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Microbiology in clinical practice, 3rd edition

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    Microbiology in clinical practice, 3rd edition By: d c shanson. (Pp 500; £39.99 (paperback)) 1999. Oxford: Butterworth and Heinemann. ISBN0 7506 3110 4.

    In an age in which the former elegance of scientific writing has given way to ill formed prose, check lists, and dreary tomes, this book is a welcome change. It is well written and cleverly structured, with a comprehensive index to guide one to the needed section in a hurry. These advantages will be appreciated by the target readership of junior hospital doctors and medical students; and also by hard pressed microbiologists, consultants in communicable disease control, and infection control nurses. It meets the demands of integrated training and clinical application, now an essential approach in the field of infection: I suspect that more senior practitioners will also place this volume in a readily accessible part of their bookshelves. Weighing in at 1.3 kg, it is sadly too large to be carried around in the pocket, but Shanson has wisely avoided the pitfalls of oversimplistic brevity. For those students daunted by the length, there is a guide to priority reading, picking out the essential sections that will help them through undergraduate and probably also postgraduate examinations.

    The author has succeeded in producing a new edition—the last was in 1989—that reflects the many changes in emerging infection and research. Common and vexing topics are easily tracked down from index headings, but I was disappointed that the topic of water borne pathogens is covered only under “infections of the gastrointestinal tract”, although organisms associated with water, such asLegionella pneumophila andMycobacterium marinum, are mentioned elsewhere. Public health and epidemiological aspects are reasonably well covered, but understandably take second place to microbiological investigation and treatment. For example, there is no attempt to resolve the current debate about the policy for prophylaxis and exclusion from food or nursery work in typhoid carriers and contacts. The introduction of routine vaccination against meningococcal infection in the United Kingdom is also too recent to have been included. The limited public health coverage is balanced by frequent references to the need for discussion between consultants in communicable disease control and microbiologists about both investigation and control of episodes of infection, which lays the basis for the shared approach involved in contemporary management of infection. I also liked the way the book concentrates on United Kingdom practice and the infection problems that practitioners are likely to meet, including the wide range of tropical and imported infections in returning travellers. Although more illustrations might be expected from the substantial price, the book is still excellent value for money in comparison with other comprehensive microbiology texts. The summaries give a good grounding for further forays into history and research and will be a boon for lecture preparation. The need to cover both the advances and the clinical dilemmas in microbiology has inevitably meant the sacrifice of the anecdote and historical detail that made earlier applied microbiology writing so inspiring, as exemplified by Christie in his editions of Infectious diseases: epidemiology and clinical practice. Nevertheless, Christie and other fine authors are included in the list of further reading. Meanwhile, many will find that Shanson's text amply satisfies most needs. A book which chooses as its only quotation the charming lines from Swift—

    “So, naturalists observe, a flea

    Hath smaller fleas that on him prey;

    And these have smaller fleas to bite 'em,

    And so proceed an infinitum.” —neatly bridges the gap between scholarly detail and practical modernity: and yes, fleas are also in the index and succinctly covered in the text.