FRCPath Medical Microbiology exam guidance
Practical help for Part 1 and Part 2, with curated resources, exam tips, and structured learning pathways.
If you want to know more about the exam, click on the buttons below. This is based on my 12 years of experience supporting trainees in the UK and guiding numerous overseas trainees.
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Daily newsletter
Microregistrar Infection NewsletterMicroregistrar Infection Newsletter · Tuesday 13 October 2026
ISAC and ESCMID propose new MRSA categories and advise treating MODSA and OS-MRSA as MRSA.
A new position statement in CMI (12 Oct, ISAC-SAWG and ESCMID-ESGS) sorts methicillin resistance into three groups: mec-mediated MRSA (mecA/mecB/mecC); MRLM (methicillin-resistant lacking mec), split into HBSA (replacing “BORSA”) and MODSA; and OS-MRSA (mec-positive but oxacillin-susceptible). It’s exam-relevant, and worth checking against how your lab words its reports. Elsewhere, the E.mbrace phase 3 trial found no protection from the 9-valent E. coli vaccine, and ECDC now shows the DRC at 8,978 / 4,336.
14New journal items, from 7 journals1New on Microregistrar Moodle2/9Watched pages with something new25Source links in this issue1New guidance item (MRSA naming position statement)4Coverage gaps we could not closeCounted from today’s digest. New journal items are the ones listed as new in the Journals tab (1 Lancet Infect Dis, 1 J Infect, 2 CMI, 3 JAC, 4 J Clin Microbiol, 2 ICHE, 1 IJID); the UK encephalitis guideline we covered yesterday isn’t counted again. Links are unique content links across the issue, not counting our two website links. Gaps come from the Coverage gaps list. Today’s digest has no sources checklist, so there’s no checks card.
Also today
The other headlines from today’s issue. Each one links through to the full summary. In the UK it’s quiet: the flu/COVID week 41 report is still the latest, the week 42 report is confirmed for 15 Oct, and the England measles update is due the same day.
Microregistrar Moodle · 1 newNew on Microregistrar Moodle
Interactive HYN: CMV colitis (12 Oct 2026).
Lancet Infect Dis · phase 3E.mbrace: the E. coli vaccine didn’t work
In 17,701 vaccinated adults aged ≥60 with a UTI in the previous 2 years, there were 11 vs 13 invasive E. coli cases (vaccine vs placebo): vaccine efficacy 14.6% (95% CI −106.6 to 65.4). Stopped early for futility; safety was acceptable. No E. coli vaccine is coming soon.
J Infect · editorial · watchedEl Niño 2026–27: what UK infection services should expect
Mainly imported vector-borne and enteric infections, not local spread. Take detailed travel histories (down to province or district, plus flooding and freshwater exposure). A dengue- or chikungunya-like illness without travel is a public-health incident.
Ebola · ECDC updatedECDC catches up: 8,978 cases, 4,336 deaths
ECDC’s page (updated 12 Oct 13:35, data to 10 Oct) now matches DRC SitRep 149. In Kenya, 108 of the 122 listed contacts of the imported fatal case are in quarantine with no symptoms (11 Oct). No SitRep after 149 and no new WHO DON.
CDC · MMWRUnapproved botulinum toxin at a Colorado medical spa
Three women who received the same lot of a non-FDA-approved product had symptoms on the day of injection; none were admitted. Worth remembering for botulism-like illness after cosmetic injections.
Watch · Irkutsk · unchangedDON620 is still the latest
No plague; contacts cleared.
Still not confirmed: the cause of death remains undetermined.
What we could not confirm
On Irkutsk, the cause of death is still undetermined. We couldn’t re-verify US measles today (still 4,080 as of 8 Oct) or read several CDC pages. We found no DRC SitRep after 149 and didn’t check the INSP site directly. Several journal pages were blocked, so some takeaways come from abstracts or snippets, and five papers are title-level only.
Microregistrar Moodle update
New on Microregistrar Moodle since our last issue: one item.
New · 12 Oct 2026 Interactive HYN: CMV colitis
An interactive teaching item. There’s no further description on the sheet.
The full list is in the Microregistrar moodlecloud sheet ›
Watched pages
We check nine pages every morning for anything new, compared with what we saw last time (checked 13 Oct 2026 08:08 BST; all 9 were reachable). Two have something new: JAC and the Journal of Infection. The other seven were quiet, including RCPath exams.
Health Protection Report (UKHSA)
No changeNo new reports (still volume 20 issue 9, 24 Sep).
UK SMI News (RCPath)
No changeNo new items.
RCPath Examinations
No changeNo new exam news. Autumn 2026 applications are still shown as closed. The only change was a booking-system entry, not an exam announcement.
Green Book
No changeNo new or updated chapters.
UKHSA organisation page (GOV.UK)
No changeNothing meaningful new overnight. The flu/COVID week 42 report is confirmed for 15 Oct.
NICE published guidance
No changeNo new infection or antimicrobial items.
Journal of Antimicrobial Chemotherapy
NEW
- 12 Oct: Oxazolidinones in staphylococcal infection: linezolid or tedizolid? (ESCMID ESGS narrative review). JAC › · doi:10.1093/jac/dkag323 ›
- 12 Oct: Phylogenetic diversification of PoxtA. doi:10.1093/jac/dkag339 ›
- 12 Oct: Eravacycline clearance during continuous venovenous haemodiafiltration (CVVHDF). doi:10.1093/jac/dkag345 ›
All three are summarised in the Journals tab.
Journal of Infection
NEW12 Oct: The 2026–27 El Niño event: what should UK infection services expect? (Tweed, O’Reilly, Turtle, Dunning; NIHR HPRUs). Summarised in the Journals tab.
Full text › · doi:10.1016/j.jinf.2026.106872 ›
The UK encephalitis guideline reappeared under a different link; it was in our 12 Oct issue, so it isn’t counted as new.
Journal of Hospital Infection
No changeNothing meaningful new.
Agencies & guidance
The MRSA naming position statement is today’s guidance change. ECDC has caught up with the DRC’s Ebola figures; UKHSA and WHO are unchanged.
Guidance changes
ISAC/ESCMID · position statement · new MRSA mechanism and nomenclature (CMI, 12 Oct)
It proposes three categories:
- mec-mediated MRSA: mecA, mecB or mecC; may show heteroresistance.
- MRLM (methicillin-resistant lacking mec): cefoxitin- and/or oxacillin-resistant, mec-negative, with no heteroresistance. When the mechanism is characterised, it splits into HBSA (hyper-β-lactamase producers: low-level oxacillin resistance, mostly cefoxitin-susceptible; replaces “BORSA”) and MODSA (PBP 1–4 modifications; usually cefoxitin-resistant in routine labs). Use “MRLM” when the mechanism isn’t known, because routine labs can’t easily tell them apart.
- OS-MRSA: mec-positive but phenotypically oxacillin/cefoxitin-susceptible, due to mutations, deletions or insertions.
Management: treat MODSA and OS-MRSA as MRSA. Points to check against local practice: discordant cefoxitin screen vs mec/PBP2a results, and how reports are worded.
A European society position statement, not UK national guidance; it’s a proposal for naming, so check with your lab before changing report wording.
Other guidance No other changes
No new UK SMI, Green Book, NICE infection guidance or EUCAST changes found.
UKHSA / England
UKHSA · flu/COVID-19 · unchanged Still the week 41 report (8 Oct; data to 4 Oct)
Hospital flu PCR positivity 6.5% and COVID-19 9.1%; RSV at baseline. The week 42 report (data to 11 Oct) is confirmed for 15 Oct.
UKHSA: flu and COVID-19 surveillance reports, 2026 to 2027 season ›
UKHSA · Outbreaks under monitoring Still at week 40
The week 40 chapter is still the latest. NOIDs are also unchanged at week 40.
UKHSA · MHRA · unchanged Everything else
Measles in England: 1,003 lab-confirmed cases 1 Jan–14 Sep, next update due 15 Oct. HPR is still 20(9) and Vaccine Update is still issue 376. No infection-related MHRA safety alerts in the window.
ECDC
ECDC · Ebola page · updated DRC: 8,978 confirmed, 4,336 deaths (data to 10 Oct; page updated 12 Oct 13:35)
These are new figures for ECDC and match DRC SitRep 149. 945 in isolation; +64 cases and +21 deaths on 10 Oct (Ituri 30, Nord-Kivu 25, Haut-Uélé 7, Tshopo 2); 2,356 recovered; 81% of contacts under follow-up; 65/167 health zones in 7 provinces.
Ituri 6,639 (3,074)Nord-Kivu 1,883 (1,075)Haut-Uélé 379 (159)Tshopo 59 (22)Bas-Uélé 13 (4)Sud-Kivu 3 (1)Sud-Ubangi 2 (1)Kenya: 108/122 contacts of the imported case are in quarantine and have no symptoms (Cabinet Secretary, 11 Oct). Europe: the Leiden medevac healthcare worker (admitted 1 Oct) is still the most recent European case. ECDC rates the import risk to the EU/EEA as very low.
ECDC · CDTR · unchanged Week 41 is still the latest
Published 9 Oct; the next is normally on Friday. No new ECDC risk assessments on 12–13 Oct.
WHO and other
Watch · Irkutsk · unchanged DON620 is still the latest
DON620 (Irkutsk, 10 Oct) is still the latest DON, and there’s no Ebola DON after DON619 (8 Oct). No plague; contacts cleared.
Not confirmed: the cause of death is still undetermined.
DRC · no new SitRep SitRep 149 is still the latest
The national tracker still shows SitRep 149 (report 10 Oct, published 11 Oct) as the latest.
UNGA · policy UN Political Declaration on Pandemic Prevention, Preparedness and Response
WHO welcomed its adoption (WHO Director-General on X, 12 Oct). A policy milestone with no immediate clinical change.
CDC / US
CDC · MMWR · Notes from the Field Unapproved botulinum toxin product at a medical spa, Colorado, 2025–26 (MMWR weekly, 8 Oct)
A poison centre report led to an investigation. 3 women who received the same lot of a non-FDA-approved botulinum toxin product reported numbness and tingling, muscle weakness, dysphonia, blurred vision or neck stiffness on the day of injection. None were admitted. The product was bought from an online supplier. CDC testing of a different lot found active toxin type A with no excess toxin or contaminants.
Takeaway: worth remembering when assessing iatrogenic botulism-like illness after cosmetic injections.
CDC · measles · not re-verified 4,080 US cases (as of 8 Oct)
We couldn’t re-verify this today because the CDC page refused our access; the weekly update usually comes on Wednesdays.
CDC · quiet HAN, newsroom and EID
No new health advisory (the latest infection HAN is still the rabies PEP advisory of 10 Sep). No October infection press releases; the feed’s latest item is dated 22 Sep. Nothing new in EID early release since 2 Oct.
CDC · travel health notices · unchanged Travel notices
Level 4 Ebola in Ituri and Nord-Kivu (DRC); Level 3 in Haut-Uélé and Tshopo; Level 2 for other DRC/Uganda areas and global polio; Level 1 global dengue (2 Oct).
Journals
Fourteen new items from seven journals, including four from our watched JAC and Journal of Infection pages. Takeaways are abstract-level only, and five items are title-level.
Lancet Infectious Diseases — new
Lancet Infect Dis · phase 3 RCT E.mbrace: ExPEC9V vaccine against invasive E. coli disease
Adults aged ≥60 with a UTI in the previous 2 years; 17,701 vaccinated (8,858 vaccine / 8,843 placebo). There were 24 invasive cases from vaccine serotypes (11 vs 13), giving VE 14.63% (95% CI −106.57 to 65.38): no protection. Stopped at a prespecified futility analysis. More low-grade reactions with vaccine, balanced serious adverse events, and no vaccine-related deaths.
Takeaway: good immunogenicity didn’t translate into protection, so preventing E. coli bacteraemia still depends on UTI and catheter care and on stewardship.
Journal of Infection — new on our watched page
J Infect · editorial · open access · watched The 2026–27 El Niño event: what should UK infection services expect?
- NOAA gave an 81% chance of a “very strong” El Niño in Oct–Dec.
- Expect mainly imported effects. South/South-East Asia (Sep–Nov): dengue, chikungunya, enteric fever, leptospirosis, scrub typhus. East Africa (Sep–Jan): malaria, arboviruses, cholera, Rift Valley fever. Latin America and the Caribbean (late 2026–early 2027): dengue, Zika, Oropouche. Southern Africa (Dec–Apr): malaria and cholera.
- UKHSA baseline for 2026 so far: 137 dengue cases in England (Jan–Jun), 59 chikungunya (England, Wales and Northern Ireland, Jan–Jun), 557 malaria (Jan–May) and 287 travel-associated enteric fever (first half of 2026).
- Europe-only travel no longer excludes dengue or chikungunya: France and Italy had >1,000 local chikungunya cases in 2025, and France has had local dengue in 2026.
- There are no established invasive Aedes populations in England, so a compatible illness without travel should be escalated (Imported Fever Service and public health).
- Wetter UK weather may matter for STEC, Salmonella, Legionella, Vibrio and cryptosporidiosis.
Takeaway: take detailed travel histories, down to province or district, plus flooding and freshwater exposure.
Full text › · DOI: https://doi.org/10.1016/j.jinf.2026.106872
JAC — new on our watched page
JAC · ESCMID ESGS review · watched Oxazolidinones in staphylococcal infection: linezolid or tedizolid?
Takeaway: covers pharmacology, adverse effects, drug interactions, contraindications and treatment optimisation for both agents. A useful single reference for OPAT and long-course bone/joint decisions.
JAC · resistance genes · watched Phylogenetic diversification of PoxtA
Takeaway: an ABC-F ribosomal-protection gene giving phenicol/oxazolidinone/tetracycline resistance. There are 21 close homologues, mainly in Bacillota, from clinical, agricultural, food and environmental sources, on mobile contexts (Tn6657, Tn6246, Tn8026) that favour co-selection and spread.
JAC · PK · watched Eravacycline clearance during CVVHDF
A single-patient report of negligible clearance.
Title-level only; no abstract available.
CMI — new
CMI · position statement MRSA mechanism and nomenclature
Takeaway: the new three-category scheme; the full summary is in Guidance changes.
CMI · hepatitis delta Nationwide hepatitis delta characterisation in Spain
Title-level only; abstract not retrieved.
Journal of Clinical Microbiology — new
JCM · AST Aztreonam-avibactam susceptibility testing against NDM-producing Enterobacterales (n=254)
Takeaway: all 245 NDM isolates were susceptible (MIC₉₀ ≈ 1–4 mg/L). Disk diffusion had 98% categorical agreement and gradient strips 99%, with no very major or major errors. Essential agreement was low (ETEST 67%, MIC Test Strip 85%), and both strips underestimated MICs. Disk and strip testing work for the category, but treat strip MIC values with care.
JCM · blood cultures 4-day blood culture incubation in children (55,825 bottles, BACTEC FX)
Takeaway: 99.0% of aerobic and 98.7% of anaerobic positives flagged within 4 days. Only 1 true pathogen was missed, with no change in management. Contaminants took longer to flag (median 22 h vs 11.5–14 h). This adds paediatric data to the case for revising UK SMI’s 5-day standard.
JCM · parasitology Five molecular assays for Strongyloides
Takeaway: results didn’t agree, no single primer set found all positives, one assay detects S. stercoralis only, and some probe-less runs amplified gut bacteria. Know which assay your reference lab uses.
JCM · Legionella Legionella pneumophila PCR yield by specimen type during a community outbreak
Title-level only; abstract not retrieved.
ICHE and IJID — new
ICHE · IPC · health economics Cost-effectiveness of CPE screening, Hong Kong tertiary hospital, 2015–24
Takeaway: 447,745 tests; 2.7% of episodes positive (96% colonisation). An estimated 63.6 infections averted and 47.8 QALYs gained per year (number needed to screen 590). The programme saved money (about US$758k a year) and stayed cost-effective in sensitivity analyses. Supports sustained CPE admission screening.
ICHE · HIV Recurrent healthcare-associated paediatric HIV outbreaks in Pakistan
Title-level only; abstract not retrieved.
IJID · tick-borne Borrelia miyamotoi tick-borne relapsing fever in Germany
Title-level only; abstract not retrieved.
Already covered
J Infect UK adult encephalitis guideline (12 Oct).
On X
One search of the UKHSA, ECDC, WHO, CDC, WHO Director-General and CDC Director accounts (12 Oct onwards).
No breaking infection signals. WHO posted about the UNGA pandemic preparedness declaration and the WHO Pandemic Hub strategy, and UKHSA posted a MenB two-dose reminder.
What we could not confirm
We want you to know exactly where today’s issue has limits, so here are the 4 sources we had trouble with and what went wrong.
Source Issue CDC The measles data page and MMWR/HAN pages refused our access. The items above came from CDC’s syndication feeds (MMWR, newsroom, HAN), EID and the travel-notice feed. US measles wasn’t re-verified today. DRC Ministry of Health No SitRep after 149 found; the INSP site wasn’t checked directly. UKHSA Week 41 Outbreaks under monitoring and NOIDs, and week 42 flu/COVID, aren’t published yet (flu/COVID due 15 Oct). England measles is due on 15 Oct. Journals Elsevier/Lancet/CMI and ASM article pages were blocked or didn’t load. Abstracts came from DOI records, publisher snippets and the open-access Journal of Infection page. No abstracts for the B. miyamotoi, hepatitis delta, Legionella PCR, Pakistan HIV or eravacycline papers. No new NEJM, JAC-AMR, OFID, JID, ARIC or Eurosurveillance items in the window (Eurosurveillance’s next issue is on 15 Oct). Sources
Today’s digest doesn’t include a sources checklist, so we can’t show ticked and open checks this time. These are the sources it draws on, as described in the issue.
- Watched pages (9 pages, all reachable, checked 13 Oct 08:08 BST)
- Microregistrar Moodle sheet (1 new item)
- UKHSA GOV.UK: flu/COVID week 41 report, Outbreaks under monitoring, NOIDs, measles, HPR; MHRA alerts
- ECDC: Ebola outbreak page and CDTR week 41
- WHO Disease Outbreak News (DON620 and DON619 still the latest) and the DRC national tracker (SitRep 149)
- CDC: syndicated MMWR, newsroom and HAN feeds, EID and travel notices (partial)
- Journal sweep plus watched journal feeds
- X: one search of official accounts
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