What do you do when the proverbial stool sample hits the rotary ventilation device and ALL your IT stops working, yep all of it, all at once!? What happens when the laboratory computer system locks everyone out and you can’t put results in or look results up? What can you do when the fancy piece of automation that moves agar plates around the lab like some kind of daemonic sushi bar fails because of a power cut?
 
What would you do? Burst into tears? Swear profusely? Run screaming to the nearest pub? Sing a jolly pop song?

Over the past few weeks I have seen a lot of patients being admitted with infections due to the bacterium Staphylococcus aureus, which we have grown from their blood cultures. S. aureus is a common pathogen, but the number of positive blood cultures has been above our normal baseline, and I have found myself giving the same advice over and over again to the ward doctors looking after these patients.
 
S. aureus bacteraemia is a serious infection with a mortality of at least 20%; that is on average 20 in 100 people with S. aureus in their blood will die despite what we do to try and help. That’s a lot! And it gets even worse if you can’t find the cause of the bacteraemia, up to 60%. The mortality for S. aureus from an unknown source is so high for lots of reasons; patients are often frail or have underlying immunodeficiencies, but also because if you can’t find the “focus” you can’t easily undertake “source control”. If you can’t control the source, then the infection will persist…! Your patient might not!!!!
 
So, one of the key parts to dealing with S. aureus bacteraemia is finding the source or focus of infection so you can deal with it.

​NOTE: Don’t forget to treat the patient whilst looking for the source. S. aureus is a serious pathogen, so don’t wait for your investigations or results… treat first and then ask the questions!

This may seem like a strange question for a Microbiologist to ask but it’s not as straight forward as many people think. I have blogged about this kind of thing before, but recent conversations with other healthcare workers have shown me that many still do not understand the effect that antimicrobial resistance is going to have on the wider scope of medicine. Well, it’s my blog so I’m going to blog about it again… 😊
 
Most people, including healthcare workers, think that antimicrobial resistance’s biggest threat is related to our ability to treat common infections such as pneumonia, urinary tract infections or cellulitis, but I think that is incorrect. Don’t get me wrong, it’s still important, but for me it’s not the most important threat from antimicrobial resistance.
 
Before I tell you what I think the biggest threats are, let me tell why treating common infections isn’t the biggest threat…