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Clinical Microbiology for Diagnostic Laboratory Scientists


Sarah J. Pitt



School of Pharmacy and Biomolecular SciencesUniversity of Brighton, UK
















For Alan

Love appears to be an infection which cannot be cured



And for my parents

Margaret and John


This book is intended for post‐registration and post‐graduate level scientists who are developing careers in diagnostic clinical microbiology. It is suitable for those who are working in hospital laboratories while studying for advanced qualifications, as well as full‐time MSc students. The aim is to prompt readers to make connections between the clinical symptoms, pathogenesis of infections and the approaches used in laboratory diagnosis. This is not a comprehensive account of all aspects of clinical microbiology, but a consideration of a range of infections caused by selected pathogenic bacteria, viruses, fungi, protozoa and helminths. The idea is to use these examples to illustrate clinical and diagnostic issues, to stimulate critical appraisal of published evidence and to encourage problem‐solving in the clinical laboratory context.

There is an introductory chapter, which outlines the scope of clinical diagnostic microbiology and the key areas for the laboratory scientist to be aware of. In the subsequent six chapters, a type of infection is reviewed in depth, using particular pathogenic microorganisms to illustrate salient points. As well as journal articles, there are references to publically available epidemiological data and professional guidelines throughout the book. This includes links to specialist websites. I hope that the reader will find the mixture of sources of information useful and a helpful place to start their own exploration of topics which interest them. At the end of each chapter there are three exercises related to management of a diagnostic service and assessing the suitability of test methods to specific contexts. There are no right or wrong answers to these, but the reader could discuss them with their laboratory colleagues or university tutor. Chapters 2 to 6 also include clinical case studies based on the content of the chapter. Application of appraisal and problem‐solving skills should lead to the solutions in each case, but the outline answers are provided in Appendix 1, so the reader can check their interpretation of the information.

Pathology laboratory services seem to be continually in the process of reorganisation and reconfiguration. The ways in which laboratory scientists are expected to work is changing, due to the possibilities afforded by new techniques. This often includes requirements for multi‐site working patterns and a more multidisciplinary outlook. However, the laboratory scientist should never lose sight of the point of their work, which is to help the patient. Microorganisms and the diseases that they are associated with are endlessly fascinating – and new pathogens are being discovered all the time! The graduate microbiologist can make a valuable contribution to patient care through questioning received wisdom, investigating different laboratory methods and evaluating research.

Sarah J. Pitt


I would like to thank my colleagues Rowena (Bertie) Berterelli, Heather Catty, Cinzia Dedi, Dr Annamaria Gal, Joseph Hawthorne and Simonne Weeks at the University of Brighton and Lindsey Dixon, Judith Feeney, Cassandra Malone, Nicholas O’Flanagan, Clare McKeon and Clare Reynolds at Brighton and Sussex University Hospitals NHS Trust/Frontier Pathology for their help and support. It is thanks to all of them that I was able to collect the pictures of slides and photographs of test strips and cultures used for many of the figures in this book. I would also like to thank Ian Phillips who recently retired from working at Public Health Wales, Cardiff, but not before allowing me to use some of his pictures.

I would especially like to thank Dr Alan Gunn of Liverpool John Moores University for his unfailing encouragement throughout the process of writing this book, for proofreading and commenting on drafts and also for providing material for some of the figures.

Thanks are also due to the staff at Wiley‐Blackwell for their assistance at the various stages of the project.