eBook sneak peek

Point of Care Publication’s second project has just been announced on the publisher’s website. Their eBook on Clinical Microbiology and Infectious Diseases is nearing completion.  This second eBook will complement Germ: the language of infection.

POCP’s production team advised the Micrognome that they will release their eBook in several formats compatible with a range of eBook readers and hand-held devices. We were able to take a sneak peek and this is what it looks like on the iPad mini.


The Micrognome will put in a request for more information on the contents as soon as Point of Care Publications are ready.


Bread Winners in search of germs overseas

On the Asian bread trail

The crazy bug hunters have been at it again. This time they took to the air courtesy a mixed bag of budget Asian airlines. They converged on the northern Malaysian city of Ipoh for a field applications worship. There we were welcomed by the staff of University of KL’s Royal College of Medicine Perak. In Ipoh they take their hospitality very seriously. We were sampling fresh local bread less than 24 hours after arriving. Here is a view from the top floor of their rather smart building, looking over a nearby mosque.

And this is the first of our encounters with freshly made bread. It was served as an accompaniment to Moroccan lamb, tabouleh and other Arabic delicacies. By the time we’d made it back home, the team had sampled naan, dosai, pakoras and the wonderfully calorific murtabak. Plain white bread is, well, just plain by comparison.

Another bread for the team

The bug hunters did get down to some serious field work before knuckling under with their set of automatic pipettes. Here they are among the tea bushes in the Cameron Highlands (home of the giant strawberry, for Australian collectors of bizarre giant replicas). The last time we were in tea growing country was June this year when we deployed our field lab to Central Province, Sri Lanka. Our photographer captured the moment the yellow tops came into evidence among the bushes.

tea bags?

Once in the lab it was time to sweat the small stuff. That’s how we earn our crust, working systematically through a series of samples with our Lab Without Walls field portable equipment set. Here you can see a Micrognome demonstrating the use of a Mk I head as a substitute for an anglepoise lamp, while one of the workshop participants dispenses PCR reagents.

two legged lamp stand

And the results of our bread run?

  • blood culture confirmatory PCR panel run on positive cultures same day
  • 5 of 6 suspected Burkholderia isolates confirmed as B. pseudomallei AND shown to be SE Asian clade by PCR assay
  • 3 of 5 hospital admissions shown to have dengue virus genotypes 1 or 2 on same day
  • hands on familiarisation with field applications of molecular microbiology in national workshop
  • lectures on severe sepsis, melioidosis and other activities of the Lab Without Walls

out of the box and into action

Ipoh has a great reputation for Asian food and is now a direct budget flight from Singapore.


2011 MicroGnome Review

This is the time of year when we reflect on the event of the past year and prepare for what might be coming over the horizon. 2011 was a year of steady progress in the field of infectious diseases, with notable milestones in all of the big three and some game-changing developments for other infections.

The MicroGnome has picked a handful of achievements for this 2011 MicroGnome review that should inspire anyone with an interest in infection. If you have been living under a stone all year, maybe you should try the coffee zone for a less demanding read.

Reporting the preliminary results of a phase three trials of the RTS,S vaccine candidate in neonates and infant groups from seven African countries over 14 months, the authors of a November paper in the New England Journal of Medicine reported a halving of malaria, and a 45% reduction in severe malaria cases. While these effects are far less than routinely used childhood vaccines, they raise hopes for development of a mortality-reducing malaria vaccine.

Promising early performance studies prompted the World Health Organisation and other donor agencies to equip clinical laboratories in resource-poor countries with rapid molecular screening tests for pulmonary tuberculosis. In a useful review of this application of molecular microbiology, Carlton Evans explains the need for caution in the introduction of this technology to low and middle income countries.

There is a growing awareness of the potential for antiretroviral agents in a preventive role. In a mathematical model of the cost effectiveness and impact of different strategies, an international group showed that effective preventive pre-exposure prophylaxis of the uninfected partner could be more effective than commencing ART earlier in the infected partner.

The application of mass spec-based methods for identifying the contents of blood cultures has been gathering pace in Europe for several years, and has started to spread to other parts of the world. While some clinical laboratory directors might have their heads stuck in the sand, there are plenty of pathologists who would give an arm and a leg for equipment that can trim around 24hr or more off the time to identification of bacterial causes of septicaemia. Klein and colleagues are one of many groups working out how to implement this emerging technology in a busy clinical laboratory service.

Influenza: working out why the vaccine had adverse effects

the adverse effects of Australian produced vaccine are thought to have been due to suboptimal virus splitting by a deoxycholate-based procedure. Benefits of vaccination still outweigh the risk of adverse effect.

A phase three trial of a tetravalent live attenuated vaccine against dengue virus is now under way. Once industrial production of this promising candidate has been established, its efficacy confirmed and administration optimised, it will be of considerable interest to many parts of the tropics where dengue is a substantial burden on the public health.

So what’s in store for 2012, apart from more of the same?

At a guess, it looks like we’re going to drill deeper into severe sepsis, see an expanding series of field studies and continue our peripatetic investigation of tropical infectious diseases. The language of infection series is set for significant expansion in support of teaching and training activities. One outcome of our 2011 MicroGnome Review was to recognise the need for an expanded writing team. The group sends you their best for 2012, and will now pause briefly to welcome in the New Year.

A bit of breadth to your language

And now for the next instalment in the Language of Infection series; adjetivos.

This will appear shortly as the latest in the series to date on www.priobe.net. In the meantime, here is version 1.0 for your consideration and comment.

Adjectives are the describing words used to give a bit of additional detail to the naming words called nouns. A good place to start is with the adjectives that are used to describe specific infections. These often end in ‘–al’ and show that the infection is associated with that particular microbe.