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I am signing out blood culture results. A patient has an E. coli resistant to amoxycillin clavulanate (augmentin) in both their blood culture and urine specimen. I ring up the patient’s doctor to see how the patient is doing. The patient is currently on augmentin but is nevertheless feeling much better, has been switched to …
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I happened to be visiting a microbiology lab in a large teaching hospital last year. We were shown all the assays they used to rapidly identify a pathogen from positive blood cultures: PCR assays, FIuorescent In-Situ Hybridisation (FISH). They had the works! The range of tests available was very impressive, and would be the envy of most diagnostic microbiology laboratories. But …
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I hadn’t been feeling quite right since Christmas… Upset stomach, loose bowel motions, no appetite, and worst of all I didn’t even feel like a glass of wine in the evenings! The symptoms weren’t that severe, unfortunately not even bad enough to keep me off work, but they just grumbled on and on… After a …
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A lot of antibiotic treatment of infectious diseases is still “empirical” in nature. “Empirical” generally means “based on experience”, so to administer an empirical antibiotic means to give the antibiotic that is most likely to work based on previous experience with that infection. Antibiotic treatment has traditionally been empirical because waiting for culture and susceptibility …
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For several years now, the standard empirical treatment for gonorrhoea has been intramuscular ceftriaxone. This wasn’t always the case, but the resistance rates for both penicillin and ciprofloxacin crept up to levels that meant using them as empirical antibiotics was no longer a satisfactory option. N. gonorrhoeae is particularly vulnerable to antibiotic resistance, essentially because it has no …
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At my laboratory we only test nasal Staphylococcus aureus susceptibility to mupirocin in the following two circumstances: Prior to joint replacement surgery as part of a Staphylococcal decolonisation bundle In patients where the clinical details state recurrent skin infections In the patients about to get their joints replaced, our nasal Staph aureus resistance rate to …
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One of the great things about having your own microbiology blog is that you don’t need to ask anybody for permission. You can write about whatever you want, even if it is only remotely related to microbiology! You have no deadlines to meet. If you want to post three articles in a day, you can. If you …
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There is one thing certain in the microbiology laboratory, that the results will be uncertain. This has nothing to do of course with laboratory systems or the competency of staff members. Just an acceptance that there is no such thing as a certain result… The other thing to note is that the degree of certainty …
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There are many causes of a lymphocytic CSF, both microbiological and non-microbiological. Here is a quick and non-exhaustive summary: Enteroviruses- probably the most common cause, in most parts of the world. Herpes Simplex Virus (HSV)- one of the most important to diagnose/exclude as HSV encephalitis is associated with a high mortality rate. “Lots of other …
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When I was offered the chance to go to a WHO influenza meeting in Kathmandu, I grabbed it with both hands. Such opportunities certainly don’t come by every day… However the trip to Nepal did not get off to the best of starts. On the flight to Kathmandu, I started to get toothache. By the time we landed …
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