{"id":2618,"date":"2015-12-07T14:52:46","date_gmt":"2015-12-07T01:52:46","guid":{"rendered":"http:\/\/microbiologymatters.com\/?p=2618"},"modified":"2015-12-07T14:52:46","modified_gmt":"2015-12-07T01:52:46","slug":"keeping-abreast-of-change","status":"publish","type":"post","link":"https:\/\/microbiologymatters.com\/?p=2618","title":{"rendered":"&#8220;Keeping Abreast of Change&#8221;"},"content":{"rendered":"<p><span style=\"color: #0000ff;\"><a href=\"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2015\/12\/coryne.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-2620\" src=\"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2015\/12\/coryne.jpg?resize=250%2C200\" alt=\"coryne\" width=\"250\" height=\"200\" data-recalc-dims=\"1\" \/><\/a><\/span><\/p>\n<p><span style=\"color: #0000ff;\">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.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">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 &#8220;foreign&#8221; to cling to.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">However this is not the case for breast abscesses and mastitis. Corynebacteria, including both lipophilic\u00a0( <em>Corynebacterium kroppenstedtii, C. tuberculostearicum,<\/em> <span style=\"color: #0000ff;\"><em>C. accolens<\/em> <\/span>) as well as non-lipophilic strains (<span style=\"color: #0000ff;\"><em>C. striatum, C. minutissimum<\/em> <\/span>)are now well established as causative agents in breast abscesses. <\/span><\/p>\n<p><span style=\"color: #0000ff;\">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.<\/span><\/p>\n<p><span style=\"color: #0000ff;\">This is all very well, but from a practical point of view, what implications does all the above have for the clinical microbiology laboratory?<\/span><\/p>\n<p><span style=\"color: #0000ff;\">Here are my thoughts&#8230;<\/span><\/p>\n<ul>\n<li><span style=\"color: #0000ff;\">All specimens from breast abscesses should be put up on media encouraging the growth of lipophilic bacteria, such as <span style=\"color: #ff0000;\">polysorbate (Tween)<span style=\"color: #0000ff;\">.<\/span><\/span><\/span><\/li>\n<li><span style=\"color: #0000ff;\">All recurrent breast abscesses or recalcitrant cases of mastitis\u00a0should have <span style=\"color: #ff0000;\">tissue excised and histology performed<\/span>. Along the same lines the finding of granulomas on histology should prompt the clinician to consider not just mycobacteria, but also corynebacterium infection.<\/span><\/li>\n<li><span style=\"color: #0000ff;\">Given the aetiological importance of corynebacteria, all pus from breast abscesses should probably be incubated for <span style=\"color: #ff0000;\">5 days as routine<\/span>. (We don&#8217;t do this currently at my laboratory, but we probably should&#8230;.)<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #0000ff;\">Here are a\u00a0couple of\u00a0articles on this topic to have a read through: (5 min each)<\/span><\/p>\n<p><a href=\"http:\/\/cid.oxfordjournals.org\/content\/35\/11\/1434.full.pdf+html\">Corynebacterium species isolated from patients with mastitis<\/a><\/p>\n<p><a href=\"http:\/\/jcm.asm.org\/content\/45\/5\/1666.full\"><em>Corynebacterium accolens<\/em> Isolated from Breast Abscess: Possible Association with Granulomatous Mastitis\u00a0<\/a><\/p>\n<p><span style=\"color: #0000ff;\">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\u00a0infections in the future.<\/span><\/p>\n<p><em>Michael<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 &#8220;foreign&#8221; to cling &hellip; <a href=\"https:\/\/microbiologymatters.com\/?p=2618\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">&#8220;Keeping Abreast of Change&#8221;<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[4],"tags":[392,393,394],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p37jIp-Ge","jetpack-related-posts":[{"id":1665,"url":"https:\/\/microbiologymatters.com\/?p=1665","url_meta":{"origin":2618,"position":0},"title":"&#8220;The Bottom Line&#8221;","author":"michael","date":"June 5, 2013","format":false,"excerpt":"This post continues the \"merdish\" theme of the previous article. There are two\u00a0of types of microbiology samples in this area\u00a0which I have always had some reservations about as to their usefulness. These are samples from peri-anal abscesses and pilo-nidal sinuses. There a few reasons why I believe that sampling from\u2026","rel":"","context":"In &quot;The Art of Microbiology&quot;","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":1922,"url":"https:\/\/microbiologymatters.com\/?p=1922","url_meta":{"origin":2618,"position":1},"title":"&#8220;Spending money where it matters..&#8221;","author":"michael","date":"September 18, 2013","format":false,"excerpt":"\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 I suspect the next revolution in diagnostic bacteriology will be (routine) rapid identification of bacteria from blood cultures which have flagged positive on blood culture analysers. Fluorescent In-Situ Hybridsation (FISH) technology\u2026","rel":"","context":"In &quot;Future of Microbiology&quot;","block_context":{"text":"Future of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=15"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":768,"url":"https:\/\/microbiologymatters.com\/?p=768","url_meta":{"origin":2618,"position":2},"title":"&#8220;All samples are equal but some are more equal than others&#8230;&#8221;","author":"michael","date":"February 17, 2013","format":false,"excerpt":"Most samples that arrive into the microbiology laboratory are processed. However there are some where the clinical usefulness of the result must be almost negligible. Let me give you a few examples... Swabs of boils that have just been lanced. It is the lancing (draining of pus) which will almost\u2026","rel":"","context":"In &quot;The Art of Microbiology&quot;","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":3456,"url":"https:\/\/microbiologymatters.com\/?p=3456","url_meta":{"origin":2618,"position":3},"title":"&#8220;Separating the wheat from the chaff&#8221;","author":"michael","date":"July 4, 2017","format":false,"excerpt":"For every two or three genuine positive blood cultures, there is usually one which represents skin contamination (in my laboratory at least). As laboratory microbiologists, we often need to make an assessment about the likelihood of this fact, in order to guide the clinicians. The \"offending\" microbes are usually coagulase\u2026","rel":"","context":"In \"blood cultures\"","block_context":{"text":"blood cultures","link":"https:\/\/microbiologymatters.com\/?tag=blood-cultures"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2017\/07\/ehat-300x210.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":3690,"url":"https:\/\/microbiologymatters.com\/?p=3690","url_meta":{"origin":2618,"position":4},"title":"&#8220;Choosing wisely bacteriology II: Swabs from the peri-anal area&#8221;","author":"michael","date":"December 5, 2017","format":false,"excerpt":"There is so much scope for \"choosing wisely\" in general bacteriology, it is difficult to know where to start... Peri-anal swabs are rarely of value in changing patient management. That is primarily because you are swabbing an incredibly \"dirty\" area in the first place. 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I have never been a perfectionist, and the idealistic pursuit of perfectionism can hinder real-life achievement and progress.\u00a0 The quote came back into my conciousness during the early days of the COVID pandemic when I\u2026","rel":"","context":"In &quot;The Art of Microbiology&quot;","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts\/2618"}],"collection":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2618"}],"version-history":[{"count":4,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts\/2618\/revisions"}],"predecessor-version":[{"id":2623,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts\/2618\/revisions\/2623"}],"wp:attachment":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2618"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2618"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2618"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}