The Critical Care ward round was moving slowly. It was a Monday and so most of the patients were new to everyone, including the Microbiologist.
 
The next patient was a middle aged woman who had been intubated and ventilated but who looked otherwise pretty well. [You get a feel for how unwell a patient is just by standing at the end of their bed and observing; equipment, medications, drains and tubes, as well as the colour and appearance of the patient are all clues.]
 
“This lady has Guillain-Barre Syndrome, so no infection issues” said the Critical Care Registrar moving past the end of the bed.
 
Guillain-Barre Syndrome is a rare neurological syndrome of progressive weakness that usually recovers with supportive care. It is thought to be autoimmune in nature.
 
“How did she present?” asked the Microbiologist doing his normal “I’m looking for trouble” kind of thing.
 
Humouring the Microbiologist the Registrar explained that the patient had presented with progressive difficulty swallowing and speaking following an episode of diarrhoea and vomiting. She had become so weak they had needed to ventilate her.
 
“This sounds like sausage poisoning” said the Microbiologist

"Why do we give broad spectrum antibiotics like Benzylpeniciilin, Gentamicin and Metronidazole to babies with necrotising enterocolitis [NEC] when their gut is sterile?" asked the Neonatal Unit [NNU] Registrar.
 
It was the middle of the NNU multidisciplinary ward round.
 
"Pardon?" said the Microbiologist, caught red-handed reaching for a second chocolate biscuit and suddenly feeling self-conscious as everyone turned to stare at him.
 
"Babies are born with a sterile gut so when they develop NEC why do they need antibiotics; surely there are no bacteria to cause a problem". The Registrar restated his question again but with more clarity.
 
The Microbiologist recognised the question was being rephrased; he obviously looked like he did not understand what was being asked! It was actually a very good observation of the Microbiologist! But it was an even better question thought the Microbiologist…so it needed a good answer…
 
Fortunately the Microbiologist was on the ball, and in fact was armed with the latest research provided by the NNU Pharmacist only a few weeks earlier.
 
Hopefully everyone knows where babies come from... but do you know where babies gut bacteria come from? Read on...

Well that’s what the Telegraph newspaper says so it must be true!
 
Okay, let’s try and bring this down a peg and look at what is really the story behind the sensationalist headline. Whilst it is sometimes amusing to read these stories, the lack of balance with resulting scare-mongering is frustrating.
 
A study has been performed by Public Health England in association with the National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, looking at the presence of Flaviviruses in deer and deer ticks in the UK. Gosh! What a mouthful, even abbreviated that’s NIHRHPRUEZI, yeah! So we’ll just call them “Liverpool” from now on!!!
 
Anyhow back to the Flaviviruses! Some Flaviviruses cause tick-borne encephalitis (TBE), a condition transmitted by ticks of the Ixodes spp. which usually feed on deer. There are three main types of TBE based upon geographical area:

• European (Scandinavia down to the Adriatic)
• Far-Eastern (Russia, China, Japan)
• Siberian (Siberia and the Baltic)