The book is 374 pages long and divided into 20 chapters with an index. It is slightly larger than the average paperback with black-and-white illustrations. As with the first edition (Professor Graham Ayliffe) there is a foreword by an eminent infection control specialist, Professor Didier Pittet.
Each chapter begins with an interesting quote (chapter 6: ‘the dream of every bacterium is to become two bacteria’). Chapter 1 deals with the basics of infections and is well laid out and informative. The next three chapters covering administrative arrangements, surveillance and outbreak management are equally well-written. Chapter 5 covers epidemiology and biostatistics and chapter 6, disinfection and sterilization. The latter again is comprehensive but from a practical perspective I particularly welcome Table 6.4 which provides a suggested action plan for the various levels of total viable count in endoscope rinse water. Isolation precautions are reviewed in chapter 7 and a two-tier approach is recommended – the first tier being standard precautions for all patients regardless of their infection status and the second, transmission-based measures for patients known/suspected to have communicable disease or infected and/or colonized with multi-resistant organisms. However, there are inaccuracies in Appendix 7.1 which lists the infectious disease organism and infection control measures required. SARS (again topical) according to the table only requires standard and contact precautions – no mention of droplet spread. Measles is listed as an airborne pathogen on page 7 but not in the table. With regards to influenza, airborne spread is mentioned but not the circumstances under which this can occur (only when undertaking aerosol-generating procedures).
A good and thorough review of hand hygiene is presented in chapter 8 and chapter 9 deals with personal protective equipment with good diagrams. However, on page 156 it should read ‘it is important to note that surgical masks do not provide protection against droplets [sic] nuclei;’ likewise, ‘lumber’ puncture on page 239 irritates although spelt correctly on the next page. Similarly, on page 177, it is generally accepted that development of resistance by Enterobacter to third-generation cephalosporins during treatment is not due to induction of AmpC beta-lactamase but to selection of de-repressed mutants producing high levels of the enzyme. Sixty-seven pages are devoted to special pathogens (chapter 11) on topics such as Clostridium difficile, prion disease, blood-borne viruses, tuberculosis, Legionnaires' disease, etc. This is a tall order as Legionella and some other topics would easily justify a specific chapter and require a degree of expertise. Unfortunately there are numerous errors concerning testing methods for Legionella currently in use and some control procedures such as periodic flushing of water outlets as described is misleading.
This book on the whole contains a number of well written chapters, especially those dealing with the fundamentals of infection control. However, it would benefit from a rigorous proofreading as well as amendment of some content. Nevertheless I find myself drawn to it and despite the reservations above would recommend it to anyone interested in infection control.
