Frontiers in Antimicrobial Resistance: A Tribute to Stuart B. Levy
http://www.100md.com
《新英格兰医药杂志》
This book, the unifying theme of which is antimicrobial resistance, consists of 7 major sections containing a total of 40 chapters. The chapters are organized according to specific types of mechanisms of resistance and according to individual human pathogens (almost all of them bacteria). In addition, the section on the ecology and fitness of drug resistance discusses the use of antimicrobial agents in animals (mainly antibacterial) and plants (mainly antifungal). The section on policy, education, and exploration explores regulatory and political issues and includes an infomercial for the scientific and public-health organization cofounded by Dr. Stuart B. Levy.
Most of the chapters follow a generally uniform outline, so that mechanisms of resistance and other topics can be compared and contrasted for different pathogens and antimicrobial agents. Although some topics appear to be included unduly repetitiously in different chapters, the advantage of the repetition is that each chapter can be read as a stand-alone mini-review. I found that the repetition of some mechanisms of resistance led to better understanding, because the discussions are written from different perspectives.
This book is more than a thorough, state-of-the-art review of bacterial antimicrobial resistance; it is a labor of love and a tribute to Levy, a professor of molecular biology and microbiology at Tufts University and a cofounder of the Alliance for the Prudent Use of Antibiotics. Except for a brief introduction and a remarkable poem (to be sung to the tune of "Lemon Tree"), Levy makes no written contribution to the book. There are 78 contributors, from 12 countries, who are authorities on antimicrobial resistance and students or collaborators of Levy. The evolution of antibiotic resistance and the roles of these notable contributors can be seen in a historical context. What makes this book unique is not only the testament to a scientist but also the personal recollection by each of the investigators of their work in this field. Such a collaborative effort allows for the inclusion of personal opinions, editorial comments, anecdotes, and philosophical insights. Many chapters are written with gusto and enthusiasm. Where else would you find chapter subheadings such as "Quo Vadis?" (in chapter 10, "Multiple Antimicrobial Resistance," by Anthony M. George), "A Cruise on the Pig Lagoon" (in chapter 33, "Ecology of Antibiotic Resistance Genes," by Abigail A. Salyers et al.), "Countries Coalesce and Shed the Shame" (in chapter 38, "Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission," by Kathleen T. Young and Thomas F. O'Brien), "High School Student Discovered Mutants Resistant to Pine Oil" (in chapter 12, "Biocides and Resistance," by Bonnie M. Marshall and Laura M. McMurry), and "From Annoyance to Insight" (in chapter 13, "The Nexus of Oxidative Stress Responses and Antibiotic Resistance Mechanisms in Escherichia Coli and Salmonella," by Bruce Demple)?
There are some limitations to the book, however. Despite its title, it focuses primarily on antibacterial agents; antifungal agents are mentioned, but only cursorily, although there is a chapter on drug-resistant Plasmodium falciparum. Surprisingly, not a single chapter deals with antiviral or antifungal resistance. The chapters on the mechanisms of resistance of anticancer agents seem oddly misplaced. In this age of the Internet, a fast-moving field such as antimicrobial resistance may not be adequately updated in textbook form. The bibliography in this book, however, is relatively up to date, including references as recent as 2004.
Such a textbook is potentially useful to clinical infectious-disease physicians, microbiologists, and pharmacists, but there are problems. Most of the chapters are highly technical and burdened with jargon that would be understandable only by researchers in the field. The bewildering plethora of acronyms, abbreviations, and numbers denoting organisms, gene loci, and resistant factors are challenging to follow. Many of these terms, known by the editors and authors but not necessarily by the readers, are arbitrary, with no logical schema. Although this problem is an example of an evolving field, it also provides an obstacle for the nonexpert — I often found the dense text difficult to read.
Some may correctly argue that the comprehension of such a broad topic necessitates hard work on the part of the reader, but I would suggest that the book could have avoided some of its major problems by including introductory chapters that would have served as a primer for antibiotic resistance. Such a primer would have provided a conceptual overview for the nonspecialist and the methodologic data needed by a seasoned researcher; basic principles could have been illustrated in simplified drawings; and a helpful glossary of the numerous terms could have been included.
This book will be of value to researchers and policymakers in a highly publicized and important field. It is not only a comprehensive reference textbook, but also a historical manifesto. In a second edition, perhaps the editors could retain the unifying theme yet broaden the book's appeal to nonresearchers, who could then appreciate the enthusiasm of the authors and the rigor of their work.
Victor L. Yu, M.D.
University of Pittsburgh
Pittsburgh, PA 15240
vly@pitt.edu(Edited by David G. White,)
Most of the chapters follow a generally uniform outline, so that mechanisms of resistance and other topics can be compared and contrasted for different pathogens and antimicrobial agents. Although some topics appear to be included unduly repetitiously in different chapters, the advantage of the repetition is that each chapter can be read as a stand-alone mini-review. I found that the repetition of some mechanisms of resistance led to better understanding, because the discussions are written from different perspectives.
This book is more than a thorough, state-of-the-art review of bacterial antimicrobial resistance; it is a labor of love and a tribute to Levy, a professor of molecular biology and microbiology at Tufts University and a cofounder of the Alliance for the Prudent Use of Antibiotics. Except for a brief introduction and a remarkable poem (to be sung to the tune of "Lemon Tree"), Levy makes no written contribution to the book. There are 78 contributors, from 12 countries, who are authorities on antimicrobial resistance and students or collaborators of Levy. The evolution of antibiotic resistance and the roles of these notable contributors can be seen in a historical context. What makes this book unique is not only the testament to a scientist but also the personal recollection by each of the investigators of their work in this field. Such a collaborative effort allows for the inclusion of personal opinions, editorial comments, anecdotes, and philosophical insights. Many chapters are written with gusto and enthusiasm. Where else would you find chapter subheadings such as "Quo Vadis?" (in chapter 10, "Multiple Antimicrobial Resistance," by Anthony M. George), "A Cruise on the Pig Lagoon" (in chapter 33, "Ecology of Antibiotic Resistance Genes," by Abigail A. Salyers et al.), "Countries Coalesce and Shed the Shame" (in chapter 38, "Alliance for the Prudent Use of Antibiotics: Scientific Vision and Public Health Mission," by Kathleen T. Young and Thomas F. O'Brien), "High School Student Discovered Mutants Resistant to Pine Oil" (in chapter 12, "Biocides and Resistance," by Bonnie M. Marshall and Laura M. McMurry), and "From Annoyance to Insight" (in chapter 13, "The Nexus of Oxidative Stress Responses and Antibiotic Resistance Mechanisms in Escherichia Coli and Salmonella," by Bruce Demple)?
There are some limitations to the book, however. Despite its title, it focuses primarily on antibacterial agents; antifungal agents are mentioned, but only cursorily, although there is a chapter on drug-resistant Plasmodium falciparum. Surprisingly, not a single chapter deals with antiviral or antifungal resistance. The chapters on the mechanisms of resistance of anticancer agents seem oddly misplaced. In this age of the Internet, a fast-moving field such as antimicrobial resistance may not be adequately updated in textbook form. The bibliography in this book, however, is relatively up to date, including references as recent as 2004.
Such a textbook is potentially useful to clinical infectious-disease physicians, microbiologists, and pharmacists, but there are problems. Most of the chapters are highly technical and burdened with jargon that would be understandable only by researchers in the field. The bewildering plethora of acronyms, abbreviations, and numbers denoting organisms, gene loci, and resistant factors are challenging to follow. Many of these terms, known by the editors and authors but not necessarily by the readers, are arbitrary, with no logical schema. Although this problem is an example of an evolving field, it also provides an obstacle for the nonexpert — I often found the dense text difficult to read.
Some may correctly argue that the comprehension of such a broad topic necessitates hard work on the part of the reader, but I would suggest that the book could have avoided some of its major problems by including introductory chapters that would have served as a primer for antibiotic resistance. Such a primer would have provided a conceptual overview for the nonspecialist and the methodologic data needed by a seasoned researcher; basic principles could have been illustrated in simplified drawings; and a helpful glossary of the numerous terms could have been included.
This book will be of value to researchers and policymakers in a highly publicized and important field. It is not only a comprehensive reference textbook, but also a historical manifesto. In a second edition, perhaps the editors could retain the unifying theme yet broaden the book's appeal to nonresearchers, who could then appreciate the enthusiasm of the authors and the rigor of their work.
Victor L. Yu, M.D.
University of Pittsburgh
Pittsburgh, PA 15240
vly@pitt.edu(Edited by David G. White,)