Patrick R. Murray - Murrays Basic Medical Microbiology: Foundations and Clinical Cases

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MURRAYS BASIC MEDICAL MICROBIOLOGY, SECOND EDITION

ISBN: 978-0-323-87810-4

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Previous edition copyrighted 2018.

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By writing an introduction to the second edition of Basic Medical Microbiology, I have an opportunity to reflect on the important changes that have been made to the first edition for the benefit of the students who use this text as well as the materials that have been retained. In many ways, microbiology is an evolving science with newly discovered pathogens and diseases. This was dramatically illustrated by the global pandemic caused by SARS Coronavirus-2 and the subsequent variants. However, I think it is important to recognize that student learning also evolves. The challenges of remote learning during the COVID-19 pandemic brought this acutely into focus. The one thing that did not change when I prepared this edition of Basic Medical Microbiology was the underlying foundation for this textbook. So, I ask for forgiveness for retaining a portion of the original Preface; after this, I will explain the why and how of the changes in this second edition.

What is the bigger challenge for a student or the instructor in the understanding of what is important in medical microbiology? Many years ago, when I took my first graduate course in medical microbiology, I read thousands of pages of text, listened to 5 h of lectures a week, and performed lab exercises 6 h a week for 1 year. I was given a wonderful foundation in microbiology, but I frequently asked myself a question that was also voiced by other students: do I really need to know all this stuff? The answer to that question is certainly no, but the challenge is understanding what information is needed. Years later, when I set out to write my first textbook on microbiology, my goal was to give the students only what they need to know, described in a way that is informative, factual, and concise. I think I was successful in that effort, but I also realize that the discipline of microbiology continues to change as do approaches to presenting information to students. I am still firmly convinced that my efforts in my first textbook, Medical Microbiology, and subsequent editions are important, as they form the foundations of microbiology knowledge for a student. This cannot be replaced by a quick search of the internet or a published review because much of the subject matter presented in medical microbiologyepidemiology, virulence, clinical diseases, diagnostics, and treatmentis a distillation of the review of numerous research articles and clinical and technical experience. Having stated that, students frequently turn to review books consisting of abbreviated summaries, illustrations (should I say cartoons), and various mnemonic aids for mastering this subject. As I have watched this evolution of learning microbiology, I am struck by the sacrifice that has been made. I believe microbiology is a beautiful subject, which balances health and disease defined by the biology of individual organisms and microbial communities. Without an understanding of biology, lists of facts are soon forgotten. But I am a realist and know the burden students face, mastering not only microbiology but also a number of other subjects. So the personal question I posed wasis there a better way to present to the student a summary of information that is easy to understand and remember? This book is my approach to answering this question. First, almost by definition, it is not comprehensive. Just as I have carefully selected organisms and diseases to present in this book, I have also intentionally not mentioned othersnot because they are unimportant but because they are less common. I have also not presented a detailed discussion of microbial biology and virulence or the immune response of the patient to an infection, but simply presented the association between an organism and the disease it causes. Again, I felt those discussions should be reserved for Medical Microbiology. Finally, the organization of this book is focused on organismsbacteria, viruses, fungi, and parasitesrather than diseases. This is because I think it is easier for a student to remember a limited number of diseases associated with an organism rather than a long list of organisms (or a significantly incomplete list) implicated in a specific disease such as pneumonia. Patients present with diseases, and the observer must develop a list of organisms that could be responsible; so to aid the student, I provide this differential diagnosis in the introductory chapter of each organism section. I also provide in these introductory chapters an overview of the classification of organisms (a structural framework to remember organisms) and a listing of antimicrobials that are used to treat infections. The individual chapters in Sections IIV are organized under a common theme: a brief discussion of the individual organisms, a summary of facts (properties, epidemiology, clinical disease, diagnosis, and treatment) provided in a concise table, and illustrations provided as a visual learning aid. The most significant change that was made in this second edition was the reorganization and expansion of the clinical cases in a series of eight clinical syndrome chapters in Section VI. My goal was to provide clinical situations that illustrate for the student how the foundational knowledge gained in the organism chapters can be used to make clinical diagnoses. Finally, examination questions are provided in Section VII to help students assess their ability to assimilate this material. Again, I will emphasize that this text should not be considered a comprehensive review of microbiology. On the other hand, I believe that if students master this material, they will have a firm foundation in the principles and applications of microbiology. I welcome comments on how successful my efforts are.