Metapneumovirus (hMPV) – bug of the week

Human-metapneumovirus-sept-2016-path-north summary sheet.

See also this local case reports of severe pneumonia due to hMPV.  Includes discussion of Hunter New England region, NSW,  Australia epidemiology and current knowledge / research in to hMPV.

Note the change to taxonomy that has occurred in 2016 : Pneumoviridae is a new virus family in the order Mononegavirales. It was created in 2016 by elevating the now dissolved paramyxoviral subfamily Pneumovirinae.

 

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Blood culture liaison process – advice by organism type- Gram positives

SECOND CLINICIAN CALL: Confirmed culture identification with susceptibility available

  • Prior to calling, check the isolate antibiogram to see that species and susceptibility make sense – see EUCAST Expert rules which provide intrinsic resistance characters by species, including unusual phenotypes.
  • If possible speak to the same clinician who you initially contacted about the Gram stain result (look at your diary record !). Make sure your interaction has an proper formality about it – this is essential for building clinician respect for the laboratory service. See previous posting concerning ISBAR process.
  • Document additional clinical data required for completion of an Bloodstream infection event record after your contact (refer to this example template for these records with definitions of key data items). These records of significant BSI events are gold when it comes to analysis of local epidemiology of sepsis (community or hospital acquired/associated).

Specific advice by organism:

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Example template for documenting significant bloodstream infections

Suggested format for documenting significant BSI for later analyses.  Sub documents with key definitions will be provided soon. Print this sheet onto a single A4 page and maintain a records folder. Include documentation of the clinical liaison process as below.  Definitions for significance will be discussed in a future posting.  Continue reading

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Adenovirus – bug of the week

Adenovirus overview -2016-path-north; Prepared for our weekly pathology teaching round by one of our registrars.

Reference

Image credit: http://www.daviddarling.info/encyclopedia/A/adenovirus_infection.html

 

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Severe primary dengue- recent case and discussion

Guest posting from our Infectious Diseases advanced trainee, Dr Milton Micallef.

N.B.

dengue

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Positive blood culture clinician liaison process (microbiology) part 1

Documentation!

  • Always note down all clinician discussions in a large personal diary or preferably on the electronic pathology record for the patient’s sample if this exists.
  • Categorise and record the clinical relevance of the positive culture – a standard template to be shared soon.

Improve blood culture collection practice

  • Ensure that your clinicians know how to collect blood cultures correctly – pathology registrars/ residents can get involved with training . See this resource for an example of best practice.
  • Calculate your blood culture contamination rates regularly and identify locations that require followup training (if rate of contamination > 5%)

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Endemic Hepatitis E in Oz (and elsewhere) – update from Prof Josh Davis

Guest posting: A/Prof Josh Davis, Infectious Diseases Physician, John Hunter Hospital, NSW, Principal  Research Fellow, Menzies School of Health Research, NT, Australia.

Another excellent presentation from Josh.  HEV talk ASID Annual Scientific Meeting 2016_Davis.  An essential topic for ID and Pathology post-grads!

References (both free text)

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What adverse fetal outcomes are associated with dengue in pregnancy?

Guest posting: Dr Ayesha Akram, Microbiology Registrar, Pathology North, NSW. 

Prematurity and low birth weight are important causes of neonatal death and despite increasing awareness of the importance of these adverse pregnancy outcomes, the causes remains unknown on many occasions. Dengue fever is endemic in many regions of the world especially in Southeast Asia and Oceania. With 390 million estimated dengue infections each year woman of reproductive age are also at increasing risk of symptomatic dengue infection.  Previously very little was known about the possible adverse effects of dengue infection during pregnancy. Continue reading

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Hepatitis C- updates on biology and the new treatments from Josh Davis

Guest posting: A/Prof Josh Davis, Infectious Diseases Physician, John Hunter Hospital, NSW, Principal  Research Fellow, Menzies School of Health Research, NT, Australia.

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Extrapolating key antibiotic susceptibilities for Staphylococcus aureus

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