Consider specific diagnostic approaches to each agent, including where relevant, serological testing, antigen detection and nucleic acid amplification methods. Also know what is locally in use in your laboratory.
Immunisation – need to know about the vaccines that are available – relevant for HPV, HBV, Influenza, Dengue, JEV, Polio, HAV, HEV, MMR, Rotavirus.
Particular attention required for those agents underlined. This is not an exhaustive listing but includes all viruses of current clinical relevance.
It’s useful to know your schedules and appreciate something of the rationale for the dosing recommendations. Also be aware of key vaccines that are yet to be introduced – e.g. rotavirus, HPV. Please work through the SAQ below.
In the news:
Some short questions to consider:
- Contrast the PNG and NHS schedules above. What important gaps are there?
- Why has IPV replaced OPV in the NHS schedule?
- What is happening with wild type polio control across the world? Which subtype has been eradicated? Where are the remaining areas of activity for wild type polio?
- How does OPV revert to virulence?
- What are the risks of dengue vaccine? What is its efficacy in different groups?
- How does one estimate vaccine efficacy?
Guest posting: Dr Ian Marr, Microbiology Registrar, Pathology North.
Melioidosis is a cause of severe pneumonia, bacteraemia, urosepsis, prostatic abscess, CNS infection, pyogenic myositis and liver and spleen abscesses. It is found in PNG especially around the Balimo region – see Warner, Currie et al 2018 : Melioidosis in Papua New Guinea and Oceania- an important short read.
Melioidosis is caused by Burkholderia pseudomallei, a Gram-negative rod, straight or slightly curved, with bipolar staining, or safety pin appearance. It is highly motile when viewed under phase contrast microscopy. Continue reading
Dr Ian Marr has produced a useful summary for our local ID & Micro tutes recently which is shared – Rabies_2018 Marr .
It includes reference to Australian bat lyssavirus which clearly may have an incidence outside of Australia (in bats and/or humans)! Serosurveillance of bat populations in the Philippines has suggested that lyssavirus infection of bats might be more widespread than previously thought.
For the purposes of post-grad UPNG pathology revision, I would suggest you consider these additional questions-
- What is the local epidemiology of rabies in SE Asia? Especially focus on prevalence of cases within Indonesia.
- Read up the rabies vaccine advice provided by the Australian NHMRC Immunisation handbook.
From Cepheid Xpert brochure:
Here are the four presentations given to National Academy of Medical Sciences, Bir Hospital Pathology and Medicine Residents over the week commencing 7/5/18 by Emeritus Professor Robert Martin, President of the Diagnostic Microbiology Development Program.
Elements of laboratory QMS (WHO)
Here are the three presentations given to National Academy of Medical Sciences, Bir Hospital Medical Residents over the week commencing 7/5/18. Thank you for attending and I hope they were useful. Please feel free to contact me via email if you have questions! As mentioned, I do encourage you to enrol in the international online AMS MOOC course. Best wishes, John
Here are example antibiograms for Hunter New England (NSW). These are constructed by assessing the % susceptible for specific bugs and drugs, taking only the first isolate of a species per person per annum. Where is it possible extrapolate susceptibility rather than test or we know a particular species is intrinsically susceptible, we enter “S”. Conversely, species that are intrinsically resistant to an antibiotic (e.g. Gram negatives and vancomycin) are marked as “R”. In either situation, there is no rationale for actually testing that antibiotic against the species.
Guest posting: Dr Syeda Navqi, Microbiology Registrar, Pathology North.
Group: Aerobic actinomycetes
- Gram positive bacteria that are usually filamentous and branched, commonly producing a fungus like mycelium that fragments into rod shaped or short coccoid form.
- All grow better under aerobic than anaerobic conditions, a feature distinguishing them from most organisms in the genus Actinomyces.
- The organisms containing mycolic acids in their cell walls (included in the genera Nocardia, Rhodococcus, Gordonia, Tsukamurella, and Corynebacterium) are rather closely related on the basis of molecular genetic studies. c.f. Streptomyces, Actinomadura, Dermatophilus have no mycolic acid.
- Nocardia is the most important genus as the most commonly isolated aerobic-actinomycete human pathogens.
- There are approximately 87 validly named species included in Nocardia genus.