Textbook of Diagnostic Microbiology 5th Edition

Book Preface

We welcome you to the fifth edition of the Textbook of Diagnostic Microbiology.

This edition embodies our commitment to convey information on the ever-evolving, complex, and challenging field of diagnostic microbiology. Similar to previous editions, we remain committed to preserving the tradition of providing a well-designed and organized textbook. This edition maintains the building block approach to learning, critical thinking, and problem solving, features that clinical laboratory science and clinical laboratory technician students, entry-level clinical laboratory practitioners, and others have found valuable and effective. In response to our readers’ needs, we continue to enhance these features that have made this textbook user-friendly. Because the goal of the Textbook of Diagnostic Microbiology is to provide a strong foundation for clinical laboratory science students, entry-level practitioners, and other health care professionals, discussions of organisms are limited to those that are medically important and commonly encountered, as well as new and re-emerging pathogens. Students and other readers are provided with valuable learning tools to help them sort through the vast amount of information—background theoretic concepts, disease mechanisms, identification schemas, diagnostic characteristics, biochemical reactions, and isolation techniques—to produce clinically relevant results.

In this edition, considerable changes have been made to show the vital nature of the field of diagnostic microbiology. A discussion on forensic microbiology has been included in Chapter 30, Agents of Bioterror. The text has been updated to reflect pathogens newly recognized in the past decade, present new applications of immunologic and/or molecular approaches to diagnose infections and identify infectious agents, and determine antimicrobial resistance in microorganisms. Despite the progress made and significant advances that have occurred in their control, prevention, and treatment, infectious diseases remain a major threat to human health. The combined affects of rapid demographic, environmental, societal, technologic, and climatic changes, as well as changes in the way we live our lives, have affected the occurrence of infectious disease. This fifth edition discusses the continuing spread of infectious diseases and the emerging public health issues associated with them.

Whereas the recovery of etiologic agents in cultures has remained the gold standard in microbiology in determining the probable cause of an infectious disease, the increase in our capabilities for microbial detection and identification can be attributed to the advances in molecular diagnostic techniques and how they are applied in clinical laboratories. Extensive biomedical research has focused on the potential applications of nanotechnology to medicine—nanomedicine. Chapter 12 has been updated by incorporating discussions on the use of nanotechnology in drug delivery systems, and Chapter 39 includes a discussion of biomarkers in the diagnosis of septicemia. The application of matrixassisted laser desorption-ionization time-of-flight (MALDI-TOF) mass spectrometry in microbial identification has been added to Chapter 11.

Organization

Part I has remained the backbone of the textbook, providing important background information, Part II emphasizes the laboratory identification of etiologic agents, and Part III focuses on the clinical and laboratory diagnoses of infectious diseases at various body sites—the organ system approach. Part I presents basic principles and concepts of diagnostic microbiology, including quality assurance, which provide students with a firm theoretic foundation. Chapters 7 (Microscopic Examination of Infected Materials) and 8 (Use of Colony Morphology for the Presumptive Identification of Microorganisms) still play vital roles in this text. These two chapters help students and practitioners who may have difficulty recognizing bacterial morphology on direct smear preparations, as well as colony morphology on primary culture plates, develop these skills through the use of color photomicrographs of stained direct smears and cultures from clinical samples. These two chapters also illustrate how microscopic and colony morphology of organisms can aid in the initial identification of the bacterial isolate. A summary of the principles of the various biochemical identification methods for gram-negative bacteria is described in Chapter 9. This chapter contains several color photographs to help students understand the principles and interpretations of these important tests. Part II highlights methods for the identification of clinically significant isolates. Bacterial isolates are presented based on a taxonomic approach. Although diseases caused by the organisms are discussed, the emphasis is on the characteristics and methods used to recover and identify each group of organisms. Numerous tables summarize the major features of organisms, and schematic networks are used to show the relationships and differences among similar or closely related species. Chapters devoted to anaerobic bacterial species, medically important fungi, parasites, and viruses affirm the significance of these agents. Chapter 29 describes viral pathogens, including severe acute respiratory syndrome and the highly pathogenic avian influenza virus. Chapter 31 describes an increasingly complex entity—biofilms. Recently, it has become evident that microbial biofilms are involved in the pathogenesis of several human diseases.

The organ system approach in Part III has been the foundation of the Textbook of Diagnostic Microbiology and provides an opportunity for students and other readers to “pull things together.” Chapters begin with the anatomic considerations of the organ system to be discussed and the role of the usual microbiota found at the particular site in the pathogenesis of a disease. Before students can recognize the significance of the opportunisticinfectious agents they are most likely to encounter, it is important for them to know the usual inhabitants at a body site. The case studies included in the chapters in Part III enhance problem solving and critical-thinking skills, and help students apply knowledge acquired in Parts I and II. The case studies describe the clinical and laboratory findings associated with the patients, allowing students opportunities to correlate these observations with possible etiologic agents. In most cases, the cause of the illness is not disclosed in the case study; rather, it is presented elsewhere in the chapter to give students the opportunity to think the case through.

Pedagogic Features

As with the previous editions, each chapter is introduced by a Case in Point. These introductory case studies represent an important pathogen, infectious disease, concept, or principle that is discussed in the chapter text and is used to introduce the learner to the main context discussed in the chapter. The Case in Point is followed by “Issues to Consider.” These are points in a bulleted format that the learners are asked to think about as they read the chapter.

New to this edition are the Case Checks, a feature that aims to reinforce understanding of the content or concept within the context of the Case in Point at the beginning of the chapter or case study at the beginning of a section within the chapter. The Case Check highlights a particular point in the text that intends to help the learner connect the dots between the content under discussion, as illustrated by the case study.

To further reinforce learning, identification tables, flow charts, and featured illustrations have been updated, and new ones have been added. Learning objectives and a list of key terms are also found at the beginning of each chapter. The key terms include abbreviations used in the text; this places abbreviations where students can easily find them. At the end of each chapter, readers will find Points to Remember and Learning Assessment Questions to reinforce comprehension and understanding of important concepts. Points to Remember includes a bulleted list of important concepts that the reader should have learned from reading the chapter.

This edition of the Textbook of Diagnostic Microbiology, as in the previous editions, incorporates the expertise of contributors along with elements such as full-color photographs and photomicrographs, an engaging and easy-to-follow design, learning assessment questions and answers, opening case scenarios, hands-on procedures, and lists of key terms to strengthen the learning strategy.

Ancillaries for Instructors
and Students

For this edition, we continue offering a variety of instructor ancillaries specifically geared for this book. For instructors, the Evolve website includes a test bank in ExamView containing more than 1200 questions. It also includes an electronic image collection and PowerPoint slides. For students, the Evolve website includes a laboratory manual.

Connie R. Mahon
Donald C. Lehman
George Manuselis