years. If so, a joint publication with the Institute of Biomedical Sciences would ensure that these useful guidelines attract a wider readership and therefore have an even greater chance of being effectively implemented.
R. P. D. Cooke
Department
of Medical Microbiology, District General Hospital, Kings Drive, Eastbourne, East Sussex BN21 2UD, UK
of Hospital
Infection
(1995) 31, 157-l 58
Book reviews The Microbiology and Epidemiology of Infection for Health Science Students. Meet-s P, Sedgwick J, Worsley M. London: Chapman & Hall 1995. E14.99. 330~~. ISBN 0 412 59900 7. The broad subject of infection, encompassing microbiology, infectious diseases and epidemiology is vast. Health care professionals in every field frequently encounter patients suffering from the results of infection. The names of microorganisms and the infections that they cause appear to be designed specifically to confuse, and the mechanisms of the spread of infection are a mystery to the uninitiated. Consequently, a clear understanding of the processes that lead to infection and a grounding in the subject of infection control is necessary for all health care professionals and should be provided at an early stage in their training. This book provides an introduction to these diverse, yet linked topics and, in my view, has tackled the task successfully. The first section of the book describes the interactions between the defences of the host, the pathogenic characteristics of microorganisms, and the routes of transmission that lead to infection. This is followed by a systematic consideration of each major genus and species of bacterium, virus, fungus and parasite in turn. An overview of the pathogenesis of each important microbe, diagnosis and treatment of infections caused and, when relevant, the epidemiology and appropriate control measures are given. Appropriately, no attempt is made to give details of the laboratory identification of individual organisms. The third section deals with some of the commoner clinical infective syndromes and with general principles of disease diagnosis and treatment. While accepting that increased detail in this section would lead to some repetition, I feel that the opportunity to give an indication of the relative frequencies of causative organisms for the commoner infections was missed. For instance, it was not clear that sore throat is predominantly a viral disease and that diptheria and Haemophilus influenzae are very rare causes of upper respiratory tract infection in developed countries. Finally, the principles of the prevention of infection in the community and in medical settings are described. A pragmatic and logical approach to a subject prone to rituals and unvalidated procedures is taken. The book is very readable and succeeds in keeping the reader’s attention through the liberal use of boxes containing a delightful selection of historical and background information. Clear and precise descriptions of commonly used terms are given in the text. Additionally, a useful glossary of terms used and an introduction to the confusing subject of microbial taxonomy are provided. The degree of detail given is, in my view, just right for the in tended readership of students on health science and biomedical degree courses. In addition, I believe that it is also particularly suited to the requirements of
158
Book reviews
trainees in most of the health care and related professions at an early stage of their training, particularly to nurses, environmental health officers and medical laboratory scientific officers. I highly commend this book.
A. J. Mifsud
Laboratory of Hospital Infection, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK
Guidelines for Standards in Laboratory Practice in Medical Microbiology. S. Mehtar, Ed. Publication Number 3, Association of Medical Microbiologists 1994. ElO.00. ISBN 09525044 05. ‘The aim of this document is to provide guidelines or checklists for the purchasers and providers to ensure quality and standards continue to be maintained’. With such an opening statement, medical microbiologists responsible for the management of laboratory services will welcome this publication. It should prove particularly useful when read in conjunction with the Clinical Pathology Accreditation Scheme Handbook. The guidelines are divided into six sections: (1) General; (2) Bacteriology; (3) Virology; (4) N on - viral serology; antibiotic susceptibility testing and antibiotic assays; (5) Mycology; and (6) Quality education and training. Within the first five sections, standards are stated and the criteria to attain them listed. In the last section, though standards and criteria are not given, they are due to be published in a subsequent supplement. None of the standards are controversial and should be endorsed by all. However, the chosen criteria may occasionally cause disagreement amongst medical microbiologists. For instance, the standard for the detection of clinically relevant enteric pathogens includes the following criterion: ‘toxin production and culture for Clostridium difficile should be performed on samples where there is a history of antibiotic therapy, hospitalization or pseudomembranous colitis’. This is contrary to the advice of a recent Department of Health and Public Health Laboratory Service report which recommends C. dif$cile toxin detection alone for sporadic cases. However, the main thrust of this publication will be to promote further discussion and a review of laboratory protocols. Individual medical microbiology laboratories may then wish to modify the guidelines to make them more applicable to their own local needs and population. With the rapidly changing developments in medical microbiology, the Association of Medical Microbiologists may wish to consider a second edition within a few years. If so, a joint publication with the Institute of Biomedical Sciences would ensure that these useful guidelines attract a wider readership and therefore have an even greater chance of being effectively implemented.
R. P. D. Cooke
Department
of Medical Microbiology, District General Hospital, Kings Drive, Eastbourne, East Sussex BN21 2UD, UK