Part II preparation I approached this quite differently from Part I - I didn’t really use textbooks but instead spent a lot of time going through guidelines and websites instead. I continued to use my Anki study deck from Part I (which functioned as revision for Part I knowledge), and kept adding to it during this time. My study group prepared for this in a similar way to Part I viva by running through questions with each other – by the time we got to the exam we were all very used to answering questions over Zoom in the viva format! Book reviews How to be a lab director (I used a version tha ..read more

Our trainee Shireen recently passed her Royal College of Pathologists of Australasia Examination. She was invited to share her exam preparation strategy for the benefit of our other trainees. Disclaimer This document is based on my personal experience and what worked well for me to get me through the exams. Everyone’s experience will be different and what worked for me may not work so well for someone else (and vice versa)! This is also not comprehensive and is just my attempt to cobble together a list of the resources that I used or found particularly helpful. There are also many other res ..read more

Lactococcus garviae is a Gram positive coccus that somewhat resembles Enterococci. It is a known animal pathogen having originally been isolated from cases of bovine mastitis.  It also causes pneumonia in pigs, and haemorrhagic septicaemia in fish (Gibello, 2016).  Many recent publications in the literature relate to its impact on aquaculture where it is a major pathogen (Meyburgh, 2017). I encountered my first clinical isolate of L. garviae (from the blood culture of a patient) in April 2012. A quick internet search found that L. garviae bacteraemia had been associated with raw fis ..read more

On 31 Dec 2019, our associate consultant Dr Karrie Ko posted a Reuters report on the Department of Microbiology junior doctors WhatsApp chat- “Chinese officials investigate cause of pneumonia outbreak in Wuhan.” It didn’t elicit an immediate response. At that time most of us did not even know where Wuhan was, or that it had a population of over 11 million. It all seemed very remote. My regular tea-buddy is from the Department of Molecular Pathology. Through Jan, the Wuhan pneumonia situation cropped up regularly in our discussions. If there was a need to diagnose this new disease by polymerase ..read more

The first ever case of zoonotic fish-associated S. dysgalactiae subspecies dysgalactiae (SDSD) infection was isolated in our lab in 2005. This was during a period when we were actively looking out for cases of Streptococcus iniae, another fish-associated zoonosis (see an earlier post). We had isolated a Streptococcus from the blood culture of a breast cancer mastectomy patient with cellulitis ascending her upper limb to the chest following a puncture injury of her index finger on the same side. She had been cleaning fish (Red Tilapia) and shrimps at the time. This is a typical setting for S ..read more

This story from my perspective begins on the 28 December 2015- at 5.27 pm precisely. I know because that exact moment is captured on the WhatsApp chat on my handphone. That’s my virology colleague remarking that he was signing out more Hepatitis E results than he expected. I’m no virologist but it did seem odd to me too. Hep E virus (HEV) is a positive-sense, single-stranded, non-enveloped, RNA virus that is spread by the faecal-oral route. When I was a microbiology trainee I was taught it was a disease mainly of developing countries due to ingesting contaminated water and shellfish. The sanit ..read more

Let’s say hypothetically one day you come across this Gram stained slide  of a positive blood culture from a patient on the haematology unit. Yup, it is a mould. Those are hyphae. We don’t often see moulds in blood cultures but there is one that typically infects haematology patients. Fusarium spp. OK, these are immunocompromised patients who are more susceptible to fungal infections, fungi are everywhere, especially in the tropics, bad things happen. Over the next 3 weeks you get another 2 cases of Fusarium fungaemia. All 3 patients are on the same unit. You check that they were not admitted ..read more

There is general advice and exam specific advice (highlighted text has hyperlinks). General Advice This applies to preparing for local practice in Singapore. This has a slightly American slant (unfortunately the exams you will be sitting are British and Australian). Refer to your JCST Seamless Programme Medical Microbiology Training Syllabus and use this as a checklist. Literally tick off each item as you go so that there are no gaps in your training experience. During your lab training you will be used to seeing tests as individual items. However you must get your head round to seeing thing ..read more

We have previously blogged about using the Olympus Air for taking images of Gram stains. This gave the image quality of a dedicated microscope camera but the added convenience of quickly sharing the image because it was transferred to a handphone. But why not just use a handphone to capture the image directly?Anyone who has tried this will realise it is not as easy as it sounds. If you just hold the handphone lens flush against the microscope eyepiece, it is very difficult to get a good image of the slide because the wide angle of the camera lens tends to include the sides of the eyepiece barr ..read more

The SGH laboratory has been doing antimicrobial surveillance testing on regular  systematic sample collections of Neisseria gonorrhoeae sent to us from the Department of  Sexually Transmitted Infection Control, National Skin Centre since 1992 (at least). These results are submitted to the World Health Organization Gonococcal Antimicrobial Surveillance Programme (WHO GASP). If you are interested, the reports are freely available at the WHO GASP website (https://www.who.int/reproductivehealth/topics/rtis/gonococcal_resistance/en/).Local isolates of N. gonorrhoeae are often resistant to penicilli ..read more