This now twelfth edition of Bailey and Scott's Diagnostic Microbiology attests to the continued need for a comprehensive and functional publication to guide students and practitioners through the ever-changing field of clinical microbiology. Through seven decades, the many revisions of the original, condse laboratory manual. Methods for Diagnostic Bacteriology, by Isabelle G. Schaub and M. Kathleen Foley, have been mandatory additions to personal and laboratory bookshelves. The classic Bailey and Scott series grew from the efforts of Elvyn G. Scott and W. Robert Bailey, who joined Schaub and Foley for their fifth edition. Since then, a succession of authors has undertaken the increasingly daunting task of updating and expanding this work while adding the areas of parasitology, mycology, virology, and molecular diagnosis—disciplines now considered integral to the clinical microbiology laboratory.

The challenges that confront clinical microbiologists in this first part of the twenty-first century could not have been foreseen by the authors of the original text. They were not charged with the need to balance fiscal restraint with increasing demands for conducting expensive, albeit more rapid, automated and molecular diagnostic tests. Nor was vigilance for acts of bioterrorism (inflicted even in the earliest centuries of civilization) of everyday concern to them. In the absence of antimicrobial therapy, there was no need for these pioneers to follow strict criteria for performing antimicrobial susceptibility tests in the face of a growing number of antimicrobial agents active against an increasing number of potential pathogens, many of which formerly were considered normal flora. The original authors were unaware of the opportunistic infections of patients with AIDS and other immune-compromising conditions and the emerging and reemerging infectious diseases that have arisen, often as the consequence of ongoing political and social upheavals. The specter of antimicrobial agent-resistant microorganisms, with their expanding repertoire of resistance factors, had not yet appeared. To our benefit, however, the present advances in molecular techniques have permitted a better understanding of antimicrobial agent resistance factors and the relationships among certain groups of microorganisms, so that we can better control them and define their role in specific disease syndromes. These molecular advances have also given rise to highly specific methods for microbial identification and in some cases, methods for their direct detection in clinical specimens, even when they cannot be cultivated in vitro.

To address such issues as they affect traditional and modern practices in the field, Betty Ann Forbes, Daniel F. Sahm, and Alice Weissfeld again bring their expertise to this latest edition of Bailey and Scott's Diagnostic Microbiology, Each author has made contributions to update previous information and provide new concepts in his or her respective areas of expertise. Whether a beginning or experienced practitioner, the reader will appreciate the clearly written, practical, and informative approach that has been taken in each chapter. In three parts, the authors describe basic issues in medical microbiology; general principles for safety, specimen management, and diagnostic approaches, including for antimicrobial susceptibility testing; and bacterial identification. Of note are the extensive revisions of the chapter that addresses nucleic add-based analytic methods for microbial identification and characterization and the addition of case studies for each chapter. The fourth through sixth parts are written by other experts in the fields of parasitology, mycology, and virology. Again, these parts have been revised and updated extensively to indude, for example, coverage of SARS and avian influenza. The seventh part assists diagnosis by organizing the material in an organ system approach. In a new eighth part on clinical laboratory management, a chapter is induded to guide the laboratory response to bioterrorism. New and updated tables, diagrams, and color photographs throughout the text enhance and facilitate comprehension of the subject matter.

As before, the authors have approached the subject from the point of view of a bench technologist confronted with a culture plate of microbial growth. A few direct observations (e.g., gram-stain reaction and morphology, growth on certain media) and standard rapid tests (e.g., oxidase, catalase) are used to place the organisms into major groupings from which identification then proceeds. The chapter sections guide workup of the culture. The chapters that deal with antimicrobial susceptibility testing are espedally valuable for technologists in small clinical laboratories who often are requested to perform susceptibility tests on organisms for which no standardized method is available. Emphasis on dinical relevance and cost effectiveness are espedally pertinent in the current health care climate.

The success of the previous editions written by these authors signifies that their approach is valued by clinical microbiologists at all levels of expertise. With its updated material and attention to cutting-edge concepts, this revision merits high regard and will no doubt quickly replace well-wom copies of the previous edition.

Josephine A. Morello, PhD

Professor Emerita of Pathology Former Director of Hospitals Laboratories and Clinical Microbiology Laboratories University of Chicago Medical Center Chicago, Illinois

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