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Doctor, doctor, is there a mythological creature on my heart valve?

27/6/2017

 
​The patient turned up at his GP practice clutching a letter to his chest and telling the receptionist “I must see my doctor today!” before bursting in to tears.
 
The receptionist got a message to the doctor who agreed to slot the patient in to this morning clinic as soon as possible. When the patient was finally seen he presented a letter to the doctor. The letter from Public Health England (PHE) said “patients who have undergone heart surgery (valve and coronary artery bypass grafting) since 2007 were at risk of developing a severe infection, Mycobacterium chimaera. Although the risk remains low patients should contact their GP for further assessment”.  The patient explained to his GP that he had had heart valve replacement surgery last year and was now very worried he might be unknowingly infected by a mythological creature.
Mycobacteria chimaera
Chimaera - a monstrous creature composed of a lion with the head of a goat rising from its back and a tail that ends with a snake's head!

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What have you isolated today?

21/6/2017

 
An elderly patient was brought in to hospital having fallen in the garden where he had been for 3 days because he was unable to get himself back on his feet. He was unkempt and had a number of areas of broken skin on his head and neck as well as his arms. These wounds were infested with maggots which looked to have started to digest the healthy skin at the base of the wounds. The patient was very unwell with high blood inflammatory markers, renal failure and sepsis. He was started on IV Piptazobactam for sepsis of unknown origin.
maggots carry Wohlfahrtiimonas chitiniclastica

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Killing super bugs with super antibiotics?

15/6/2017

 
Picture
Okay, it may not look like much but the antibiotic in the diagram above may just represent the saviour of antimicrobial therapy! Or rather, the method by which this antibiotic was created may be what really saves us! I’m very excited!!!
 
The picture shows a modified version of the antibiotic Vancomycin from a paper in Proceedings of the National Academy of Sciences of the United States of America (PNAS… unfortunate acronym!). The authors Okano et al have “manufactured” this new version of Vancomycin to have potent activity against normally Vancomycin-resistant bacteria.

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Coughs are like hairballs, they don't need antibiotics

6/6/2017

 
How do you manage patients with an acute cough in primary care? It’s a common problem and one that accounts for over £15 million worth of antibiotic prescribing every year in the UK.

So are antibiotics really necessary? What happens if you don’t give antibiotics immediately or give the patient a delayed prescription with clear instructions on when to take them? How many of these patients will come back later? How many will be admitted to hospital and how many might die?! 
Delayed antibiotic prescribing in acute cough

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    Blog Author:

    David Garner
    Consultant Microbiologist
    Surrey, UK

    Please DO NOT advertise products and conferences on our website or blog

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