Monthly Archives: December 2015

“Bread and Butter”

Confessions of a Microbiologist, Future of Microbiology,

Chleb_z_Połajewa

If you are a microbiology scientist your bread and butter might be reading plates and  identifying Staph aureus etc from wound swabs. In the future, this will be done for you by interpretative software analysing digital images.

If you are a senior scientist, your bread and butter might be validating/authorising microbiology reports. In the future this will be done for you by sophisticated rules engines.

If you are a microbiology technician, your bread and butter might be putting up swabs onto agar plates, setting up Maldi-TOF plates or inoculating susceptibility broths. In the future this will be done for you by automation. (if not already)

If you are a clinical microbiologist your bread and butter might be giving antibiotic or best testing advice to clinicians. In the future this will be done for you by robust apps on the clinicians’ smartphones.

Worried?

The nature of our jobs are going to change in the future. This might be 2 , 5, 10 or 20 yrs down the line depending on the nature and pace of change. If we expect to continue doing our current job in its current format, then sooner or later your job will be made redundant by advancing technology. Difficult news to swallow, but absolutely the truth.

You might think that the above will lead to a loss of jobs, and it may well lead to a net loss. (This has been debated ad nauseum elsewhere) However on the plus side new jobs (and job descriptions) will almost certainly be created.

For example in the future, new jobs may be available for those who:

  • are expert at maintaining, troubleshooting, configuring and calibrating automated equipment.
  • can develop apps and write rules engines.
  • are comfortable developing testing algorhythms, and composing and formatting online manuals.

We will still need microbiological knowledge, but not in the encyclopaedic way we did a generation ago….

When it comes to this it doesn’t really matter how fast you work or how good you are at your routine work. Advancing technology never pays much attention to these parameters. It just targets bread and butter work and eventually eats it up.

We need to be aware of what our daily bread and butter is in the workplace, what is likely to happen to it in the future, and how we (personally) are going to adapt in order to stay relevant.

Michael

“Keeping Abreast of Change”

The Science of Microbiology, ,

coryne

Normally corynebacteria do not cause much excitement when isolated from wound swabs or pus from abscesses. In fact most of the time we virtually ignore such isolates.

We only usually pay much attention to corynebacteria when prosthetic material is involved, as these bacteria usually only cause clinical problems when there is something “foreign” to cling to.

However this is not the case for breast abscesses and mastitis. Corynebacteria, including both lipophilic ( Corynebacterium kroppenstedtii, C. tuberculostearicum, C. accolens ) as well as non-lipophilic strains (C. striatum, C. minutissimum )are now well established as causative agents in breast abscesses.

Even more interesting, the lipophilic corynebacteria seem to cause a specific type of histological pattern called granulomatous lobar mastitis, with granulomas, neutrophil inflammation, and cystic spaces visualised.

This is all very well, but from a practical point of view, what implications does all the above have for the clinical microbiology laboratory?

Here are my thoughts…

  • All specimens from breast abscesses should be put up on media encouraging the growth of lipophilic bacteria, such as polysorbate (Tween).
  • All recurrent breast abscesses or recalcitrant cases of mastitis should have tissue excised and histology performed. Along the same lines the finding of granulomas on histology should prompt the clinician to consider not just mycobacteria, but also corynebacterium infection.
  • Given the aetiological importance of corynebacteria, all pus from breast abscesses should probably be incubated for 5 days as routine. (We don’t do this currently at my laboratory, but we probably should….)

Here are a couple of articles on this topic to have a read through: (5 min each)

Corynebacterium species isolated from patients with mastitis

Corynebacterium accolens Isolated from Breast Abscess: Possible Association with Granulomatous Mastitis 

Now that Maldi-TOF is well established in most clinical microbiology laboratory networks, corynebacteria can now generally be diagnosed more quickly and easily, and this I am sure will further improve our understanding of breast infections in the future.

Michael

“Welcome to the Future”

Future of Microbiology, ,

IMG_3033

The excitement levels have been cranking up in our lab with the recent installation of the Kiestra Total Lab Automation system. Although we are not yet putting “live” samples through it I have been very impressed with what I have seen so far. It has exceeded my expectations and it clearly offers huge potential in terms of quality and efficiency improvements.

And I am not just saying that. If it was terrible I would say so….

I have just finished my initial basic training on the system and there are a few take home messages I have picked up from the course.

  • It is a sophisticated product already, but there is clearly more to come…. See this article
  • The more you know about the system and how it works, the more you will be able to configure it to maximise efficiency. Even though as a clinical microbiologist I won’t have too much day to day hands on involvement with the system, I fully intend to know it “inside out”
  • The better you maintain and look after it, the better it will perform, and the less likely it is to break down.

Sure it is nice to be the first microbiology lab in New Zealand to have such a system in place, but I am aware of the fact that such systems will be commonplace throughout the country in a few years time.

I feel that if as a microbiologist, you are not excited by such a system and the potential it provides, you are probably in the wrong profession.

If you have any specific questions on installing a Kiestra, just let me know and I will try and answer.

More to come on this topic!

Michael