It’s the time of year when Microbiology Registrars begin to have palpitations and panic attacks about the impending FRCPath Part 2 exams in spring. All Microbiology Consultants in the UK (and also many overseas) have done the exams to attain Fellowship of the Royal College of Pathologists, and it is a gruelling experience. I have had the pleasure of helping a number of Registrars prepare for the exam and this year is no different. For those of you who don’t know, the FRCPath Part 2 exam is four days long: day 1 is six hours of written exams and days 2-4 is a practical laboratory-based diagnostic exam where the results from day 1 informs the actions of days 2 and 3 subsequently. Getting it wrong can cause spiralling errors...
“A new antibiotic kills pathogens without detectable resistance” is the rather uninspiring title of what is being hailed as a landmark piece of work published by Nature this month. The work by Ling, Schneider, Peoples et al as a collaboration between pharmaceutical companies and research scientists, in Massachusetts in the USA and Bonn in Germany, presents the first new class of antibiotic to be discovered in more than 30 years. What’s more, the authors claim that resistance to this new agent is unlikely to occur. So what’s the hype all about and should we all heave a sigh of relief that the antibiotic drought is over? Perhaps that would be a bit premature…. Let’s look at Teixobactin a bit further (and what better way than in the format of the book Microbiology Nuts & Bolts?).
The last couple of weeks have been very busy in the NHS, and the Microbiology laboratory has been inundated with samples from patients with fevers. Many have coughs and colds and are otherwise okay, but others have severe invasive infections such as pneumonia, cellulitis and meningitis! Yep, if you hadn’t noticed already, winter is definitely here.
Every year in the UK we have an increase in respiratory illnesses in the winter, in particular with influenza. So how do we know when it is flu-season? There is a threshold based upon the observations and testing of patients in certain sentinel GP practices and laboratories around the country and when they are seeing enough cases of influenza it means that the winter virus is here. This year is no exception, and we are now seeing a lot of cases of influenza therefore we are allowed to prescribe Oseltamivir (Tamiflu) based upon the clinical suspicion of influenza. Out of season a confirmed laboratory test is usually required. In fact influenza is circulating in the community at levels higher than the last three years and there have been 74 outbreaks reported nationally in the last week according to Public Health England, 60 in care homes.
Staphylococcus aureus in blood cultures makes patients really unwell and is a common cause of sepsis, the treatment of which should ideally be started within 1 hour otherwise mortality rises 7% per hour delayed. So it’s important to know and recognise this bacterium and more importantly to be able to decipher the “gobbledygook” terminology the Microbiologist uses when they relay the result!