The Editor-Chief-in-Charge is a curd nerd… she not only loves to eat cheese BUT she also makes her own cheese. There is nothing quite as tasty as homemade cheese but it’s certainly not fast food. In fact it’s a very, very, very slow food. It takes a day to make, a couple of days to press, and months or years to mature…. But it is great fun and it might surprise you to know that it is also a lesson in microbiology. [I wonder if the ECIC will still be a curd nerd after reading this?!]
The government are allowing us to visit the beach but are advising us to stay out of the water as there are no lifeguards on duty and do not want additional casualties in hospital. But there might be another reason for us to consider staying out too! Viruses!!! Really!!? Can you actually find viruses in the sea? It’s a simple question but not one many of us have considered before… including me, but then why would we?
You might think that seawater is too salty for viruses and that they would never survive in such a hostile environment. Alternatively you might think that if viruses can survive on surfaces like plastic, metal and cardboard then why not also in the sea. But do we know?
Well back in 1990 Scientists confirmed that viruses can indeed be found in seawater; while looking at seawater with transmission electron microscopes (TEM) they saw “something unusual” but they didn’t actually know at that time what it was… however they could see them! So they started to study them. Remember, TEMs can “see” much smaller objects than normal light microscopes; the limit of magnification of a light microscope is about 1,000x, not enough to see a virus, whereas TEMs can magnify 10,000,000x! OK I know you youngsters think 1990 seems a long time ago but in scientific terms it’s not that long, it’s only since these discoveries in the 1990s that they actually confirmed viruses were there, even though “infection” from contaminated seawater was suspected.
Further studies have shown that in fact there are lots and lots and lots of viruses in seawater….
There seems to be huge amount of confusion about what tests are available for Covid-19. It doesn’t help that politicians and the media keep using the wrong terms and don’t understand what the different tests tell us. The squabbles seem to surround the numbers delivered rather than correct testing!
There are 3 main tests that are currently being discussed:
In order to understand the value of these tests it is important to understand the basic structure of a virus.
The structure of a virus
The Microbiologist picked up the phone to call out a result.
“This one looks interesting” he said to himself even though he knew he had been told never to use the word interesting in relation to microbiology…. Ever…!
“You have a baby boy on the ward with salmonellosis, what’s the story?” he asked when the Paediatric SHO answered the phone.
“He’s a six week old who developed bloody diarrhoea a couple of days ago and started vomiting. He was febrile and looked septic so we started him on empirical IV Ceftriaxone.”
“Any pets?” asked the Microbiologist.
“He’s only 6 weeks old, why would he have any pets?” answered the tired junior.
“Not him, the family; specifically reptiles. Any snakes or lizards?”
“I have no idea.”
“Well carry on with the IV Ceftriaxone as he has a Salmonella species in his blood culture and call me back about the reptiles… no wait, I’ll come up and ask myself.”
The junior doctor hung up. Muttering to himself about mad Microbiologists he wandered off to get on with some other work.
So why did the Microbiologist want to know about reptiles? Was he just mad or was there method to his madness?
Bacteria are clever! Okay, not in the sense of being able to complete cryptic crosswords or even “think” but over the years they have developed many ways of getting around their hosts ability to attack them.
A recent newspaper headline drew my attention to some work done at Newcastle University, in the UK, where they have discovered bacteria doing something a little bit naughty… stripping!
The Biomedical Scientist walked hesitantly into the duty Microbiologists office.
“We have a mould growing in a blood culture” they said.
“You mean a yeast?” asked the Microbiologist.
“Nope, definitely a mould” replied the BMS.
“A contaminant maybe?” asked the Microbiologist again, now starting to hope this was the case.
“Nope, definitely not a contaminant” replied the BMS.
“Please tell me this was handled in Cat 3?” asked the Microbiologist again, starting to sound worried and thinking he should maybe put the Health and Safety Executive (HSE) telephone number into his phone!
“Nope, not in Cat 3” replied the BMS looking crest fallen, “but it should have been… I think it’s Talaromyces marneffei”
The Microbiologist just stared at them lost for words… why did it always happen when he was on duty?!
What is Talaromyces marneffei?
T. marneffei is a dimorphic fungus; it has two types of growth depending on the temperature (a bit like cheese! Cheese is a solid block when in the fridge but when sliced and put on toast under a grill it’s all gooey!!!) It used to be called Penicillium marneffei, but like many other microorganisms it has undergone a recent name change just to keep us on our toes.
Once upon a time… a long time ago… in a distant land… and a galaxy far, far away
The Microbiologist was busy authorising the laboratory results when his phone rang. The call identification showed it was Accident and Emergency (A&E) majors so it might be urgent…It was the A&E doctor.
“I have a patient with positive blood cultures who we sent home 4 days ago”, they said in a slightly panicked voice.
“What did the blood culture grow?” asked the Microbiologist.
“They had a temperature of 38.5 oC and so had blood cultures taken, but clinically it looked like they had a viral upper respiratory tract infection, so we discharged them”, came the reply.
“But what did the blood culture grow?” asked the Microbiologist again slightly louder this time.
“The patient was fine, the temperature settled with Paracetamol. But I think I need to get them back in, repeat the blood cultures and start IV Piptazobactam for sepsis” continued the doctor starting to border on the hysterical.
“STOP TALKING, JUST TELL ME WHAT THE BLOOD CULTURE GREW!” shouted the Microbiologist in a last ditch effort to break through the A&E doctors ranting.
“Oh! It grew a Cutibacterium spp. and I’ve never heard of it before so thought it must be significant”.
“Okay. Take a deep breath and calm down” said the Microbiologist “you might not have heard of Cutibacterium but I am sure you have heard of Propionibacterium acnes?”
“Yea, that’s a skin contaminant but it definitely says Cutibacterium” muttered the A&E doctor now frustrated at the Microbiologist!
“Good, now let me explain the joy that is changes in names…” replied the Microbiologist, "while you're on the phone do you know what these used to be called too?!? I'm doing a quiz for Friday lunchtime..."
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!”
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