Every one has important dates in their lives. This is one for me…
This is my last day working as a microbiologist in New Zealand before heading off to Paris (via Scotland).
It has been a week of sad farewells, morning teas, lunchs, office clearing etc etc.
At these functions, I have received a lot of eulogies. As I am still alive I will call them living eulogies. As is the nature of eulogies, they are quite flattering, not to mention a little embarrassing. (but they are quite pleasant nevertheless…)
This is also an important date because it marks the six month anniversary of this website. It has come along way since those first few weeks, when I would be putting in 2-3 hours a day work into it and getting 5 views! It is still far from the finished article however and I will spend the next six months developing the website, keeping it as ever personable, informal and easy to read.
Yes, I will remember the 28th June as an important date, but no point in looking back. I have lots of personal and microbiological goals to achieve and look forward immensely to a new chapter of my life in Paris…
I am talking here about Multi-Drug Resistant Organisms in the bacterial sense, ie MRSA, ESBLs, VRE etc.
The first thing to say is that in New Zealand we don’t see that many of them, certainly compared with other countries in the world. Click here for more about this.
But what I want to focus on here is the measurement of MDRO rates. There are two main ways to measure these rates.
- 1) Crude Rates: The total number of MDRO isolates per population. e.g number of MRSA isolates per 100,000 population. This is the type of measurement preferred by reference laboratories as they often only receive the resistant isolates, not the susceptible ones…. However this type of rate varies widely depending on how much screening is done at any one institution. The more MDROs are looked for, the more that will be found. The amount of MDRO screening performed in New Zealand varies dramatically from one hospital to another dependent on contractual and other factors.
- 2) As a percentage of total isolates. The MDRO rate can also be measured as a percentage of the total number of bacterial isolates, both susceptible and resistant. e.g The MRSA percentage rate is calculated by calculating the number of MRSA isolates as a percentage of the total Staphylococcus aureus isolates (both methicillin susceptible and resistant). A further example is the percentage of ESBL producing E.coli as a percentage of total E.coli.
I prefer the latter method. I think it is more comparable across areas and it also allows better comparison of rates over time. The Crude MDRO rate measurement is too biased by the amount of testing done and is also susceptible to population fluctuation.
I am not saying that the percentage method is perfect. Like all these things it is susceptible to bias also…..
Currently in our laboratories (NZ): (2012)
- 10% of our total Staph aureus isolates are methicillin resistant (MRSA)
- 1% of our E.coli isolates are ESBL producing.
- 11% of our K. pneumoniae isolates are ESBL producing.
When I return to work in Europe it will interesting to compare the percentage rates with what I am currently used to and speculate as to the differences.
With three more days to go at work in New Zealand, I am just going through my office files working out what I need to take with me and what needs to be dumped…
It would not have been so many years ago, that moving all my microbiology files, old research papers, presentations, textbooks, journals, etc etc would have required several cardboard boxes.
Now I am going to walk out of my office with a USB stick attached to my key ring, a memory “USB credit card” in my wallet, and everything backed up on “Google Drive“.
The days of needing to haul around cardboard boxes are more or less gone, but for those of us of a certain age, we sometimes forget that this is even possible….
The power to store information digitally is now quite staggering. I will thus be ruthless with the remaining paper files in my office, safe in the knowledge that I am not leaving anything behind…
For a wandering microbiologist like myself, paperless travelling is the way to go….