Reviewer: farrin Alan Manian, MD, MPH (Mercy Hospital St. Louis)
Description: This is a fifth edition of a practical guide to the principles and control of infectious diseases in hospitals. This multiauthored book, coedited by two infection control experts, was first published in 1975
Purpose: The primary goal is to provide a practical guide on infection control and prevention of healthcare-associated infections for those in the trenches of patient care, particularly in the U.K. Given the rapid pace of change in many aspects of infection control and prevention, an updated edition is clearly needed every few years.
Audience: The intended audience is essentially anyone involved either directly or indirectly with the everyday workings of infection prevention and control in healthcare facilities, including physicians, nurses, and ancillary personnel. Because both editors and virtually all of the contributors seem to hold professional positions in the U.K., the book is particularly focused on infection control and prevention as practiced (or should be practiced) in that country.
Features: The first of the book's three sections has seven chapters dedicated to the basic principles of infection control including administrative, surveillance, and decontamination issues. The five chapters in the second section on prophylaxis and treatment of infections cover topics ranging from antimicrobial stewardship to occupational health issues. The remaining chapters are devoted to prevention of infection in patients and healthcare workers, with one chapter covering prevention of infectious diseases in the community (e.g. schools and prisons). The book is well written in an easy-to-understand manner that keeps readers interested. Chapters covering topics often not considered in the mainstream of infection control and prevention (e.g. laundry and antibiotic stewardship) are particularly well done and informational. Another potentially attractive feature of the book, particularly to the British audience, is its frequent references to U.K. rules and regulations pertinent to infection control activities of healthcare facilities in that country. Although the book has relatively few figures and tables, many of them are quite useful (e.g., a figure depicting a hepatitis B immunization algorithm and a table displaying antibody levels against pathogens and toxins used in determining the degree of protection). Several shortcomings of the book are noteworthy. First, there are occasional contradictory statements. For example, in the chapter on decontamination of medical equipment, it states that for laryngoscope blades "cleaning and drying may be sufficient," while the chapter on operating theatres recommends that laryngoscopes be "reprocessed via a sterile supply department (SSD)." Similarly, the book refers to decontamination of razors used for preoperative hair removal in one chapter, while proscribing their use in another section. Second, some recommendations would have benefited from a qualifying statement about the lack of scientific evidence for their support, or when available, citation of one or more recent peer-reviewed journal references. For example, the book recommends that staff refrain from wearing long-sleeved shirts/blouses and white coats when providing patient care without mentioning that there is no scientific evidence that directly links enforcement of these measures to a reduction in the rate of hospital infections. Similarly, "removal of white coats and jackets worn around the rest of the hospital" prior to entry into critical care units is presented as essential and in need of strict enforcement without further elaboration or qualification. In the chapter on decontamination of the environment, the book states that the inanimate environment of the hospital is of "little importance in the spread of endemic hospital infection" while referencing three articles, all of which were published over 20 years ago. In the chapter on surveillance of infections, it states that infections "acquired in theatres...will be apparent in the early post-operative period, a maximum of 3 post-operative days," with no references to support this view. Lastly, readers who practice outside of the U.K. may not find frequent references to U.K. regulations and rules particularly useful, especially when similar attention is not paid to regulations in other developed countries, including the U.S.
Assessment: This is a generally useful book on infection control and prevention in hospitals, particularly for readers involved either directly or indirectly with infection control and prevention practices in the U.K. For those who work in healthcare facilities not affected by U.K. rules and regulations, other more comprehensive and referenced guides are available.
"The book contains several gems ... It should be available to the legal department of every hospital, and to any non-specialist director of infection prevention and control, for these alone. Trainees in infection control and microbiology will certainly find it helpful."
—Journal of Hospital Infection, 2009
"...an essential purchase for all infection control nurses, doctors and other health professionals in the field."
—Nursing Standard
"For more than thirty years, Ayliffe's essential text has provided guidance in infection control... The authors have managed to strike a balance appropriate for the target audience which is wide, from students to specialists... The book covers most of the key areas including practical measures to improve quality of care, minimize risk, save lives, improve antibiotic use and reduce costs... Although infection control practices are in constant evolution, this book contains the most up to date principles and provides a practical approach for all healthcare staff. The fifth edition lives up to my expectations and I recommend it as an invaluable basic tool."
—ACP News
