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Indian Journal of Medical Microbiology, Vol. 27, No. 4, October-December, 2009, pp. 386-387 Book Review Antimicrobial resistance - The modern epidemic current status and research issues Reba Kanungo Editor, Indian Journal of Medical Microbiology, A-3/38 Labourdonnaise Street, Puducherry-605001 Correspondence Address: Editor, Indian Journal of Medical Microbiology, A-3/38 Labourdonnaise Street, Puducherry-605001, rkanungo1@gmail.com Code Number: mb09114 Edited by D Raghunath,V Nagaraja and C Durga Rao, Macmillan Publishers India Limited Price Rs 715 This book is a collection of papers presented at the ninth Sir Dorabji Tata Symposium held in March, 2008, at the Indian Institute of Science Campus. Sir Dorabji Tata Symposia are a series presenting reports on tropical diseases in India. Resistance to antibiotics has been fascinating albeit a difficult study of bacterial mechanisms vis-a-vis human infections. Constant efforts to understand the mechanisms have resulted in several path breaking discoveries in antibiotic resistance among bacteria. This book is a compilation of series of lectures. The emphasis is on current status and research issues, testing methods, clinical uses of antibiotics and discussing basic testing methodologies; interpretations, reporting and matching with disease progression. Ample illustration of sensitivity plates, diagrams, charts and tables highlights current practices. Quality control in resistance testing has been emphasized. Resistance mechanisms in protozoa have been infrequently investigated. Targeting the plasmodium via purine metabolic path has been discussed in great detail in the chapter on resistance in protozoa which will perhaps encourage new drug designing. Kala azar found in several parts of India has become difficult to treat due to steadily increasing resistance to several compounds. A short chapter briefly discusses the reasons for resistance and preventive policies in Kala azar briefly dwelling upon interesting aspects of risks in nonantimony antileismanials. The papers on drug resistant tuberculosis are a highlight of the symposium. The current status of resistance in India traces development of MDR TB to prevalence of primary resistance and acquired resistance in several parts of the country. XDR TB and its testing methodology using phenotypic and genotypic methods are included in this session. The global scenario of XDR TB with the World Health Organization perspective, in 2008, has also been highlighted. The session on laboratory issues is an amalgamation of several clinically important laboratory tests. It begins with antifungal testing methodology and break point interpretations for clinically important filamentous fungi and yeasts. Salmonella infections have been endemic in almost all parts of India. Trends in antibiotic resistance have been closely monitored across the country through several reports and review articles. A chapter in this session deals with resistance patterns and phage type prevalence studies in India. Several studies on methicillin resistant Staphylococci (MRSA) discuss the genetic basis of resistance, molecular typing methods, clonal studies of hospital and community acquired MRSA with virulence determinants. Clinical implications of MRSA, prevention and control have also been discussed. Basic research complimenting clinical studies is the right step forward. The session on basic research begins with an insight into discovery and development of new antibiotics. An understanding of molecular mechanism for drug development has been discussed for antifungal and fluoroquinolones for mycobacteria. Bacterial cell wall as a drug target for antibiotics has been explored in the chapter on novel targets for design of therapeutics. Monitoring antibiotic resistance in hospitals coupled with infection control is a laboratorian's dilemma. This is perhaps the best way to contain emergence and spread of resistance among hospital pathogens. This session includes a paper highlighting the process and is a mixed bag of papers on community acquired and spread of multi drug resistance across the nation and globe, including resistance in Salmonellae. Resistance in HIV also finds place at the session. An important public health scourge could have been discussed in greater detail in the Indian context. Papers on policies and practices governing use of antibiotics in animals, transfer of resistance from domestic animal sources bring up the rear of this session. A panel discussion on the role of public health professionals and the community in control of antibiotic resistance presents a comprehensive report on understanding the complexity of the problem, reflections on policies and practices in India. A paper from Swedish experience and global challenge highlights the need for a concerted global effort to contain antimicrobial resistance. Location-specific, integrated, antibiotic resistance management strategy outlines the flow path of antibiotics from manufacturer to hospital waste water disposal. The paper stresses the need for awareness and policies to address this problem. Rear of this monogram contains abstracts of best posters presented during the symposium. The problem of antibiotic resistance is multifactorial. The ninth Sir Dorabji Tata Symposium brought together several scientists, clinical and basic researchers, and laboratorians on a single platform to discuss various aspects of antimicrobial resistance. The original papers have been presented as they were with several photographs, figures and tables. Minor editing could have improved the presentations. Some of the tables and figures appear very crowded. The editors, however, must be congratulated on their attempt to disseminate this information in the form of a book as has been done earlier. Priced at Rs 715, with an attractive jacket, this monogram makes interesting reading and would be useful for medical institute libraries as well as personal collection. Copyright 2009 - Indian Journal of Medical Microbiology |
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