Take a look at this, its bacteria!
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!”
It was another dull and dreary afternoon giving advice when an excited Dermatologist phoned about a patient with funny skin lumps. (Microbiologists get excited about bugs, Dermatologists get excited about rashes, so lumps and bumps together… what can I say…we were very excited!!)
Their patient was a keen gardener who had been clearing a large number of blackthorn trees (good for making sloe gin) and despite wearing thick gloves had managed to get pricked and scratched all the way up their arms. At the site of one of those puncture wounds they had developed a small red lump which had eventually turned into a small ulcer. The ulcer hadn’t got much better and over the next few weeks the patient had noticed a number of other lumps appearing up their arm and then hard swellings in their armpit.
Yep, it’s coming up to that time of year. All of Microbiology is excited as there is about to be a holiday and eggs are likely to feature in a big way… no not Easter!!! Its holiday time and people will be going to exotic countries and bringing back souvenir parasites and their eggs will be involved in working out what is wrong with them. Yep us Microbiologists’ love eggs, not just the chocolate variety. I don’t know, you lot all have chocolate on the brain :-)
Okay, so the Bug Blog is usually about the clinical and scientific aspects of microbiology but this week I’m going to do something a bit different. Now I’m not someone who watches much TV; there was very little on that interested me over the Christmas period. However, I did watch a short TV hospital dramatization called Charité on Netflix which I thought was brilliant and something that anyone interested in microbiology would also enjoy. OK so it’s in German with English subtitles, but it is the best show I have watched in a long time! Let me explain.