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Laboratory Diagnosis of Bacterial Infections

2001 Edition, July 27, 2001

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Active, Most Current

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ISBN: 978-0-585-41796-7
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Product Details:

  • Revision: 2001 Edition, July 27, 2001
  • Published Date: July 27, 2001
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 952
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


The science relating to infection has expanded exponentially, and we are all no doubt aware of the difficulties of attempting to assimilate this new knowledge. There are many texts that eloquently describe the clinical aspects of infectious diseases, as well as several that layout in detail the mechanics of procedure and methodology. Our book makes no pretense ofproviding voluminous detail on either. Rather, as in the Laboratory Diagnosis of Viral Infections. Second Edition, Revised and Expanded, edited by Dr. Edwin E. Lennette (Marcel Dekker, Inc., 1991), we propose that the need is to provide timely and pointed material for the laboratorian and diagnostician to use in selecting and applying diagnostic maneuvers for everyday practice.

Over a decade ago, many predicted that molecular technologies would render most classical diagnostic methods obsolete. Although the trend toward molecular diagnostics increases, there has developed a hybrid of classical and new methods; both equally important no matter how simple or complex. The balance of emphases will no doubt continue to shift in the direction of molecular techniques but perhaps more so due to the increasing number of new pathogens and new disease associations. The chapters by Alex van Belkum and Wil Goessens, David Fredricks, and Marc Struelens highlight this change, its impact, and its future potential. The science, while becoming complex, has nevertheless led to very exciting times for diagnosticians.

New basic science begets new medicine. Within a short period of time, new pathogens have been identified at an unprecedented pace. The revolution in the field of immunocompromised hosts has led to a medical renaissance for bacteria which were in large part deemed innocuous. Old diseases have often been renamed "emerging infections." Given the state of the art, a new pathogen once defined quickly becomes studied to the point where diagnostic tools and genomics are recognized in a few short years. The chapter by Anna Sander on human bartonellosis serves to remind us how quickly progress can be made when scientific minds are so directed.

A primary purpose of diagnostic technologies is to establish certainty, but certainty of diagnosis necessarily evokes interventionist strategies, the most directly influenced being antimicrobial therapy. Antibiotic use, while critical to the beneficial outcome in many circumstances, has become a complex issue, as outlined by John Turnidge and Jan Bell. For many pathogenic bacteria, antimicrobial resistance continues to increase. Molecular techniques have become of value both to determine said resistance and to clarify the epidemiology of change.

The diagnostic laboratory cannot be viewed as a "stand-alone" entity. Its functions are intimately related to patient care and in many respects constitute a form of medical practice. As the applications of diagnostic bacteriology evolve, new diagnostic modes will likely emerge that are in a sense laboratory-based but not necessarily based in the formal microbiology laboratory. For example, John Holton and Dino Vaira illustrate this latter concept thoroughly in their chapter on gastric helicobacters.

Throughout the chapters, we have made use of dendrograms to illustrate the relationship of various bacteria. The intent here was not to provide detailed figures for illustrating DNA homologies but rather to provide a guide for those less acquainted with these relationships in general form.

Our world is as small or as large as we make it; the scientific community is no different. Over the last two decades especially, we have learned much about new diseases and new diagnostic techniques from our international colleagues. Lessons of the past have been rekindled. Globalization has forced us to renew our appreciation of the many communities in which we live in large part because of the various aspects of life that facilitate the transmission of infectious microbes. Accordingly, the input from several international scientists and laboratorians is a reflection of this diversity and of the need to share our knowledge globally. Along this line, I would like to thank Dr. Alasdair MacGowan of Bristol for his comments on Chapter 13. The need to continue sharing our knowledge in this fashion and to view the diverse multinational contributions as being essential to the ''big picture" will no doubt remain.