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Molecular Microbiology
  1. J Kerr

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    Edited by D H Persing, F C Tenover, J Versalovic. Washington DC: ASM Press, 2003, $124.95 (hardback), pp 748. ISBN 1 55581 221 X

    The availability of molecular diagnostic methods has increased dramatically over the past 15 years. This revolution has changed the landscape of medical diagnosis and management, and continues to do so, providing a new layer of depth to our understanding of the pathogenesis of disease, along with newly identified targets for a range of pharmacological and immunological treatments. Consequently, these developments demand an appropriate level of understanding on the part of medical and other healthcare staff.

    This large, hardback book is edited by a diverse and accomplished group, and covers the part of the above revolution as it broadly applies to microbiology. The first section, Diagnostic principles, reviews DNA probe technology, nucleic acid amplification, nucleic acid sequencing, molecular strain typing, and novel approaches to the detection of nucleic acid amplification products. The second section, Diagnostic applications, is an in depth review of the use of molecular technologies to detect and characterise bacterial, viral, fungal, and parasitic pathogens. Also included are sections on pharmacogenetics and host genomics as they influence infectious disease outcomes, in addition to discussion of the crucial areas of laboratory standardisation, proficiency testing, and quality control.

    Mutation detection forms a particular theme throughout the book, as would be expected, because nucleotide mutations contribute to microbial virulence; antigenic diversity of pathogens; attenuation; survival in hostile environments both in vivo and in vitro including immune evasion, antimicrobial resistance, and response to treatment; host susceptibility to and defence against infection; and the ability of the host to metabolise therapeutic antimicrobial drugs, etc. This is dealt with very well in the book across many different chapters. For example, several chapters are devoted to the various approaches to mutation scanning of microbes (screening methods (PCR based and non-PCR based)), DNA sequencing, phylogenetic analysis, strain typing approaches, pharmacogenetic methods of infectious disease management, and host susceptibility to microbial infection and cancer.

    Single nucleotide polymorphisms (SNPs) occur throughout the human genome and the book describes their discovery through nucleotide sequencing, the various categories based on geographical location and therefore importance (coding, regulatory, intronic, and intergenic), and routine methods of detection. The presence of SNPs within various human genes has been shown to confer susceptibility, resistance, or phenotype modification to several infectious diseases, which are discussed in detail. For example, susceptibility to respiratory syncytial virus (RSV) infection (interleukin 8; IL-8), susceptibility to septic shock, cerebral malaria, mucocutaneous leishmaniasis, human papillomavirus/cervical cancer development (tumour necrosis factor α), susceptibility to a fatal outcome in meningococcal disease (IL-1β), immunodeficiency as a result of defective opsonisation (mannose binding lectin), human immunodeficiency virus 1 (HIV-1) susceptibility (CCR-5), susceptibility to intracellular pathogens such as Mycobacterium tuberculosis (N-RAMP (SLC11A1)), etc.

    Various SNPs occurring within cytochrome P450s and drug transporters, such as P-glycoprotein and multi-drug resistance associated proteins, affect the metabolism of antibiotics including erythromycin, clarithromycin, primaquine, quinine, sulfonamides, isoniazid, dapsone, proguanil, HIV-1 protease inhibitors, imidazoles, rifampicin, and chloramphenicol. The book describes these SNPs, the function of the genes relevant to this section, and the methods available to detect an array of such polymorphisms to maximise efficacy and reduce toxicity of antibiotics towards efficient management of infectious disease.

    In conclusion, this reference book brings together a wealth of information from diverse sources towards a common theme of molecular microbiology and infectious diseases. The book is well written by experts in the various fields, contains many helpful illustrations with colour plates, and will appeal to microbiologists, pathologists, infectious disease specialists, pharmacologists, and students of these disciplines. This is a thoroughly enjoyable book to browse or read and I envisage using my copy on a regular basis.