Interview with Sarah S. Long, MD
How has Principles and Practice of Pediatric Infectious Diseases, 6th Edition evolved since the first edition?
Principles and Practice of Pediatric Infectious Diseases began with a blank yellow pad.
The goal was/is to provide a comprehensive, reliable, up-to-date reference focused on evidence, presented in a practical manner.
The aim was/is to guide the subspecialist or generalist clinician to understand the problem, diagnose the etiology and manage the patient to optimize outcome.
The method was/is to simulate for readers an infectious diseases expert at their side. Sections of the book were set up to reflect how we sort through problems: first by organ-based clinical syndromes that lead to construction and honing of a differential diagnosis; then by a compendium of potential bacterial, viral, fungal and protozoal pathogens, their epidemiology, clinical propensities, diagnostic tests, optimal management and prevention. Other sections were set up to serve as primers as well as blueprints for policy to control and prevent infectious diseases in the community and in the healthcare setting, to use laboratory tests to support clinical thinking, and antimicrobial agents for their greatest benefit.
What is the most exciting aspect of the new edition? What chapter or topic covered are you most excited about?
The field of infectious diseases is ever changing. On the microbial front, emerging pathogens, globalization of people and microbes, and escalating antimicrobial resistance are relentless. On the patient side, new cohorts of children are living with immunocompromising conditions, therapies and devices that make them exquisitely vulnerable to a broadened array of microbes. Fortunately, on the medical front, novel diagnostics, expanding therapeutics and new vaccines are becoming available continuously but the practitioner needs rapid access to reliable resources in order to gain the knowledge and confidence to implement their use in patients’ best interests.
Considering all of this, each chapter and thus each edition includes extraordinary new information and guidance. Every chapter from the previous edition is reviewed, authors are recruited who are seasoned clinicians and epidemiologists in their topical areas, suggestions for changes are made to authors, and both revised and new chapters are reviewed by a Pediatric Infectious Diseases associate editor and the editor for content, format and readability. As dramatically as content has changed from edition to edition, the template for types of content and their layout in chapters, by section, has not changed since the first edition. The reader can expect to find answers to questions in a predictable spot and format. Despite the large number of chapters and contributors, the textbook is scripted to read as the single voice of the expert at your side, anticipating every question.
The pandemic of our lifetime also has had enormous impact on the 6th edition, with substantial inclusion of SARS-CoV-2 across organ-based clinical syndrome chapters as well as in the greatly expanded human coronavirus pathogen chapter. The 6th edition has exciting new content on the microbiome in health and disease, principles of antimicrobial stewardship, molecular diagnostic tests and new antimicrobial agents and vaccines.
Who will find the greatest value from Principles and Practice of Pediatric Infectious Diseases, 6th Edition? Has the audience changed since the book first published?
The intended audience for the textbook has stayed the same, focused on the gap that we saw when it was a blank yellow pad. It is first a compendium of clinical approach, pathogens, diagnosis, management and prevention for the Infectious Diseases specialist caring for a child. Even the seasoned subspecialist should be rewarded with finding of any “odd” microbe identified by a laboratory test accessible in the Index and its nuanced meaning in the text. The textbook also is meant to be an invaluable point-of-care quick consultation for outpatient general pediatric practitioners as well as inpatient hospitalists and other subspecialists.
What new ideas, practices, or procedures would you like to highlight for the new edition?
Images of clinical findings, especially dermatologic findings, have been greatly expanded and enhanced, and are easily transferred to your powerpoint presentations. New figures augment understanding of pathophysiology and algorithms show stepwise considerations in diagnosis, evaluation and treatment. Web resources have been added throughout, for additional information/guidance and for access to experts regarding unusual infections. A benefit of the book’s references online is that the full text of the article is just a click away.
What problem do you hope the future generation of your specialty will be able to solve?
My hope is that future generations will take away from the manner and content of the textbook our belief that clinical observation must be diligently acquired and that knowledge and thoughtfulness must then follow … not to be cut short or eclipsed by algorithms, order sets and indiscriminate application of molecular testing.
Sarah S. Long, MD
I am currently Professor of Pediatrics at Drexel University College of Medicine in Philadelphia. After graduating from the Sidney Kimmel (then, Jefferson) Medical College I ventured north just 24 blocks to St. Christopher’s Hospital for Children and Temple University where I had extraordinary training in Pediatrics and Infectious Diseases. After a year as an NIH research trainee, I returned to St. Christopher’s for my first clinical appointment, as Chief (and only physician) of Infectious Diseases, and stayed for a career. I was pulled to the children of North Philadelphia for whom social determinants lead not only to food insecurity but also to vulnerability to infectious diseases. I have been stubbornly committed to bringing them the best clinical decisions, which lead to their optimal outcomes from infectious diseases. Not long after arriving I concluded that if this could be accomplished for North Philadelphia children, why not for children everywhere and why not for prevention. I have striven to have impact on three fronts: education through Principles and Practice of Pediatric Infectious Diseases, research through clinical and epidemiologic studies of vaccine preventable diseases, and policy by serving on national vaccine advisory committees — for the American Academy of Pediatrics, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention. Even with these national commitments, my most cherished moments still are at the bedside of a child — with a parent, medical student, resident and fellow — all learning together.