“We have a lady with puerperal fever. She’s 2 days post-delivery and pretty unwell. Critical Care are reviewing her now and we’d like some advice about the best antibiotics to give her” said the Obstetrics Registrar.
 
Excellent thought the Microbiologist; they’re being proactive about a serious problem.
 
“If she’s not allergic to anything then IV Benzylpeniciilin and Clindamycin. Have you looked for retained products and done a DNC?” asked the Microbiologist.
 
“She’s really unwell, we don’t really want to take her to theatre. We might damage the uterus” replied the Registrar.
 
“She’s unlikely to improve if you don’t,” said the Microbiologist sympathetically. “You need to remove as much infected material as you can. I know it sounds brutal but it’s really important”.
 
“Okay,” said the Registrar sounding doubtful, “my Consultant is with the patient at the moment so I’ll go and tell them what you have advised. Thanks for your help.”
 
The Microbiologist put down the phone and put down his pen. Time to visit the obstetric ward and see what is going on…

Happy Valentine's Day! The Love Virus is in the air...
“Chinese media are showing hardworking hero stories, it's Jeong Jae Pung’s wedding anniversary … ‘come home soon’ his sign says [according to the BBC reporter] … his wife is a nurse looking after virus patients and contact with the outside world is forbidden…” (BBC News at 10, 13/02/2020)

So what’s wrong with this picture?
The nurse is on a mobile phone wearing her PPE outside of the hospital, according to the UK’s guidelines it should be removed inside the patient’s room and why is she using her mobile phone?!

This breaches Infection Control policy in so many ways; leading to contamination of the hospital and the wider environment and also exposes this person and their family to the virus. She might as well not bother wearing the PPE at all.

This picture is so crazy it deserves a caption competition, no prizes, just the kudos for being the wittiest reader of the bug blog!
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Add your caption below or on Facebook :-)

It’s all over the news; a new deadly plague is spreading across the World in an unstoppable wave of death and disease! Cities are falling, governments are collapsing, mass panic and chaos are ensuing… or at least that’s what the media would have us believe about the novel coronavirus from Wuhan in China. Gosh, it’s reminding me of the game of Pandemic!

The Microbiologists were out having their Christmas curry together when the oncall phone twitched into action. Looking around the table, under pulled crackers and wrapping paper, the oncall Microbiologist (the only one not drinking!) took the call while the others ordered some more drinks and food… It was a noisy gathering as Microbiologists don’t get out much…
 
The waiter looked expectantly to take more drinks orders….
 
“I’m sure she said a mango lassie, I’ll get her one …yes… one mango lassie please and five cobra beers and another taka dahl, thanks”. The waiter scuttled off.
 
“I ordered you the mango lassie” said the (tipsy off duty) Microbiologist
 
“Why did you get me a lassie?” asked the oncall Microbiologist.
 
“You said mango lassie while on the phone… when we were ordering more drinks… didn’t you!?!”
 
“No… that was the Med Reg from the Royal Free, saying they thought one of contacts of the Dutch Lassa fever cases might be transferred to us for follow up and thought we’d like to be aware, as it was in the news and may cause us a call or two if the local media get to know!”… continuing… [and huffing]  “Really… its 10:30 on Friday night, I do not need to know this oncall, but everyone wants their minute of fluster and fame!!” … “Mango lassie…?! You lot need a hearing test or less Cobra beer!” said the oncall Microbiologist.
 
“5 Cobras and a mango lassie…” said the waiter with impeccable timing!
 
The Microbiologists crumpled in laughter and thanked the waiter who just looked puzzled and said he’d bring over the dahl.

Warning: this blog mite make you itch!
 
The Oncology Registrar sat in the Multidisciplinary Team meeting looking thoroughly miserable. They looked like they hadn’t slept for ages, and whilst this can often be the case for junior doctors, the Microbiologist knew the registrar had only just returned from annual leave.
 
Whilst trying to pay attention to the patient discussions the Microbiologist watched as the poor Registrar kept scratching at his hands and arms.
 
As the meeting drew to a close, the Microbiologist wandered over…they can’t help but meddle!!!
 
“You look like your suffering” he said sympathetically, when in fact he was “itching” to make a shrewd diagnosis!!!
 
“Yeah. My hands and arms are really itchy, and it was worse in that room as it was so hot. I think I’m allergic to something”.
 
The Microbiologist wasn’t so sure.
 
“Show me your hands” he said.
 
The Registrar helpfully held out his hands which looked red and inflamed.
 
Looking closely whilst not touching (oooh, all those germs!!! He’d seen the Infection Control hand plates in the past!!!) the Microbiologist soon realised the likely cause of the problem.

The Microbiologist was slowly meandering through the daily authorisation, trying to stay awake and not authorise something important without seeing it first… honestly we do really pay attention but it can be a little dull authorising out more than a hundred urine results a day!
 
Suddenly something caught their eye. A wound swab was growing Candida auris. The Microbiologist sat up straight in his chair (I am notorious for slouching at the duty desk!) and picked up the phone to find out more.

It was a hot and dozy afternoon in the microbiology lab. The air-conditioning system was on the blink again and a nice large lunch of sausages, chips and beans had made the Microbiologist particularly sleepy. The telephone rang.

​​“My patient has plague!” screamed the excited junior doctor.

​I’ve had the dubious pleasure of dealing with various incidents and outbreaks over the years. They can be very stressful experiences for everyone concerned, but a clear methodical approach can go a long way to alleviating the levels of stress both in both you and your colleagues.
 
Imagine the scenario:
It’s 9am and the Senior Biomedical Scientist knocks on your door “ummm the laboratory has inadvertently processed a tissue sample containing Brucella melitensis on the open bench!”

The patient was admitted 3 days after arriving in the UK from Nigeria. He had felt unwell with a fever and generalise aches and pains the day before he travelled. On the morning of admission he had noticed a rash on his left leg as well as tender enlarged lymph nodes in his groin.
 
The admitting Consultant Physician spoke to infection control before the patient arrived and it was decided to admit the patient directly to a negative pressure side-room in the infectious diseases unit without bringing the patient into the main hospital in case this might be a viral haemorrhagic fever. The patient met a diagnosis of low possibility of viral haemorrhagic fever; temperature ≥ 37.5 oC PLUS been in endemic area within 21 days of onset of illness.

Between 2000 and 2003 a large outbreak of Clostridium difficile occurred in Montreal, Quebec, Canada. There are differing reports as to the extent of the outbreak, but some estimate that in 8 hospitals there were 7,000 cases and 600 deaths in 2003. This is at least a 5 fold higher incidence and mortality than considered “normal” by the Canadian public health officials. The strain of bacterium was identified as the now notorious O27 strain, but it was soon realised that this “outbreak” was in fact going on all over the World, not just in Quebec. Apparently Clostridium difficile means the “obstinate spindle” bacterium… and I think all Microbiologists would agree with the term, though some of us might be less polite in our language!