European Manual of Clinical Microbiology

European Manual
of Clinical Microbiology
1st Edition
EMCM
The Editors thank the financial support of Companies to allow the achievement of this manual.
However, the members of the editorial board have disclosed any potentially relevant conflicts of
interest likely to prejudice the data published in this book or inconsistent with the objectives of
the ESCMID and the SFM.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted in any form or by any means, electronic, mechanical photocopying, recording
or otherwise, without the prior permission of the Publishers, the European Society for Clinical
Microbiology and Infectious Diseases (Basel) or the Société Française de Microbiologie (Paris).
No responsibility is assumed by the Publishers for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any
methods, products, instructions or ideas contained in the material herein. Because of the rapid
advances in the medical sciences, the Publishers recommend that independent verification of
diagnoses and drug should be made.
La Loi du 11 mars 1957 interdit les copies ou reproductions destinées à une utilisation collective.
Toute représentation ou reproduction intégrale ou partielle faite par quelque procédé que ce soit,
sans le consentement de l’auteur ou ses ayants droits, est illicite et constitue une contrefaçon
sanctionnée par les articles 425 et suivants du Code Pénal.
ISBN: 978-2-87805-026-4
Editorial
Let’s go European!
Giuseppe Cornaglia
René J. Courcol
From a French handbook to a European manual: This was the challenge met (and
won) in less than one year by the Editorial Board of and all those contributing to the
European Manual of Clinical Microbiology.
Early in 2011, the Presidents of the European Society for Clinical Microbiology and
Infectious Diseases and of the Société Française de Microbiologie, decided to
publish a text of clinical microbiology. The template for this would be the widely
popular French REMIC, which non-French authors would adapt and integrate in
accordance with ‘European’ practices and the European body of knowledge. A
number of microbiologists gathered at the ECCMID in Milano agreed to take on this
challenge.
This new book, contains contributions by nearly one hundred experienced medical
microbiologists, and is mainly intended for all those involved in medical microbiology. However, its style makes it suitable for clinicians, too, and as a reference test
for residents and students. Diagnostic schemes and recommendations spring from
the professional experience of internationally-recognised authors, and make large
use of guidelines and consensus documents published by several international
societies.
This is but the first edition of the Manual, and, like all books, it is incomplete and
not sufficiently up-to-date at the time of going to press. Future editions - possibly
available in electronic format as well - will draw on an even broader participation of
microbiologists from all over Europe, as well as on precious feedbacks of readers
throughout Europe and beyond.
Editors
Giuseppe Cornaglia
Professor of Microbiology
Department of Pathology and Diagnostics;
University of Verona
Verona, Italy
[email protected]
René Courcol
Professor of Bacteriology
Laboratoire de Bactériologie-Hygiène, Institut de
Microbiologie, Centre Hospitalier Universitaire;
Université de Lille 2
Lille, France
[email protected]
Jean-Louis Herrmann
Professor of Bacteriology
Laboratoire de Microbiologie, Hôpital Raymond
Poincaré, Assistance Publique-Hôpitaux de Paris;
Université Versailles-St Quentin
Garches, France
[email protected]
Gunnar Kahlmeter
Professor of Microbiology
Clinical Microbiology, Central Hospital
Växjö, Sweden
[email protected]
Hélène Peigue-Lafeuille
Professor of Virology
Centre Hospitalier Universitaire, Laboratoire de
Virologie ; Université d’Auvergne
Clermont-Ferrand, France
[email protected]
Jordi Vila
Professor of Microbiology
Department of Clinical Microbiology Hospital
Clinic, School of Medicine, University of
Barcelona, Barcelona Centre for International
Health Research, CRESIB Villarroel
Barcelona, Spain
[email protected]
Contributors
M. Aigner
Department of Hygiene, Microbiology and Social
Medicine, Division of Hygiene and Medical
Microbiology
Innsbruck, Austria
Guido Antonelli
Laboratory of Virology - Department of Molecular
Medicine – Sapienza University
Roma, Italy
[email protected]
Javier Ariza
Infectious Diseases Department, Hospital
Universitari de Bellvitge, IDIBELL
Barcelona; Spain
[email protected]
Bertille de Barbeyrac
Centre National de Référence des Chlamydiae;
Université Victor Ségalen Bordeaux II
Bordeaux, France
[email protected]
Fernando Baquero
Department of Microbiology, Ramón y Cajal
University Hospital (SERMAS), Ramón y Cajal
Institute for Health Research (IRYCIS), and
Network Research Centre for Epidemiology and
Public Health (CIBERESP).
Madrid, Spain
[email protected]
Paul Bates
Chair in Biomedicine, Faculty of Health and
Medicine, Lancaster University
Lancaster, United Kingdom
[email protected]
Patrick Boiron
Centre d’Ecologie Microbienne, bactéries
opportunistes, Observatoire des Nocardioses ;
Faculté de Pharmacie, Université de Lyon
Lyon, France
[email protected]
Stéphane Bonacorsi
Laboratoire de Microbiologie, Hôpital Robert
Debré, Assistance Publique-Hôpitaux de Paris;
Université Paris Diderot
Paris, France
[email protected]
Richard Bonnet
Laboratoire de Bactériologie, Centre Hospitalier
Universitaire; Université d’Auvergne
Clermont-Ferrand, France
[email protected]
Tristan Bourcier
Service d’Opthalmologie, Nouvel Hôpital Civil ;
Université de Strasbourg
Strasbourg, France
[email protected]
Emilio Bouza
Dept. of Clinical Microbiology and Infectious
Diseases, Hospital General Universitario Gregorio
Marañón, Universidad Complutense
Madrid, Spain
[email protected]
Françoise Brun-Vezinet
Département de Microbiologie, Laboratoire de
Virologie, Hôpital Bichat, Assistance PubliqueHôpitaux de Paris ; Université Paris 7
Paris, France
[email protected]
Almudena Burillo
Dept. of Clinical Microbiology and Infectious
Diseases, Hospital General Universitario Gregorio
Marañón, Universidad Complutense
Madrid, Spain
[email protected]
Christophe Burucoa
Laboratoire de Bactériologie, Centre Hospitalier
Universitaire; Université de Poitiers
Poitiers, France
[email protected]
Dominique de Briel
Département de Microbiologie, Hôpitaux Civils
de Colmar
Colmar, France
[email protected]
Rafael Canton
Servicio de Microbiologıa and CIBERESP, Hospital
Universitario Ramon y Cajal, Instituto Ramon y
Cajal de Investigacion Sanitaria
Madrid, Spain
[email protected]
Maria R. Capobianchi
National Institute for Infectious Diseases
“L. Spallanzani”
Roma, Italy
[email protected]
Etienne Carbonnelle
Service de Microbiologie, Hôpital Européen
Georges Pompidou, Assistance PubliqueHôpitaux de Paris ; Université Pierre et Marie
Curie
Paris, France
[email protected]
Francesco Castelli
Chair of Infectious Diseases, University of Brescia
Brescia, Italy
[email protected]
Concetta Castilletti
Laboratory of Virology, National Institute for
Infectious Diseases “L. Spallanzani”
Roma, Italy
[email protected]
Jean-Didier Cavallo
Service de Santé des Armées
Ecole du Val-de-Grâce
Paris, France
[email protected]
Stéphane Chevaliez
Centre National de Référence Coordonnateur
des hépatites des virus B, C et Delta. Service
de bactériologie-virologie-hygiène, Groupe
Hospitalier Henri Mondor ; Assistance PubliqueHôpitaux de Paris. Université Paris Est.
Créteil, France.
[email protected]
Massimo Clementi
Laboratory of Microbiology and Virology,
Università Vita-Salute San Raffaele, Milano.
Milano, Italy.
[email protected]
Jan Clerinx
Department of Clinical Sciences, Institute of
Tropical Medicine Antwerp (ITMA)
Antwerp, Belgium
[email protected]
Stéphane Corvec
Service de Bactériologie-Hygiène, Institut
de Biologie des Hôpitaux de Nantes, Centre
Hospitalier Universitaire ; Université de Nantes
Nantes, France
[email protected]
Giovanni Delogu
Istituto di Microbiologica, Università Cattolica del
Sacro Cuore
Roma, Italy
[email protected]
Emmanuel Dutoit
Laboratoire de Parasitologie-Mycologie, Institut
de Microbiologie, Centre Hospitalier Universitaire;
Université de Lille 2
Lille, France
[email protected]
Matthew Dryden
Royal Hampshire Hospital
Winchester, United Kingdom
[email protected]
Luc Dubreuil
Laboratoire de Bactériologie, Faculté de
Pharmacie, Université de Lille 2
Lille, France
[email protected]
Johan van Eldere
Laboratory of Experimental Bacteriology,
Department of Medical Diagnostics, University
Hospital Leuven
Leuven, Belgium
[email protected]
Heinz Ellerbrok
Robert Koch-Institute, Centre for Biological Safety
Berlin, Germany
[email protected]
Önder Ergönül
Department of Clinical Microbiology and
Infectious Disease, Ankara University, School of
Medicine
Ankara, Turkey
[email protected]
Birgitta Evengard
Dept. Clinical Microbiology, Umeå University
Umeå, Sweden
[email protected]
Pieter LA Fraaij
Department of Virology, Erasmus Medical Center
Rotterdam, The Netherlands
[email protected]
François Freymuth
Laboratoire de Virologie, Centre Hospitalier
Universitaire Côte de Nacre ; Université de Caen
Caen, France
[email protected]
Antoine Garbarg-Chenon
Service de Microbiologie, Hôpital ArmandTrousseau, Assistance Publique-Hôpitaux de
Paris; Université Pierre et Marie Curie
Paris, France
[email protected]
Christian Giske
Clinical Microbiology, Karolinska Institutet–MTC,
Karolinska University Hospital, Solna,
Stockholm,Sweden
[email protected]
Gilbert Greub
Center for Research on Intracellular Bacteria
(CRIB), Institute of Microbiology, University
Hospital Center and University of Lausanne
Lausanne, Switzerland
[email protected]
Margareta Ieven
Department of Microbiology, Vaccine and Infectious Diseases Institute, University of Antwerp
Antwerp, Belgium.
[email protected]
Benoît Jaulhac
Laboratoire de Bactériologie, Hôpital Universitaire ; Centre National de Référence des Borrelia ;
Université Louis Pasteur
Strasbourg, France
[email protected]
Per Juto
Clinic Clinical Virology, Umeå University
Umeå, Sweden.
Yamina Kabrane
[email protected]
Ingegerd Kallings
Department of Bacteriology, Swedish Institute for
Infectious Disease Control
Stockholm, Sweden
[email protected]
Laetitia M. Kortbeek
Centre for Infectious Disease Control Netherlands,
National Institute for Public Health and the
Environment
Bilthoven, The Netherlands
[email protected]
Brigitte Lamy
Laboratoire de Bactériologie, Centre Hospitalier
Universitaire de Montpellier ; Université de
Montpellier
Montpellier, France
[email protected]
Philippe Lanotte
Université François-Rabelais de Tours, UFR de
Médecine
Tours, France
[email protected]
Cornelia Lass-Flörl
Department of Hygiene, Microbiology and Social
Medicine, Division of Hygiene and Medical
Microbiology, Innsbruck Medical University.
Innsbruck, Austria
[email protected]
Patrice Laudat
Laboratoire Arnaud
Tours, France
[email protected]
Jean-Philippe Lavigne
Laboratoire de Bactériologie, Groupe HospitaloUniversitaire de Carémeau; Université Montpellier
1
Nîmes, France
[email protected]
Christine Lawrence
Laboratoire de Microbiologie, Hôpital Raymond
Poincaré, Assistance Publique-Hôpitaux de Paris
[email protected]
Jacques Le Bras
Laboratoire de Parasitologie, Hôpital Bichat,
Assistance Publique-Hôpitaux de Paris ;
Université Paris Descartes
Paris, France
[email protected]
Roland Leclercq
Laboratoire de Microbiologie, Centre Hospitalier
Universitaire Côte de Nacre ; Université de Caen
Caen, France
[email protected]
Veerle Lejon
Department of Clinical Sciences, Institute of
Tropical Medicine Antwerp (ITMA)
Antwerp, Belgium
[email protected]
Alban Le Monnier
Centre National de Référence des Listeria, Institut
Pasteur
Paris, France
[email protected]
Isabelle Leparc-Goffart
Institut de Recherches Biomédicales des Armées
– Antenne de Marseille
Centre National de Référence des Arbovirus
Marseille, France
[email protected]
Audrey Mérens
Service de biologie médicale, Hôpital d’instruction
des Armées-Bégin
Saint-Mandé, France
[email protected]
Marcelle Mounier
Pôle de Biologie-Hygiène, Centre Hospitalier
Universitaire, Limoges; Université de Limoges
Limoges, France
[email protected]
Elisabeth Nagy
Institute of Clinical Microbiology, University of
Szeged
Szeged, Hungary
[email protected]
Gérard Lina
Centre National de Référence des Staphylocoques, Hospices Civils de Lyon; Université Lyon
1
Lyon, France
[email protected]
Olav B Natås
Department of Medical Microbiology, Stavanger
University Hospital
Stavanger, Norway
[email protected]
Caroline Loïez
Laboratoire de Bactériologie-Hygiène, Institut de
Microbiologie, Centre Hospitalier Universitaire
Lille, France
[email protected]
Maria-Mercedes Nogueras Mas
[email protected]
Anton van Loon
Department of Virology, Medical Microbiology,
University Medical Center
Utrecht, The Netherlands
[email protected]
Nino Manca
Institute of Microbiology and Virology, Spedali
Civili, University of Brescia
Brescia, Italy
Luis Martinez-Martinez
Department of Molecular Biology, University of
Cantabria and University Hospital Marqués de
Valdecilla-IFIMAV
Santander, Spain
[email protected]
Max Maurin
Département de Microbiologie Clinique, Centre
Hospitalier Universitaire; Université Joseph
Fourier
Grenoble, France
[email protected]
Francis Mégraud
Centre National de Référence des Campylobacter
et Helicobacter; Université Victor Ségalen
Bordeaux II
Bordeaux, France
[email protected]
Albert D.M.E. Osterhaus
Department of Virology, Erasmus Medical Center
Rotterdam, The Netherlands
[email protected]
Tibor Pal
Department of Medical Microbiology, Faculty
of Medicine and Health Sciences, United Arab
Emirates University
Al-Ain, United Arab Emirates
[email protected]
Alvaro Pascual
Department of Microbiology, University Hospital
Virgen Macarena, and University of Seville
Seville, Spain
[email protected]
Jean-Michel Pawlotsky
Centre National de Référence Coordonnateur
des hépatites des virus B, C et Delta. Service
de bactériologie-virologie-hygiène, Groupe
Hospitalier Henri Mondor ; Assistance PubliqueHôpitaux de Paris. Université Paris Est.
Créteil, France
[email protected]
Agnès Perrin
Service de Gestion du Risque Infectieux et des
Vigilances, Centre Hospitalier Universitaire
Lille, France
[email protected]
Mathieu Picardeau
Institut Pasteur, Unité de Biologie des Spirochètes, Centre de Référence des Leptospires,
Centre Collaborateur OMS pour l’Epidémiologie
des Leptospires
Paris, France
[email protected]
Mario Poljak
Institute of Microbiology and Immunology, Faculty
of Medicine, University of Ljubljana, Ljubljana,
Slovenia
[email protected]
Maria Eugenia Portillo
Microbiology Laboratory, Reference Laboratory of
Catalunya
Barcelona, Spain
[email protected]
Claire Poyart
Centre National de Référence des Streptocoques,
Hôpital Cochin, Assistance Publique-Hôpitaux de
Paris ; Université Paris Descartes
Paris, France
[email protected]
Tomàs Pumarola
Service of Microbiology, Hospital Clinic,
Barcelona-CRESIB
Barcelona, Spain
[email protected]
Caroline Rambaud
Service de Médecine Légale, Hôpital Raymond
Poincaré, Assistance Publique-Hôpitaux de Paris;
Université Versailles-St Quentin
Garches, France
[email protected]
Didier Raoult
Laboratoire de Bactériologie, Unité des Rickettsies, Assistance Publique-Hôpitaux de Marseille ;
Université de la Méditerranée
Marseille, France
[email protected]
Philippe Riegel
Laboratoire de Bactériologie, Centre Hospitalier
Universitaire; Université Louis Pasteur
Strasbourg, France
[email protected]
Jérôme Robert
Laboratoire de Bactériologie-Hygiène, Hôpital La
Pitié-Salpêtrière, Assistance Publique-Hôpitaux
de Paris; Université Pierre et Marie Curie
Paris, France
[email protected]
Anne-Laure Roux
Laboratoire de Microbiologie, Hôpital Raymond
Poincaré, Assistance Publique-Hôpitaux de Paris;
Université Versailles-St Quentin
Garches, France
[email protected]
Martin Rottman
Laboratoire de Microbiologie, Hôpital Raymond
Poincaré, Assistance Publique-Hôpitaux de Paris ;
Université Versailles-St Quentin
Garches, France
[email protected]
Eva Ružić-Sabljić
Institute of Microbiology and Immunology, Faculty
of Medicine, University of Ljubljana, Ljubljana,
Slovenia
[email protected]
Veroniek Saegeman
Department of Laboratory Medicine,
UH-KULeuven,
Leuven, Belgium
[email protected]
Christine Segonds
Laboratoire de Bactériologie-Hygiène, Institut
Fédératif de Biologie, Hôpital Purpan, Centre
Hospitalier Universitaire
Toulouse, France
[email protected]
Ferran Segura Porta
Infectious Diseases Healthcare Programme,
Corporació Sanitaria Parc Taulí, Sabadell
Barcelona, Spain
[email protected]
Harald Seifert
Institute for Medical Microbiology, Immunology
and Hygiene, University of Cologne, Cologne,
Germany
[email protected]
Jean-Marie Seigneurin
Département de Microbiologie Clinique, Centre
Hospitalier Universitaire ; Université Joseph
Fourier
Grenoble, France
[email protected]
Katja Seme
Institute of Microbiology and Immunology, Faculty
of Medicine, University of Ljubljana, Ljubljana,
Slovenia
[email protected]
Boualem Sendid
Laboratoire de Parasitologie-Mycologie, Institut
de Microbiologie, Centre Hospitalier Universitaire;
Université de Lille 2
Lille, France
[email protected]
Kathrine Summermatter
Institute of Virology and Immunoprophylaxis (IVI)
Mittelhaeusern, Switzerland
[email protected]
Peter Tenke
Department of Urology, South-Pest Hospital
Budapest, Hungary
[email protected]
Andrej Trampuz
Infectious Diseases Service, Department of
Internal Medicine, University Hospital of Lausanne
Lausanne, Switzerland
[email protected]
Riccardo Utili
Unita di Medicina Infettivologica e dei Trapianti,
Seconda Universita degli studi di Napoli,
Ospedale Monaldi
Napoli, Italy
[email protected]
Martin Schutten
Erasmus Medical Center, Department of Virology
Rotterdam, The Netherlands
[email protected]
Jorgen Skov-Jensen
Statens Serum Institute, Mycoplasma Laboratory
Copenhagen, Denmark
[email protected]
Hoang Vu-Thien
Service de Microbiologie, Hôpital ArmandTrousseau, Assistance Publique-Hôpitaux de
Paris; Université Pierre et Marie Curie
Paris, France
[email protected]
Anne Bianchi
Centre National de Référence de la Syphilis
Paris, France
[email protected]
Anne Bouvet
Centre National de Référence des Streptocoques,
Hôpital Cochin, Assistance Publique-Hôpitaux de
Paris ; Université Paris Descartes
Paris, France
[email protected]
Emmanuelle Cambau
Laboratoire de Bactériologie, Groupe Hospitalier
Saint Louis-Lariboisière-Fernand Widal, Assistance Publique-Hôpitaux de Paris; Université
Paris Diderot
[email protected]
Christine Chaumeil
Laboratoire de Microbiologie, Fédération des
Maladies infectieuses oculaires, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts
Paris, France
[email protected]
Jean-Marie Delarbre
Laboratoire de Microbiologie, Centre Hospitalier
Mulhouse, France
[email protected]
Agnès Ferroni
Laboratoire de Microbiologie, Hôpital Necker,
Assistance Publique-Hôpitaux de Paris; Université
Paris Descartes
Paris, France
[email protected]
Frédéric Wallet
Laboratoire de Bactériologie-Hygiène, Institut de
Microbiologie, Centre Hospitalier Universitaire
Lille, France
[email protected]
Jean-Louis Gaillard
Laboratoire de Microbiologie-Hygiène, Hôpital
Ambroise Paré, Assistance Publique-Hôpitaux de
Paris; Université Versailles-St Quentin
Boulogne-sur-Seine, France
[email protected]
Wolfgang Witte
Robert Koch Institute, Wernigerode Branch
Wernigerode, Germany
[email protected]
Daniel Garin
Institut de Recherche Biomédicales des Armées
Grenoble, France
[email protected]
Bengt Wretlind
Dept of Clinical Microbiology, Karolinska Institutet
at Karolinska University Hospital Huddinge
Stockholm, Sweden
[email protected]
Associate Contributors
Henri Agut
Laboratoire de Virologie, Hôpital La PitiéSalpêtrière, Assistance Publique- Hôpitaux de
Paris ; Université Pierre et Marie Curie
Paris, France
[email protected]
Vinent Jarlier
Laboratoire de Bactériologie-Hygiène, Hôpital La
Pitié-Salpêtrière, Assistance Publique-Hôpitaux
de Paris; Université Pierre et Marie Curie
Paris, France
[email protected]
Bernard La Scola
Laboratoire de Bactériologie, Unité des Rickettsies, Assistance Publique-Hôpitaux de Marseille ;
Université de la Méditerranée
Marseille, France
[email protected]
Jean-Christophe Lucet
Hôpital Bichat, Assistance Publique-Hôpitaux de
Paris; Université Pierre et Marie Curie
Paris, France
[email protected]
Jean-Luc Mainardi
Service de Microbiologie, Hôpital Européen
Georges Pompidou, Assistance PubliqueHôpitaux de Paris; Université Pierre et Marie Curie
Paris, France
[email protected]
Catherine Neuwirth
Laboratoire de Bactériologie, Centre Hospitalier
Universitaire; Université de Dijon
Dijon, France
[email protected]
Béatrice Pangon
Laboratoire de Microbiologie, Centre Hospitalier
de Versailles
Le Chesnay, France
[email protected]
Michèle Pérouse de Montclos
Laboratoire de Bactériologie, Centre Hospitalier
Lyon Sud
Pierre-Bénite, France
[email protected]
Michel Simonet
Laboratoire de Bactériologie-Hygiène, Institut de
Microbiologie, Centre Hospitalier Universitaire;
Université de Lille 2
Lille, France
[email protected]
Ousmane Traore
Service d’Hygiène Hospitalière, Centre Hospitalier
Universitaire; Université d’Auvergne
Clermont-Ferrand, France
[email protected]
Table of contents
GENERAL CLINICAL MICROBIOLOGY
Gastroenteritis.....................................171
Clinical microbiology: a future based
on tradition.............................................17
Sexually transmitted infections............181
The principles of microbiological:
work and good laboratory practices.....21
Ocular infections.................................203
MALDI-TOF in microbiology..................31
Molecular methods in microbiology......37
Beyond culturing in microbiology..........49
Bacteria in purulent and serous fluids...197
Cutaneous infections...........................215
Dermatophytes in skin, nails and hair...223
Bone and joint infections.....................227
The diabetic foot..................................235
Quality management in microbiology....59
Perinatal infections..............................241
Round-the-clock services
in microbiology......................................69
Infections in burn patients...................251
Antimicrobial susceptibility testing........77
Microbiological examination
of postmortem samples.......................255
Transportation of biological samples
- International regulations......................87
SPECIFIC MICROORGANISMS
MICROBIOLOGICAL DIAGNOSIS
Septicemia...........................................101
Endocarditis........................................111
Catheter-related infections..................115
Anaerobes...........................................261
Borrelia burgdorferi sensu lato............271
Brucella species..................................277
Helicobacter pylori..............................283
Leptospira species..............................287
Central nervous system infections......123
Listeria monocytogenes......................291
Urinary tract infections........................133
Mycobacterium species......................297
Upper respiratory tract infections........145
Rickettsia and related bacteria...........309
Lower respiratory tract infections........153
Arboviruses.........................................315
Pulmonary infections in cystic fibrosis...163
Hepatitis virus.........................................327
Human Immunodeficiency Virus (HIV)...343
Influenza virus.....................................363
Viruses in hemorragic fevers...............369
Leishmania species.............................381
Plasmodium species...........................389
Trypanosoma species.........................399
EPIDEMIOLOGY
AND INFECTION CONTROL
Antimicrobial resistance surveillance..411
Screening for multidrug-resistant bacteria
in health care setting...........................421
Laboratory hygiene and safety...........427
Microbiology
of the health care environment............437
Molecular tools for epidemiology........445
Public health microbiology..................455
The risk of bioterrorism
and class 3 microorganisms...............461