Textbook of Diagnostic Microbiology 6th Edition

Book Preface

This is the sixth edition of the Textbook of Diagnostic Microbiology. Since the inception and publication of the first edition, the field of diagnostic microbiology has dramatically changed and become more complex. Newly recognized pathogens continue to plague society in epidemic proportion. As examples, Ebola is a virus that produced severe outbreaks in West Africa in 2014–2015. Infection with it is often fatal, if untreated. The primarily mosquito-borne Zika virus is linked to microcephaly, a birth defect. Infection with it has been declared a global public health emergency by the World Health Organization. Highly pathogenic emerging coronaviruses that affect humans, including Middle East respiratory syndrome coronavirus (MERS CoV) and severe acute respiratory syndrome (SARS) virus, cause life-threatening respiratory syndromes. This edition includes discussions on these emerging public health issues.

As in previous editions, this edition maintains the characteristic features of a well-designed and organized textbook. We maintain the building-block approach to learning, critical thinking, and problem solving, attributes that students of clinical laboratory science and clinical laboratory technology, entry-level clinical laboratory scientists, and others have found valuable and effective. The primary 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; therefore, discussions on organisms are limited to those that are medically important and commonly encountered, as well as new and re-emerging pathogens. The text provides students and other readers with valuable learning tools, such as summary tables, flowcharts, and descriptive illustrations, to help them comprehend the vast amount of information and reinforce learning. In response to our readers’ needs, we continued our efforts to enhance these features that have made this textbook user-friendly.

In this edition, we made considerable changes to show the vital nature and ever-evolving field of diagnostic microbiology. A more in-depth discussion on forensic microbiology has been included in Chapter 30, Agents of Bioterror and Forensic Microbiology. The text has been updated to reflect pathogens newly recognized in the past decade and presents new applications of immunologic and/or molecular approaches to diagnose infections, 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 effects of rapid demographic, environmental, societal, technologic, and climatic changes, as well as changes in our way of life, have an influence on the incidence of infectious disease. The sixth edition focuses on the continuing spread of infectious diseases and the emerging public health issues associated with them. Although the identification of etiologic agents through culture remains the gold standard in microbiology for determining the probable cause of an infectious disease, advances in molecular diagnostic techniques and their application in clinical laboratories have increased our capabilities for microbial detection and identification. Extensive biomedical research has focused on nanomedicine—the potential applications of nanotechnology to medicine. We updated Chapter 11 by expanding the discussion on the use of nanomedicine in diagnosing infectious diseases and Chapter 12 by exploring the use and applications of nanotechnology in drug-delivery systems. In addition, a description of the application of matrix-assisted laser desorption–ionization time-of-flight (MALDI-TOF) mass spectrometry in microbial identification has been added to Chapter 11.

Organization

Part I remains the backbone of the textbook, providing important background information; Part II focuses on laboratory identification of etiologic agents; and Part III on the organ system approach—the clinical and laboratory diagnoses of infectious diseases at various body sites.

Part I presents basic principles and concepts of diagnostic microbiology, including quality assurance, providing students with a firm theoretic foundation. Chapters 7 (Microscopic Examination of Materials from Infected Sites) and 8 (Use of Colony Morphology for the Presumptive Identification of Microorganisms) still play a vital role in this text. These two chapters help students and practitioners who may have difficulty recognizing bacterial morphology on direct smear preparations and colony morphology on primary culture plates develop these skills with 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. Chapter 9 introduces the student/ reader to the principles behind various biochemical methods for identification of gram-negative bacteria. This chapter contains several color photographs to help students understand the principles and visualize interpretations of these important tests. Part II highlights methods for the identification of clinically significant isolates. The chapters in Part II present medically important organisms through a taxonomic approach. Although diseases caused by the organisms are discussed, the emphasis is on the characteristics and methods used to isolate and identify each group of organisms. Numerous tables summarize the major features of organisms and use schematic networks 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 includes a discussion on Zika virus and other viral pathogens, including SARS virus, the highly pathogenic avian influenza virus, and MERS-CoV. Chapter 31 describes biofilm—an increasingly complex entity. It has become evident that microbial biofilms are involved in the pathogenesis of several human diseases and may be a contributing factor for the failure of antimicrobial therapy.

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.” The chapters in Part III begin with the anatomic considerations of the organ system to be discussed and the role of the usual microbiota found at a particular site in the pathogenesis of a disease. It is important for students to be knowledgeable about the usual inhabitants at a body site before they can appreciate the significance of the opportunistic infectious agents they are most likely to encounter. The case studies included in the chapters in Part III enhance problem-solving and critical-thinking skills and help students apply the knowledge they acquired from Parts I and II. The case studies describe clinical and laboratory findings, providing students with 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 figure out the explanations independently.

Pedagogic Features

As in previous editions, the “Case in Point” feature introduces the reader to an important pathogen, infectious disease, concept, or principle that is discussed in the chapter text and is used to lead the learner to the main context discussed in the chapter. The Case in Point is followed by “Issues to Consider.” These points are presented in a bulleted format, and learners are asked to think about them as they read the chapter.

“Case Checks,” a feature introduced in the previous edition, aims to reinforce understanding of the content or concept within or case study at the beginning of a section within the chapter. The Case Check highlights a specific point in the text and intends to help the learner connect the dots between the points under discussion, as illustrated by the case study.

To further reinforce learning, identification tables, flowcharts, and featured illustrations have been updated, and new ones have been added. Learning objectives and a list of key terms are also provided at the beginning of each chapter. The list of key terms includes abbreviations used in the text so that students can easily find them in the text. At the end of each chapter, readers will find “Points to Remember” and “Learning Assessment Questions,” which help reinforce comprehension and understanding of important concepts. Points to Remember includes a bulleted list of important concepts and highlights what the reader should have learned from the chapter.

The sixth edition of Textbook of Diagnostic Microbiology is enriched by the expertise of contributors and elements to strengthen the learning strategy, 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

As in the case of previous editions, we continue to offer a variety of instructor ancillaries specifically geared for this book. For instructors, the Evolve website includes a test bank containing more than 1200 questions. It also includes an electronic image collection and PowerPoint slides. For students, the Evolve website will include a laboratory manual like it always has, but this edition will include new case studies and student review questions.

Connie R. Mahon
Donald C. Lehman