# microregistrar

> microregistrar.com


## Posts

- [Aspergillus niger](https://microregistrar.com/aspergillus-niger/): The Fungus: Identification: It initially forms white colonies with a yellow back, which quickly becomes black. Conidia is rough, brownish-black, […]
- [Arcanobacterium haemolyticum, the “secretive bacteria”](https://microregistrar.com/arcanobacterium-haemolyticum-the-secretive-bacteria/): Video presentation
- [Amphotericin B](https://microregistrar.com/amphotericin-b/): Amphotericin B is a polyene antibiotic discovered in 1953 from the bacteria Streptomyces nodosus, in the Orinoco basin in Venezuela. […]
- [Antibiotic – intrinsic resistance](https://microregistrar.com/antibiotic-intrinsic-resistance-2/): Enterobacterales & Aeromonas Enterobacterales and Aeromonas are intrinsically resistant to benzylpenicillin, glycopeptides, lipoglycopeptides, fusidic acid, macrolides (Except Azithromycin, effective for […]
- [Aerococcus urinae](https://microregistrar.com/aerococcus-urinae/): Aerococcus genus, a firmicute, was first identified in 1953 [Williams, 1953]. Multiple species have been identified since then; not all […]
- [Aeromonas spp.](https://microregistrar.com/aeromonas-spp/): Aeromonas are Gram-negative bacilli, widely distributed in nature, especially aquatic environments – freshwater, brackish water, sewage system, hospital water system, and […]
- [Adenovirus](https://microregistrar.com/adenovirus/): Introduction For high-resolution images, scroll to the bottom of the page Human adenovirus has 7 species based on their haemagglutination character.Each […]
- [Actinotignum schaalii: a new pathogen](https://microregistrar.com/actinotignum-schaalii-a-new-pathogen/): An emerging pathogen Actinotignum schaalii gram stain (pic Manurx27, Wikipedia) What infection does it cause, and who is mostly affected? How […]
- [Pneumococcus - gallery](https://microregistrar.com/pneumococcus-gallery/): Streptococcus pneumoniae or pneumococci are gram-positive cocci in pairs, which may be capsulated. Colonies are 1-2mm, α-haemolytic and may appear as ‘draughtsman’ colonies (due to […]
- [Paracoccus Yeei](https://microregistrar.com/paracoccus-yeei/): Paracoccus yeei is an aerobic Gram-negative coccobacilli typically found in soil and brine. It appears as diplococci and may have a visible […]
- [Legionella Control in Healthcare](https://microregistrar.com/legionella-control-in-healthcare/): What are the Laws underpinning the Legionella control? There is a hierarchy of laws guiding the Legionella control ACOP L8:2013 […]
- [Trainee experience: Tips for part 1 FRCPath Microbiology](https://microregistrar.com/trainee-experience-tips-for-part-1-frcpath-microbiology/): One of my trainees, who joined us as a year 1 infection trainee, recently passed part 1 FRCPath. I worked […]
- [Rotavirus vaccine (study note)](https://microregistrar.com/rotavirus-vaccine-study-note/): Vaccine Efficacy– Protect against gastroenteritis due to rotavirus serotypes G1P, G2P, G3P, G4P, and G9P; some efficacy against uncommon rotavirus genotypes […]
- [Greenbook notes: Pertussis (Whooping cough) vaccine](https://microregistrar.com/greenbook-notes-pertussis-whooping-cough-vaccine/): Pertussis vaccine Pertussis vaccine is only given as a part of a combined vaccine. Monovalent pertussis vaccines are not available. […]
- [Antifungals – Synergy, indifference and antagonism](https://microregistrar.com/antifungals-synergy-indifference-and-antagonism/): A combination of antifungals is often used in cases of difficult-to-treat infections. What is the evidence in the literature about […]
- [NICE Guidelines and other documents – Infection](https://microregistrar.com/nice-guidelines-and-other-documents-infection/): Check the most recent updates here:https://www.nice.org.uk/guidance/conditions-and-diseases/infections/covid19/products?Status=Published
- [Mycoplasma genitalium Antimicrobial Resistance Surveillance (MARS) – Takeaways](https://microregistrar.com/mycoplasma-genitalium-antimicrobial-resistance-surveillance-mars-takeaways/): MARS 2nd pilot report is out. It included data from all consecutive M. genitalium specimens collected from 15 SHCs between […]
- [Staphylococcus endocarditis: Comparison – AHA, ESC and BSAC guidelines.](https://microregistrar.com/staphylococcus-endocarditis-comparison-aha-esc-and-bsac-guidelines/)
- [Turicella otitidis](https://microregistrar.com/https-microregistrar-com-2021-07-21-turicella-otitidis/): The Bacteria: Turicella otitidis is an anaerobic, non-motile, pleomorphic, gram-positive bacillus – similar to coryneform but longer.It produces a convex […]
- [What resources do I need to use for FRCPath Microbiology?](https://microregistrar.com/what-resources-do-i-need-to-use-for-frcpath-microbiology/): FRCPath Microbiology questions are heavily drawn from British and some international guidelines, recent developments relevant to the UK, and recent […]
- [Management of needlestick injury](https://microregistrar.com/management-of-needlestick-injury/): This is a study note on managing needlestick/sharps injury or body-fluid exposure. This is not a clinical guideline and must […]
- [Questions for FRCPath Microbiology](https://microregistrar.com/questions-for-frcpath-microbiology/): Where to find questions for FRCPath Microbiology? Part 1: A. The first question that comes to mind is – Are […]
- [Quick observations on the exam (Part 1/CICE) - by a successful overseas candidate](https://microregistrar.com/quick-observations-on-the-exam-part-1-cice-by-a-successful-overseas-candidate/): 2023 Spring exam experience: I have recently sat for this exam this Spring. My account is like this. I think […]
- [Sharing experience on taking the CICE](https://microregistrar.com/sharing-experience-on-taking-the-cice/): Written in 2021 One of our trainees, who was successful In the CICE, has kindly shared the study materials she […]
- [Preparing for the FRCPath Part 1 Exam in Medical Microbiology and Virology](https://microregistrar.com/preparing-for-the-frcpath-part-1-examin-medical-microbiology-and-virology/): An IMG’s Perspective by Dr Chidi Onwukwe (2018) I decided to sit for the FRCPath part 1 in MMV sometime […]
- [My prep for the part 1 exam (FRCPath Microbiology)](https://microregistrar.com/my-prep-for-the-part-1-exam-frcpath-microbiology/): by Dr Saishruti Iyer (2021) I decided to appear for FRCPath sometime last year when a senior recommended that it […]
- [Echinocandin](https://microregistrar.com/echinocandin/): Echinocandins are a class of antifungals that prevent glucan synthesis pathways necessary for fungal cell wall formation. Echinocanins are antifungals […]
- [Daptomycin](https://microregistrar.com/daptomycin/): Class: Cyclic lipopeptideSource: Streptomyces roseosporusDiscovered: 1980s; approved for use in 2003 (FDA)Molecular weight: 1620 DA. Mechanism of action: The Daptomycin (DAP) combines […]
- [Plazomicin](https://microregistrar.com/plazomicin/): Nature of the antibiotic Class: Next-generation aminoglycoside (neoglycoside), semisynthetic (sisomicin based). It is not inactivated by most aminoglycoside-modifying enzymes (AME).Molecular weight: 592.68. […]
- [Tigecycline](https://microregistrar.com/tigecycline/): Nature: Glycylcycline, a member of the tetracycline family. Semisynthetic derivative of minocycline.MW: 585.6 Mechanism of action: 1. Bind to 30S […]
- [Fosfomycin](https://microregistrar.com/fosfomycin/): Nature: Small (Mol weight – 138) phosphoenolpyruvate analogue manufactured synthetically but originally obtained from Streptomyces fradiae and some Pseudomonas sp.A […]
- [Ceftolozane-tazobactam](https://microregistrar.com/ceftolozane-tazobactam/): Class: 5th generation cephalosporin.Available as ceftolozane-tazobactam, a beta lactam-beta lactamase inhibitor (BLBLI) combination. Mechanism of Action: Similar to other beta-lactam antibiotics. […]
- [Lefamulin](https://microregistrar.com/lefamulin/): Nature of the antibiotic Semi-synthetic, pleuromutilin class.Molecular weight – 567.79 gm/mole Pleuromutilins Pleuromutilins (produced by Pleurotus sp.), discovered in the […]
- [Metronidazole](https://microregistrar.com/metronidazole/): Class: Nitroimidazole.Mol weight: 171First used in 1960. Mechanism of action: Metronidazole enters the susceptible (bacterial/parasite) cells by passive diffusion. It gets activated to […]
- [Cefoselis: a fourth-generation cephalosporin](https://microregistrar.com/cefoselis-a-fourth-generation-cephalosporin/)
- [Mechanism of resistance in Enterococcus](https://microregistrar.com/mechanism-of-resistance-in-enterococcus/): Enterococci are intrinsically resistant to many classes of antibiotics – like cephalosporins, Aminoglycoside (low-level resistance), macrolides, clindamycin, quinupristin-dalfopristin (E faecalis), […]
- [Antibiotic – intrinsic resistance](https://microregistrar.com/antibiotic-intrinsic-resistance/): Microorganisms are only listed as “intrinsically resistant” to an agent (or group of agents) when a vast majority of wild-type […]
- [Cefalexin](https://microregistrar.com/cefalexin/): Nature of the antibiotic Mechanism of action Cefalexin, like other beta-lactams, binds to the penicillin-binding protein (PBP) and prevents peptidoglycan […]
- [Mupirocin](https://microregistrar.com/mupirocin/): Nature Mechanism of action Mechanism of resistance  PK/PD Spectrum Adverse effect Use
- [Fusidic acid](https://microregistrar.com/fusidic-acid/): Fusidic acid was discovered in Copenhagen, Denmark and introduced to clinical practice in the 1960s.It was derived from a fungus, Fusidium […]
- [Antimicrobe.org: Acinetobacter species](https://microregistrar.com/antimicrobe-org-acinetobacter-species/): This is an effort to preserve some wonderful materials I used as a trainee. This website is not being updated […]
- [Antimicrobe.org: Achromobacter (Alcaligenes) Species](https://microregistrar.com/antimicrobe-org-achromobacter-alcaligenes-species/): This is an effort to preserve some wonderful materials I used as a trainee. This website is not being updated […]
- [Antimicrobe.org: Lactococcus species (Lactococci)](https://microregistrar.com/antimicrobe-org-lactococcus-species-lactococci/): William Riebel, M.D. GENERAL DESCRIPTION   Microbiology Guided Medline Search                 Lactococci are gram-positive cocci that arrange in pairs and short […]
- [Lassa fever](https://microregistrar.com/lassa-fever/): Lassa fever - virus, distribution, symptoms, test and treatment.
- [Virus – Baltimore classification](https://microregistrar.com/virus-baltimore-classification/): Baltimore classification -  classification of viruses based on how they produce their mRNA.
- [Classification of fungi](https://microregistrar.com/classification-of-fungi/): For FRCPath Microbiology, I consider the fungi highlighted in yellow are must-read. Grey highlighted ones – if you have time.
- [What prophylaxis is recommended in splenectomy patients?](https://microregistrar.com/what-prophylaxis-is-recommended-in-splenectomy-patients/): Patients with an absent or dysfunctional spleen (AoDS) are at increased risk of infection, especially with capsulated bacteria. What are […]
- [Cefiderocol](https://microregistrar.com/hello-world/): Cefiderocol, mechanism of action of cefiderocol, mechanism of resistance of cefiderocol, Use of cefiderocol
- [InfectionEye 11/9/26](https://microregistrar.com/infectioneye-11-9-26/): Infection Eye | 11 September 2026 Microregistrar · Infection Institute Curated infection intelligence Infection Eye A source-checked briefing on the infection, microbiology, outbreak and antimicrobial-stewardship stories circulating on 10–11 September 2026. Updated 11 September 2026 Primary sources prioritised UK focus, global surveillance How this edition was checked Each item below was re-checked against a government agency, public-health institute, professional society, regulator, or the original peer-reviewed publication. Where the circulated figure did not match the latest authoritative source, the story has been corrected rather than repeated. All UK Outbreaks Clinical ID AMR & stewardship Vaccines Laboratory Clinical ID · Global Verified New […]
- [Microquora FRCPath Mock exam feedback example](https://microregistrar.com/microquora-frcpath-mock-exam-feedback-example/): I organise mock FRCPath exam (part 1 and 2) with the support of two other experienced microbiologists. We select each question based on a probabilistic analysis.Part 1 is a 125 MCQ set to be completed over 3 hours.Part 2 has 2 papers with a structure similar to the RCPath exam: 5 long questions, 10 SAQ and 15 OSPE.Online, can be taken from anywhere in the world. Find more details here – microquora.com It is hard work, but I learn a lot from these mock exams. I categorise each question extensively so that I can give feedback to the candidates and help […]
- [FRCPath Sample Papers — Thematic Question Bank](https://microregistrar.com/frcpath-sample-papers-thematic-question-bank/): FRCPath Sample Papers — Thematic Question Bank FRCPath Sample Papers — Thematic Question Bank All questions from the 8 uploaded RCPath sample papers (Part 1, Part 2, CICE and OSPE formats), reorganised by theme with answers and explanations. Where the source PDF included an official College mark scheme, this is labelled “Official mark scheme”. Where it did not, the answer is Claude’s own clinical/microbiological reasoning and is explicitly flagged with a confidence band — see the Thematic Analysis tab for the full breakdown and for one flagged single-best-answer ambiguity and one self-corrected item. 71 items catalogued · 12 tabs · generated […]
- [1-min-micro: Ophthalmoscopy needed in invasive candidiasis?](https://microregistrar.com/1-min-micro-ophthalmoscopy-needed-in-invasive-candidiasis/): 60-second paper explainer – Lamberink et al. 2026 Journal in a minute 00 / 55 sec Clinical question Candida in blood.Look in the eye? A new multicentre cohort examines the yield – and the uncertainty. The cohort 402 adults with candidemia 2tertiary hospitals 7years reviewed Fundoscopy result 15 of 307had probable ocular candidiasis That is 4.9%. Twelve had probable chorioretinitis; three probable endophthalmitis. The surprise 60% were silent or unable to report symptoms 15 9 Clinical impact Management changed in all 15 Therapy prolonged15/15 Azole added/switched11/15 Intravitreal treatment2/15 Patient outcome 3 had persistent visual impairment All three were symptomatic at baseline. […]
- [Angiostrongyliasis](https://microregistrar.com/angiostrongyloides/): This topic has featured in the exam in the past. A new module is being built in microregistrar.moodlecloud.com- interactive High-Yield Notes. It will feature areas where questions came from or are likely to come in the future. It includes: a last-minute revision page, an interactive revision component and a last page with flashcards and questions See a sample here (interactive contents are disabled for safety)- Angiostrongyliasis: FRCPath Revision Trainer MR AngiostrongyliasisRat lungworm, eosinophilic meningitis and exam traps microregistrar | Infection Institute Quick Revision Condensed Overview Life Cycle Clinical and Diagnosis Treatment and Traps Revise and Test Revision aid, not clinical guidance. […]
- [Interactive High Yield Notes Module](https://microregistrar.com/interactive-high-yield-notes-module/): There will be an interactive High Yield Notes module soon in microregistrar.moodlecloud.com. This will cover the areas more likely to appear in the FRCPath Microbiology examination. See a sample below (click on the link) https://microregistrar.com/wp-content/uploads/2026/07/AmpC_Induction_Risk_Trainer-1-1.html Screenshot AmpC Induction Risk Trainer Risk of Induction of AmpC TrainerOrganism Risk · Inducer/Substrate Logic · Drug Selection microregistrar | Infection Institute 🎯Organism Risk 🔑Inducers & Substrates 💊Treatment & Practice 🃏Revise & Test Revision aid, not clinical guidance. Content is for FRCPath exam preparation. Always confirm current treatment choices against local antibiogram data and national guidelines for real patients. 📋 One-page quick glance — last-minute revision […]
- [SMI summary: Actinomyces](https://microregistrar.com/smi-summary-actinomyces/): Actinomyces — Identification Trainer UK SMI ID 9 · Trainer Identification of Actinomyces An interactive drill, not a textbook. Built to make you retrieve the few facts that actually get tested, not re-read the whole table. 0 of 0 cards seen Taxonomy ID Workflow Gram Stain Colonies MALDI & Methods Self-Test The shape of the organism core fact Click the card to flip. This is the one-line description you should be able to recite without thinking. Card 1 of 6 0 marked known Question tap to flip Answer tap to flip back ← Back Didn’t know Knew it ✓ Next → […]
- [Older SMIs](https://microregistrar.com/older-smis/): These SMIs have been withdrawn and are not being updated, and the infection here is likely obsolete and not controlled. This should not be used for clinical care. Bacteriology B 1: Investigation of bacterial ear infections and associated specimens (2014) – Withdrawn This document was withdrawn on 13 August 2024 following the publication of S 13: Painful and/or discharging ear. This is in line with the UK SMI strategy and in agreement with the UK SMI Steering Committee that technical UK SMIs will be replaced with the relevant syndromic document as they are published. B 2: Investigation of bacterial eye infections (2017) […]
- [Which LLM is best for making your PowerPoint presentation?](https://microregistrar.com/which-llm-is-best-for-making-your-powerpoint-presentation/): Here is an experiment: How good are LLMs at creating PowerPoint slides when given content?I gave the PDF containing my own notes on Erysipelothrix rhusiopathiae.Simple prompt and PDF content – see how ChatGPT 5.5, Gemini 3.5 Flash, Claude Sonnet 4.6, Manus 1.6, KIMI 2.6, Perplexity (not computer) and Copilot did. You will find the prompt (red), how long the LLM took (roughly), and what the LLM told me (inside the box).Link to the presentation PDFs are inside the attached PDF. I did not intentionally use Gamma (or a similar one). What do you think? 1 ChatGPT Prompt: Please make a PowerPoint […]
- [Microregistrar Newsletter](https://microregistrar.com/microregistrar-newsletter/): Microregistrar Weekly Intelligence | Week 21, 2026 Microregistrar.com · Weekly Intelligence Digest MicroregistrarWeekly Update Communicable disease intelligence for the FRCPath candidate & clinical microbiologist Week 21 · 2026 16–23 May 2026 Sources: ECDC · UKHSA · X/Social Intelligence 🎓 Microregistrar Platform 25 FRCPath Results — May 2026 Sitting Moodlecloud members passed their examination.Congratulations to all 25 candidates. Moodle Content Updates This Week New Ebola virus — comprehensive new chapter New Hantavirus — new chapter Exam Focus High-yield topics for the next sitting — new section 🏛 UKHSA / Gov.UK — Key Alerts (Week 21) Hantavirus Disease Added to UK Statutory Notifiable […]
- [Microbrief 9 May 2026](https://microregistrar.com/microbrief-9-may-2026/): ID & Microbiology Intelligence Brief — 9 May 2026 Infectious disease & microbiology intelligence ID & Microbiology Intelligence Brief 9 May 2026  ·  Sourced from WHO, ECDC, CDC  ·  Cross-checked against primary evidence Hantavirus AMR Vaccines Travel Medicine IPC ⚠ Fact-check note — corrections applied to source report Three factual errors identified in the source intelligence report. All are corrected below with source attribution. One claim (rodent exposure route as index event) is marked speculative pending official confirmation. All other major claims verified at >90% confidence against WHO, ECDC, and CDC primary documentation. Lead story 🔴 Active outbreak Andes hantavirus cluster […]
- [Do you have any additional tips to share?](https://microregistrar.com/do-you-have-any-additional-tips-to-share/)
- [Will passing the FRCPath part 1 help me get a job in the UK?](https://microregistrar.com/will-passing-the-frcpath-part-1-help-me-get-a-job-in-the-uk/): Yes and no. To work in the UK as a doctor, you must have GMC registration. Passing FRCPath part 1 will not grant you that. The best place to find out whether you need registration and which route is the GMC. Take this test: https://www.gmc-uk.org/registration-and-licensing/join-our-registers/registration-applications/application-registration Typically, as an overseas microbiologist, you will need either the PLAB route, full FRCPath or sponsorship/MTI. Once you have GMC registration or are eligible for it, you need to find a job and send your application. Jobs can be found in NHS jobs, Trac jobs, or BMJ. You can also find jobs via recruitment agencies, but ensure you find a […]
- [What should I read for Part 1? Books, question banks, courses and materials](https://microregistrar.com/what-should-i-read-books-questions-materials/): Which books should I read? Infection control and statistics Optional – some trainees have used additional books. I consider them optional Time is limited, hence choose carefully. You have to read many other guidelines, SMI, EUCAST etc. Microregistrar.moodlecloud.com This website will provide you with materials written keeping FRCpath in mind (including bacteriology, virology, mycology, parasitology, antibiotics, infection control, lab medicine, vaccine and statistics), along with >600 MCQ, including questions based on past papers, solved model questions, and topic-based questions (EUCAST-based questions). See the full content list here – https://docs.google.com/spreadsheets/d/1XzlEPyzUM3ljxjzMrxpXLH-Pu_xTlWGC8AtrlRzp5Zw/edit?gid=831519701#gid=831519701 Where can I find questions? RCPath past papers BIA learn infection Microregistrar […]
- [Is there a curriculum/syllabus for this exam?](https://microregistrar.com/is-there-a-curriculum-syllabus-for-this-exam/): Yes. It is the RCPath curriculum. You can find it here – https://www.rcpath.org/trainees/training/training-by-specialty/medical-microbiology-2021.html I have made a summary of the curriculum. You can download it here. Go to file, make a copy or download- https://docs.google.com/spreadsheets/d/1Oj7lTeodg5CBvE6x2p4Vhtk8gDQCqO2rxWpsEObHnUo/edit?usp=sharing Moreover, you will find many other useful informations in this document https://docs.google.com/spreadsheets/d/1XzlEPyzUM3ljxjzMrxpXLH-Pu_xTlWGC8AtrlRzp5Zw/edit?gid=1285796030#gid=1285796030
- [How long would I need to prepare for Part 1?](https://microregistrar.com/how-long-would-i-need-to-prepare-for-part-1/): This is a difficult question, as every person is different in terms of the background knowledge they have and the time they can spend. However, if I have to hazard an estimate: You might ask how many hours I need to study a day. There is no right answer. I can only tell you what other people have done. A more appropriate method is to make your study plan. Check a model study plan from this document (yellow box – part 1 candidates). Make your study plan and start preparing. Your study plan should tell you where you stand. You can […]
- [Cost, application process and exam dates](https://microregistrar.com/cost-application-process-and-dates/): Cost The exam fees change every year. In 2026, the fee for part 1 is £749. It would be useful for you to get an estimate of the whole FRCPath Microbiology expense if you know about part 2 as well. In 2026, it is £1576. This exam is only taken in London, so you have to account for the additional costs of a visa, travel, accommodation, food, and other related expenses. So the whole FRCPath exam will cost you approximately £3000 or more. On top of that, you must include your travel and other expenses. https://www.rcpath.org/trainees/examinations/exam-apply-and-pay-online.html Dates This changes every year, […]
- [Which examination should I take - FRCPath part 1 or CICE](https://microregistrar.com/which-examination-should-i-take-frcpath-part-1-or-cice/): There are 2 different FRCPath Part 1 examinations, and candidates must ensure they apply for and sit the correct exam. FRCPath Part 1 Infection ORCombined Infection Certificate Examination (CICE) Part 1 Medical Microbiology & Virology (MMV) – FRCPath Part 1 Infection and CICE are two different names for the same exam– However, you must select one of these names based on who you are Exam – Two papers of 100 MCQs each.– Each paper will be a 3-hour examination – One 3-hour paper with 125 MCQs Format – Online exam – Online exam Who is it for? Part 1 Infection exam:for […]
- [Am I eligible to take FRCPath Part 1?](https://microregistrar.com/am-i-eligible-to-take-frcpath-part-1/): This is the criteria set up by RCPath – Medically qualified candidates are required to have trained in a recognised Regional Specialist Training Programme in microbiology or virology for a period of normally not less than 12 months. Non-medically qualified candidates are required to have trained in a recognised training programme in microbiology for a period of normally not less than 12 months. In addition, they must be state registered, or the equivalent of state registered in another country. Take Home message:You require 12 months of training in an accredited post-graduate training programme (e.g. MD microbiology, DNB, etc.). You are eligible. […]
- [AMS Strategy dashboard](https://microregistrar.com/ams-strategies-dashboard/): How many AMS strategies do you know? Here are > 100 strategies from 17 families. Also, list the nature of your hospital and find out the strategies that best fit your set-up. It is an educational-experimental tool. Always discuss with your AMS expert. AMS Strategy Atlas — Interactive Learning Dashboard Educational tool only. All recommendations must be reviewed by a qualified AMS expert before clinical or policy use. § Antimicrobial Stewardship Educational Atlas v1.0 By Dr Suryabrata Banerjee microregistrar.com The Stewardship Atlas A navigable map of named AMS strategies — from preauthorisation to phage stewardship — with mechanism, evidence tier, setting, […]
- [CustomGPT: Simulated OSPE for FRCPath microbiology part 2](https://microregistrar.com/customgpt-simulated-ospe-for-frcpath-microbiology-part-2/): AI, or to be more specific LLM’s like ChatGPT can be used for education effectively. However, this needs a good understanding of LLM and domain expertise. In other words, if you want to use LLM effectively, you must have a working knowledge of LLM, its capabilities and its problems, but you must know your subject as well – in this case, a good understanding of how the microbiology FRCPath examination works. So, knowing how difficult it is for microbiology trainees to get practice with face-to-face OSPE, I built this custom GPT that will serve as an examiner, using carefully crafted case […]
- [Microregistrar moodlecloud update - Rhodotorula, AI, RAG and revision aid](https://microregistrar.com/microregistrar-moodlecloud-update-rhodotorula-ai-rag-and-revision-aid/): I regularly ask MoodleCloud members what provides more value to them. From a recent poll, I found that microbiologists preparing for the FRCPath exam using Microregistrar Moodle find the Quick revision summary helpful. All moodle chapters in the next few months will be updated with a quick revision note (yellow box). With this, it will also have an infographic generated using moodle content with the help of AI (RAG-based) .
- [Beta-lactamase inhibitors](https://microregistrar.com/beta-lactamase-inhibitors/): Clavams (Classical β-lactam-structured inhibitors) Inhibitor Structure type Mechanism Effective vs β-lactamase class Unique features Clavulanic acid β-lactam (oxazolidine ring) Irreversible suicide substrate Class A (TEM, SHV); weak vs C/D Only natural inhibitor (from Streptomyces clavuligerus); first marketed (1981) Sulbactam β-lactam (penicillanic acid sulfone) Irreversible acyl-enzyme Class A > C (limited) Has intrinsic antibacterial activity vs Acinetobacter spp. Tazobactam β-lactam (triazolylmethyl sulfone) Irreversible Class A; weak vs C/D Broader than clavulanate; used with piperacillin, cefepime Diazabicyclooctane (DBO) inhibitors — non-β-lactam, reversible Inhibitor Mechanism Effective vs Class Partner Drug(s) Key Distinction Avibactam Reversible covalent acyl-enzyme (non-β-lactam DBO) A, C, some D (e.g., OXA-48) […]
- [PVL Staph aureus](https://microregistrar.com/pvl-staph-aureus/): Post for academic purposes only. It MUST NOT be used to make a clinical decision. For clinical advice, please discuss with your doctor. PVL Staphylococcus aureus Clinical Guide Clinical Guide for Diagnosis and Management In the UK, PVL genes are carried by < 2% of clinical S. aureus isolates 🔍 Clinical Features Recognize skin/soft tissue infections and invasive disease presentations ⚠️ Risk Factors 5C model and high-risk populations and settings 🧪 Testing & Diagnosis Sample collection, processing, and PVL testing protocols 🫁 Pneumonia Management Necrotising pneumonia recognition and treatment protocols 🩹 SSTI Management Skin and soft tissue infection treatment guidelines 🦴 […]
- [Actinomyces spp](https://microregistrar.com/actinomyces-spp/): Understanding Actinomyces: The Ray Fungus That’s Actually a Bacterium ⚠️ DISCLAIMER: This content is for academic and educational purposes only. Always consult current medical guidelines and seek professional medical advice for clinical decisions. 🦠 What is Actinomyces? + 🔬 Taxonomy Despite its name meaning “ray fungus,” Actinomyces is actually a bacteria that reproduces by binary fission, not spores or budding. 🏠 Normal Flora Opportunistic pathogens that are part of normal human microbiota, typically colonizing oral cavity, GI tract, and female urogenital tract. 📊 Species Count Currently more than 30 species identified, with Actinomyces israelii being the main causative agent. Key Fact: […]
- [UK vaccination schedule (July 2025)](https://microregistrar.com/uk-vaccination-schedule-july-2025/): UK Immunisation Schedule Timeline UK Immunisation Schedule Timeline 8 weeks First vaccinations Diphtheria, tetanus, pertussis Polio, Hib, Hepatitis B Meningococcal group B Rotavirus 12 weeks Second round Diphtheria, tetanus, pertussis Polio, Hib, Hepatitis B MenB Rotavirus 16 weeks Third round Diphtheria, tetanus, pertussis Polio, Hib, Hepatitis B Pneumococcal (13 types) 1 year One year boosters MMR (Measles, mumps, rubella) Pneumococcal (13 types) Hib/MenC (born before July 2024) 18 months For babies born after July 2024 DTaP/IPV/Hib/HepB MMR 3+ years Pre-school boosters Diphtheria, tetanus, pertussis Polio MMR (if born before July 2024) 12-14 years Teenage vaccinations HPV (12-13 years) Tetanus, diphtheria, polio […]
- [Summary of SMI: ID 21: Yersinia](https://microregistrar.com/summary-of-smi-id-21-yersinia/): Interactive Yersinia Species Identification Guide 🔬 Yersinia Species Identification Guide Comprehensive laboratory identification and characterization of Yersinia species Overview Species Laboratory Process Safety Media Summary 🦠 Genus Yersinia Overview 📊 Taxonomy Family: Enterobacteriaceae Species: 17 recognized species + 2 subspecies Type species: Yersinia pestis Pathogenic species: Y. pestis, Y. pseudotuberculosis, Y. enterocolitica 🧬 General Characteristics Gram-negative, catalase-positive, oxidase-negative Facultatively anaerobic straight rods to coccobacilli Non-spore forming May show bipolar staining (“closed safety-pin appearance”) Respiratory and fermentative metabolism Optimum growth: 28-29°C Motile at 50 serogroups Pathogenic: Biotypes 1B (highly pathogenic) and 2-5 Non-virulent: Biotype 1A CIN agar: Deep-red center with transparent border […]
- [NTM Pulmonary Disease Guidelines](https://microregistrar.com/ntm-pulmonary-disease-guidelines/): (Academic purpose only. If you need clinical advice, please speak to your doctor.) NTM Pulmonary Disease Guidelines BTS Guidelines – October 2017 | Dr Swathi Gurajala, MD, FRCPath NTM Epidemiology – Relevant Species in UK M. avium complex: 45% M. malmoense: 22% M. abscessus: 14% M. xenopi: 5% M. kansasii: 4% M. chelonae: 2.6% M. simiae: 1.8% M. fortuitum: 1.8% Possible Causes for Increasing Prevalence: Enhanced awareness and improved detection Reduced incidence of TB Exposure: showers, reduced hot water temperatures, and soil Antibiotic exposure creates a favourable niche Impaired host immunity: ageing, lung disease, drugs Person-to-person transmission Definition of NTM-Pulmonary Disease […]
- [Cryptococcus (microregistrar.moodlecloud)](https://microregistrar.com/cryptococcus-microregistrar-moodlecloud/): 🦠 Cryptococcosis Treatment Algorithm Global Guidelines for Diagnosis and Management | Evidence-Based Recommendations Based on the Global Guideline for the Diagnosis and Management of Cryptococcosis (Lancet Infectious Diseases, 2024) 🧠 CNS Cryptococcosis HIV SOT Non-HIV/Non-SOT C. gattii Cryptococcoma 🔄 Disseminated Disease (Non-CNS/Non-pulmonary) 🫁 Pulmonary Disease Severe Mild With/Without Cryptococcoma 🩹 Direct Skin Inoculation Cutaneous infection 💊 PRIMARY INDUCTION THERAPY 🏥 High-Income Settings (AIIt): Liposomal Amphotericin B 3-4 mg/kg daily + Flucytosine 25 mg/kg four times daily 🌍 Low-Income Settings (AI): Single-dose Liposomal AmB 10 mg/kg + Flucytosine 25 mg/kg four times daily + Fluconazole 1200 mg daily × 14 days ⬇️ […]
- [Listeria revision card](https://microregistrar.com/listeria-revision-card/): from microregistrar.moodlecloud.com
- [What is the optimum preparation time for FRCPath examination](https://microregistrar.com/what-is-the-optimum-preparation-time-for-frcpath-examination/): Members of the microregistrar moodle programme took part in a poll. See the results.
- [Hand hygiene](https://microregistrar.com/hand-hygiene/): References 1.WHO: Hand Hygiene Improvement programmes (2017) 2.CDC: Reduction of Healthcare-Associated Infections by High Compliance with Hand Hygiene (2016) 3.Lydon et al.: ICU Hand Hygiene Compliance Systematic Review (2017) 4.Systematic review: ED Hand Hygiene Practices (2022) 5.WHO/UNICEF JMP: WASH in Health Care Facilities Report (2019) 6.CDC: Clinical Safety—Alcohol-Based Hand Sanitizers Guidance (2024) 7.Evidence-based practices to increase hand hygiene compliance (2015) 8.Sickbert-Bennett et al.: 2013–2015 Longitudinal HAI & Compliance Study 9.Impact of Direct Hand Hygiene Observations and Feedback (2022) 10.CDC: Hand Hygiene for Patients in Healthcare Settings (2024) 11.SHEA/IDSA/APIC Practice Recommendations update (2022) 12.AHA: Updated Best Practices for Hand Hygiene (2023) 13.PMC: […]
- [Pathogen-Associated Histological Features](https://microregistrar.com/pathogen-associated-histological-features/): Advertisement Cellular Feature Associated Pathogen Description Owl’s eye cells Cytomegalovirus (CMV) Large cells with intracellular inclusions surrounded by a clear halo, resembling an owl’s eye. Pathognomonic of CMV infection. Decoy cells BK virus Virally infected epithelial cells found in urine. Named for their resemblance to cancer cells, potentially causing diagnostic confusion between viral infection and urothelial malignancy. Haufen BK virus Icosahedral aggregates of polyomavirus particles and Tamm-Horsfall protein detected in the urine of kidney transplant patients with BKVN using negative-staining electron microscopy. Downie bodies Cowpox virus Intracytoplasmic eosinophilic inclusion bodies found in infected epithelial cells. Negri bodies Rabies virus Eosinophilic cytoplasmic inclusions found in […]
- [Summary: Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM](https://microregistrar.com/summary-global-guideline-for-the-diagnosis-and-management-of-candidiasis-an-initiative-of-the-ecmm-in-cooperation-with-isham-and-asm/): Introduction Candida species are the predominant cause of fungal infections in patients treated in hospital settings, causing significant morbidity and mortality worldwide. This clinical practice guide summarises evidence-based recommendations from the European Confederation for Medical Mycology (ECMM) global guideline initiative, developed in cooperation with the International Society of Human and Animal Mycology (ISHAM) and the American Society for Microbiology (ASM). Audio podcast Epidemiology and Risk Factors Type of Candidiasis Epidemiology Key Risk Factors Invasive Candidiasis Estimated 1,565,000+ cases annuallyCandidemia is most common presentationMore than 85% of fungemia cases in Europe/USA ImmunosuppressionCritical illnessIndwelling vascular cathetersAbdominal surgeryProlonged ICU stayBroad-spectrum antibioticsTotal parenteral nutrition Mucocutaneous […]
- [Using LLMs effectively for academic work](https://microregistrar.com/using-llms-effectively-for-academic-work/): This summary reflects my experience with LLMs over the past several months. I have interacted with Gemini (formerly Bard), ChatGPT (including version 4.5), Perplexity, Claude, and Grok3, along with some use of DeepSeek, Mistral, AllenAI, Leonardo, Midjourney and Copilot. Every LLM has its strengths and weaknesses, and no one LLM is the best at doing everything for your academic needs. However, the capabilities and functionalities are changing regularly and fast. Search Perplexity leads for research; Gemini excels with Google integration. Deepsearch of ChatGPT is excellent in my opinion. Grok DeepSearch is also good. Hallucination ChatGPT (DALL-E 3) and Gemini lead in […]
- [Journal review: Emergence and Spread of C difficile Isolates With reduced Fidaxomicin Susceptibilti in an Acute Care Hospital.](https://microregistrar.com/journal-review-emergence-and-spread-of-c-difficile-isolates-with-reduced-fidaxomicin-susceptibilti-in-an-acute-care-hospital/): Sarah N Redmond et al, Emergence and Spread of Clostridioides difficile Isolates With Reduced Fidaxomicin Susceptibility in an Acute Care Hospital, Clinical Infectious Diseases, 2025;, ciaf028, https://doi.org/10.1093/cid/ciaf028 Introduction & Background: Methods: Key Findings: Discussion & Implications: Some points to consider
- [Types of studies](https://microregistrar.com/types-of-studies/): Research Category Types Experimental Studies – Randomized Controlled Trials (RCT)– Laboratory Experiments– Field Experiments– Quasi-experimental Studies– Pre-test/Post-test Design Observational Studies – Cohort Studies– Case-Control Studies– Cross-sectional Studies– Longitudinal Studies– Ecological Studies Qualitative Studies – Ethnographic Research– Phenomenological Studies– Grounded Theory Studies– Case Studies– Narrative Research– Focus Groups Mixed Methods – Sequential Mixed Methods– Concurrent Mixed Methods– Transformative Mixed Methods– Embedded Mixed Methods Descriptive Studies – Surveys– Naturalistic Observation– Correlational Studies– Descriptive Case Studies– Population Studies Research Synthesis – Meta-Analysis– Systematic Reviews– Scoping Reviews– Integrative Reviews– Literature Reviews
- [Dengue vaccine - Greenbook Summary](https://microregistrar.com/dengue-vaccine-greenbook-summary/): Vaccine Description and Composition “The dengue vaccination Qdenga® is a tetravalent live attenuated vaccine. It is produced in Vero cells by recombinant DNA technology and contains serotype-specific surface protein genes of the four dengue serotypes, engineered into a dengue type 2 backbone.” Storage and Presentation “Vaccines should be stored in the original packaging at +2C̊ to +8C̊ and protected from light… Heat speeds up the decline in potency of most vaccines… Freezing may cause increased reactogenicity and loss of potency” Dosage and Administration Recommendations for Use Contraindications Qdenga® should not be given to: Precautions Adverse Reactions Management of Cases
- [MCQ 19](https://microregistrar.com/mcq-19/)
- [MCQ 18](https://microregistrar.com/mcq-18/)
- [MCQ 17](https://microregistrar.com/mcq-17/)
- [MCQ 16](https://microregistrar.com/mcq-16/)
- [Microregistrar.moodlecloud.com](https://microregistrar.com/microregistrar-moodle-frcpath/): Microregistrar.moodlecloud.com is an online learning platform for doctors preparing for the FRCPath Medical Microbiology examinations. It provides structured revision support for Part 1 and Part 2, including core microbiology topics, high-yield notes, exam-focused questions, guideline and UKHSA updates, laboratory interpretation material, and practical study guidance.
- [How to make study-schedule for part 2 FRCPath Microbiology](https://microregistrar.com/how-to-make-study-schedule-for-part-2-frcpath-microbiology/): (Experience of a successful trainee – Autumn 2023) I divided it into bacteriology/antimicrobial/clinical/ Viro/ IPC/ fungi/parasiteAs it’s always easier to prepare in that way.For bacteria – SMIs, especially tables at the back, covering all media, especially for faecal samples – how colonies of salmonella/shigella look like on CLD/DCABiochemical tests – I am sure we do know them already, but revise catalase/coagulase/oxidase/Indole/citrate/TSI can be found in SMI or any basic micro book.Simple things like oxidase/urease positives. All basic bacteria gram stain/cat/coagulase/ any special media/ any special testClostridium sSMI are really important.Some others, like GPRs actinomycete/Nocardia. Lab management likeCategory 3/2 lab to differentiateHazard […]
- [C](https://microregistrar.com/c/): Capnocytophaga canimorsus
- [Moodlecloud WhatsApp discussion](https://microregistrar.com/moodlecloud-whatsapp-discussion/): 01.01.24 30.12.23 29.12.23 27.12.23 25.12.23 24.12.23 20.12.23 19.12.23 18.12.23 17.12.23
- [B57:  BAL, sputum, associated specimens](https://microregistrar.com/b57-bal-sputum-associated-specimens/): Type of specimen Target organism CAP HAP Lung abscess Cystic fibrosis Mycobacteria disease Parasites Fungal infection Consider bioterrorism for these organisms if there is no travel history Media Safety Processing specimen Review the sputum: Is it salivary, mucosalivary, mucoid, mucopurulent, purulent and/or bloodstained? Put in on the report. If salivary, reject (unless the patient is immunocompromised or you intend to test for Mycobacteria – in that case process all types of sputum) but retain specimens at 4°C for at least 48hr. No such grading is needed for BAL. Prepare the sample – Gram & other stain Although it can be used […]
- [Yellow fever vaccine: study note](https://microregistrar.com/yellow-fever-vaccine-study-note/): Vaccine: Coadministration with other vaccines It can be co-administered (on different limbs /the same limb 2.5 cm apart) with other inactivated and most live vaccines, except MMR, which should be given 28 days apart. If yellow fever and MMR were given together due to the immediate need for protection, repeat vaccine doses should be considered individually. Who needs a yellow fever vaccine? Revaccination/Booster dose One dose confers lifelong immunity; hence routine booster is not necessary. However, it can be considered that the first dose was given. Contraindication If someone with contraindication travels to a yellow fever endemic area, they should take mosquito avoidance […]
- [What I wish I’d known by Zoie Aiken (a Video by RCPath) – about FRCPath part 2](https://microregistrar.com/what-i-wish-id-known-by-zoie-aiken-a-video-by-rcpath-about-frcpath-part-2/)
- [UK SMI notes – Ear Infections.](https://microregistrar.com/uk-smi-notes-ear-infections/): Type of specimen: Ear swab Middle ear fluid Scraping of material from the ear canal (for fungal infection) Expected organisms Otitis Externa Acute localised otitis externa Staphylococcus aureus Group A Streptococcus furuncle Erysipelas Acute diffuse otitis externa Pseudomonas aeruginosa S. aureus Anaerobes Treatment – topical cleaning of debris. Antibiotics are not useful. Chronic otitis externa Colonisation by Enterobacteriaceae Fungi Treatment – topical, cleaning of debris. Antibiotics are not useful. Malignant otitis externa P. aeruginosa. Invasive, necrotising infection. Needs aggressive antibiotic therapy and debridement. At-risk groups are diabetic, older people, immunocompromised people. Otitis media Acute otitis media Streptococcus pneumoniae, Haemophilus influenza and Moraxella catarrhalis Respiratory viruses. Less common: Staph aureus Group A Streptococcus Gram-negative […]
- [Staphylococcus lugdunensis](https://microregistrar.com/staphylococcus-lugdunensis/): Bacteria Staph lugdunensis is a coagulase-negative Staphylococcus (CoNS) capable of causing aggressive diseases like Staph aureus. Staph lugdunensis tends to be more susceptible to antibiotics compared to other CoNS. Vancomycin tolerance – can be present, i.e. the ability of bacteria to survive in the presence of an antibiotic, even if MIC testing has deemed that it should be susceptible. Check MBC: MIC ratio (more likely if >32). Coagulase-negative Staphylococcus that gives positive results in slide coagulase test – S. lugdunensis, S. schleiferi, and S. sciuriCoagulase-negative Staphylococcus that gives a positive result in the tube-coagulase test – S. pseudointermedius, S. intermedius, S. hyicus, S. delphini, S. schleiferi and S. lutrae. Pathogenesis Clinical feature Treatment
- [SMI: Investigation of whooping cough](https://microregistrar.com/smi-investigation-of-whooping-cough/): Types of specimen Cough plates are not recommended. Selective media It contains blood or charcoal or both, along with selective antibiotic supplements – penicillin, cefalexin or meticillin.It should be able to suppress other nasopharyngeal flora. Meticillin is the least inhibitory, and cefalexin is the most. Cefalexin is the drug of choice for selective media in the UK. Pertussis selective media – Regan-Lowe Charcoal Agar (Ref bd.com) Safety Containment level 2.If the procedure is likely to give rise to aerosol, perform it inside a microbiology safety cabinet. Culture PCR IS481 ptxS1 hlS1001 plS1001 Report + + – – B pertussis DNA detected – + – […]
- [Spread of Candida auris](https://microregistrar.com/spread-of-candida-auris/)
- [SMI: Investigation of Throat-Related Specimens](https://microregistrar.com/smi-investigation-of-throat-related-specimens/): Specimens Throat swab, posterior pharyngeal swab, nasopharyngeal swab, pharyngeal washings, pus aspirate, oropharyngeal swab, throat gargle. Why To investigate upper respiratory tract infection – Pharyngitis, Tonsillitis, Epiglottitis, and Laryngitis. Condition Target organisms Pharyngitis(sore throat) 1. Viral (commonest),2. Group A Streptococcus/ Streptococcus pyogenes,3. Group C/G Streptococcus – Streptococcus dysgalactiae subspecies equisimilis,4. Streptococcus anginosus group,5. Corynebacterium – C diphtheriae, C. ulcerans,6. Vincent’s angina – Borrelia vincentii and Fusobacterium species,7. Arcanobacterium haemolyticum,8. Fusobacterium necrophorum.9. Neisseria gonorrhoeae. Rare:Francisella tularensis, Yersinia enterocolitica, Mycoplasma pneumoniae and Chlamydophila pneumoniae. Other:To test for carriage – Neisseria meningitidis, Staph aureus. Epiglottitis 1. H. influenzae type b,2. Group A Streptococcus/ Streptococcus pyogenes,3. […]
- [SMI Summary: Investigation of bone marrow](https://microregistrar.com/smi-summary-investigation-of-bone-marrow/): Because it is an invasive procedure, bone marrow biopsy (typically collected from the posterior iliac crest or the sternum) is rarely used. It’s also proposed that it shouldn’t be done on people who are immune-competent.It may be useful in the diagnosis of infection in immunocompromised patients (HIV, transplant patients, or patients on high-dose steroids), caused by a small number of pathogens (listed below). Some situations where it can be useful are: The advantage of bone marrow examination over blood culture: Organisms for which it is useful: ORGANISM NOTE Salmonella typhi,Salmonella paratyphi – Enteric fever is the only bacterial infection for which […]
- [SMI notes: Investigation of infectious causes of dyspepsia (SMI B 55)](https://microregistrar.com/smi-notes-investigation-of-infectious-causes-of-dyspepsia-smi-b-55/): There are  2 SMIs related to H pylori- Identification of Helicobacter spp. (SMI ID26) & Investigation of infectious causes of dyspepsia (SMI B55). Available tests for the diagnosis of H. pylori infection There are 4 major types of tests that we can use to test for H pylori. 1. Urea breath test (UBT) 2. Stool antigen test (SAT) 3. Serology – antibody test (HiG) 4. Microscopy and culture of gastric biopsy Other tests Laboratory processing of H pylori Laboratory safety Transporting media Stain Plate selection Colony Identification Sensitivity test Other tests that can be done on biopsy H pylori resistance rate in the […]
- [SMI (note): Investigation of swabs from the skin and superficial soft tissue infection](https://microregistrar.com/smi-note-investigation-of-swabs-from-the-skin-and-superficial-soft-tissue-infection/): Specimen Advice for the users: Safety Processing Gram stain – usually not done unless deep-seated pus from a normally sterile site Plate selection CONDITION PLATES All clinical conditions Blood agarCLED/MacConkey agar Wound swab Selective anaerobic agar with metronidazole disc Pus Fastidious anaerobic, cooked meat broth;then Subculture to blood agar. Cellulitis in childrenHuman bite Chocolate agar with bacitracin (for Haemophilus and fastidious organisms) Burn patients,Immunocompromised patients,Paronychia (Will need a layer of oil to culture for mould),Intertrigo,Diabetic patient Sabouraud agar (Yeast, Moulds) Suspecting cutaneous diphtheria(foreign travel <10 days, non-healing ulcer) Hoyle’s tellurite agar Anaerobic agar/broths – incubate for five days, may need longer […]
- [Shingles vaccine: study note](https://microregistrar.com/shingles-vaccine-study-note/): Two licensed shingles vaccines are available in the UK: Zostavax® and Shingrix®. Zostavax® Shingrix® Live vaccine? Live attenuated vaccine Recombinant vaccine (Not live) Strain/ component Derived from the OKA/Merck strain of the Varicella Zoster Virus Contains varicella-zoster virus glycoprotein E antigen produced by recombinant DNA technology, adjuvanted with AS01B Route The vaccine is given IM or Subcutaneous, preferably in the deltoid region of the upper arm. For individuals with a bleeding disorder, it should be given by deep subcutaneous injection IM, preferably in the deltoid region ofthe upper arm. Subcutaneous administration is not recommended. It should be given IM cautiously in individuals with thrombocytopenia or any coagulation […]
- [Shiga toxin-producing E coli: E coli O157](https://microregistrar.com/shiga-toxin-producing-e-coli-e-coli-o157/): Introduction There are various types of E coli that live in the environment and our intestines. Although most live inside our bowel harmlessly and even be beneficial, some E coli may cause infection, like UTI, bacteraemia, gastroenteritis etc. The E coli causing gastroenteritis could be divided into six phenotypes – Shiga toxin-producing E. coli (STEC) [or EHEC/VTEC] STEC is known to cause gastroenteritis (often with visible blood) and haemolytic uraemic syndrome (HUS). The virulence factors are HUSEC The STEC can be divided into two types. Those that produce Shiga Toxin 2 (stx2) and those that do not (whether they produce stx1 or not).The […]
- [Screening blood donors for infection (note)](https://microregistrar.com/screening-blood-donors-for-infection-note/): Please note this is a study note, keeping the exam in mind. This is not a guideline and should not be used for that purpose. It is not for clinical use either. You should contact your doctor for clinical advice. Blood donation screening ORGANISM MANDATORY TEST ADDITIONAL TEST HIV anti-HIV 1+2 or HIV 1+2 Ag/Ab HIV RNA* Hepatitis B HBsAg 1. HBV DNA*2. anti-HBc [+ anti-HBs] Hepatitis C 1. anti-HCV2. HCV RNA Syphilis anti-treponemal Ab HTLV I/II Anti-HTLV I/II:anti-HTLV screening is only required for blood donations from previously untested donors and for blood donations destined for use to prepare non-leucodepleted products […]
- [Rothia mucilaginosa](https://microregistrar.com/rothia-mucilaginosa/): The Bacteria Rothia belongs to the family Micrococcaceae – the same family as Micrococcus spp., Stomatococcus spp. and Kocuria spp. There are 8 species of Rothia – but only Rothia dentocariosa and Rothia mucilaginosa has been associated with human disease. It is a member of the mouth and upper respiratory tract flora. Laboratory Infection Rothia is an opportunistic pathogen and has been reported to cause – Risk factors for Rothia infection – Immunocompromised state or some form of breach in host defence is associated with Rothia infection. A case series suggested a significant association was seen with steroid use (81% versus 13%; P= 0.0014) […]
- [Respiratory Syncytial Virus (Presentation)](https://microregistrar.com/respiratory-syncytial-virus-presentation/): Respiratory Syncytial Virus is a single-stranded RNA virus with a negative sense, non-segmental RNA. It is an enveloped virus with many proteins, which help perform various functions like Attachment to the host cell, the fusion of host cell membranes, ion channels, viral assembly, RNA binding, transcription, phosphorylation, immune evasion etc. The virus may have a spherical or filamentous structure – it is pleomorphic. RSV belongs to the mononegavirales order, paramyxoviridae family and Pneumovirinae subfamily. It is related to other common cold viruses, like human Metapneumovirus and Parainfluenzavirus. RSV is among the commonest causes of respiratory illness in children, especially infants. The […]
- [Resources for FRCPath Part 2](https://microregistrar.com/resources-for-frcpath-part-2/): by Dr Katherine Watson (2016) This article was written in 2016. However, the suggested documents are still very much relevant. Some subjects and links have been updated and new links to replace broken links. Here are some of the resources that I used in preparation for FRCPath part 2, April 2016 Bristol. One of the most useful things to do is speak to anyone you know who has already sat the exam and ask for all their past questions and tips. Bacteriology https://www.gov.uk/government/collections/standards-for-microbiology-investigations-smi Quite time-consuming, but I suggest reading all of the SMIs. I printed the flow charts from the identification […]
- [Question - SAQ/OSPE](https://microregistrar.com/question-saq-ospe/): A 45 years-old Italian farmer visiting the UK has presented to the A&E with severe and persistent headaches, insomnia, neck stiffness, and confusion. His wife mentioned noticing some personality changes and odd behaviour recently. He had a fever for the last few days but refused to visit the hospital.He does not have any rash. He drinks alcohol occasionally and is not on any regular medication. He is usually fit and well and has no other background diseases.On questioning, you have found that the farmer and his wife regularly drink unpasteurised milk. Lumbar puncture was done: CSF showed -lymphocytosis, increased protein, and […]
- [Preparing for FRCPath part 1 (Microbiology)](https://microregistrar.com/preparing-for-frcpath-part-1-microbiology/): by Dr Joanna Lumb, Consultant, Microbiology This article was written in 2014. However, this advice is very relevant, not only to FRCPath, but is transferrable to any exam. Preparing for a professional exam is a long-haul process, taking several months. As such, normal life needs to continue in the meantime – paid employment, on calls, shopping, cooking, exercise, childcare – and you need to figure out how to stay sane whilst trying to accomplish it all without feeling guilty about not spending every minute of the day revising. Plan your study leave in advance, and take advantage of the days you’re […]
- [Plesiomonas shigelloides](https://microregistrar.com/plesiomonas-shigelloides/): Plesiomonas shigelloides characteristics Plesiomonas shigelloides is a gram-negative bacillus that derived its name from the ancient Greek word plēsíon,  which means “near” or “neighbour”, as it was considered near or related to the bacteria Aeromonas. It is mostly found in freshwater, estuarine, or brackish water environments. It can be found in animals living in these environments, like fish, shrimp, shellfish, amphibians, reptiles, and vertebrates. It is mostly found in tropical waters but is increasingly reported in colder countries, especially in warmer months. It could also be found in seawater (and saltwater animals) in warmer temperatures. How do we get Plesiomonas shigelloides infection? […]
- [Pathophysiology of inflammation](https://microregistrar.com/pathophysiology-of-inflammation/): What is inflammation? Inflammation is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a process that removes or reduces harmful stimuli to help with the healing process. Cardinal signs of inflammation: There are 5 cardinal signs of inflammation. They are – Loss of function mainly occurs due to pain and swelling. Consider septic arthritis of the knee and how pain and swelling may restrict movement. What are the stimuli that can cause inflammation? Remember, not all bacteria are harmful. Many bacteria live on our skin or mucous membrane, […]
- [Norovirus](https://microregistrar.com/norovirus/): Epidemiology Norovirus is the most common cause of epidemic gastroenteritis worldwide. In the UK, norovirus outbreak is usually seen in the winter months. The virus Norovirus is a small non-enveloped RNA virus of the caliciviridae family. It has ten genogroups, but I, II and IV are primarily implicated in human infection. Genogroup II is most common in the UK. Genogroups have a preference for the blood groups; for example, genogroup I has a preference for A and O, while II prefers A and B. Transmission Norovirus is transmitted from human to human by contact, faeco-oral route, fomite and airborne droplets.Foodborne outbreaks […]
- [Neurobrucellosis](https://microregistrar.com/neurobrucellosis/): Brucellosis is a zoonotic infection transmitted to humans from animals (cattle, goats, sheep) via The UK is a non-endemic country. Most brucella cases in the UK are imported cases with links to Mediterranean or Middle Eastern countries. However, Brucella is also endemic in Central Asia, China, South Asia, sub-Saharan Africa, and some parts of Middle and South America. Clinical presentation There are three types of neurobrucellosis – meningoencephalitis, diffuse CNS involvement (predominantly myelitis and cerebellar involvement) and polyradiculoneuropathy. Sign/symptoms The patient may also have hepatosplenomegaly, hypoesthesia, paraplegia, stroke, brain abscess, and hearing loss. Investigation: Neuroimaging – CT/MRI. All suspected Brucella cases – […]
- [Nested PCR](https://microregistrar.com/nested-pcr/)
- [Necrotising fasciitis](https://microregistrar.com/necrotising-fasciitis/): Necrotising fasciitis (NF): It is an infection of the subcutaneous tissue/fat and fascia of the skin. It spreads rapidly along the fascial plane. Muscles are less commonly affected/ affected later in the disease due to better blood supply. Classification Types Organism Note Type 1 – polymicrobial/synergistic Aerobic and anaerobic bacteria Often derived from gut/bowel Type 2 – monomicrobial Group A Streptococcus (Strep pyogenes), occasionally Staph aureus (especially neonates); Commonly skin or throat derived. Type 3 Vibrio spp mainly;Other organism – Pasteurella multocida, Haemophilus influenzae , Klebsiella spp. and Aeromonas spp. Common in Asia, associated with seafood/seawater Type 4 Fungal(Candida in immunocompromised or zygomycetes in immunocompetent patients) Type 1 is the commonest (up to […]
- [MRSA guideline – HIS and IPS guideline](https://microregistrar.com/mrsa-guideline-his-and-ips-guideline/): Universal or targeted screening Rescreening Test Staff screening Decolonisation In patients with eczema, dermatitis, or skin conditions – an attempt should be made to treat underlying skin conditions. A dermatology consultant could be consulted. Alternatives are – Oilatum bath additive or Oilatum plus (with added benzalkonium chloride 6% and triclosan 2%).Mupirocin prolonged or repeated use may lead to resistance. It should not be used for two courses for 5 days. Standard/contact precaution, isolation Transfer: Share equipment Surveillance Children Environmental sampling Information Deceased
- [Microbiology for medical students / Foundation Doctors](https://microregistrar.com/microbiology-for-medical-students-foundation-doctors/): Introduction Microbiology can be a daunting subject for medical students and junior doctors alike to approach. Confronted with masses of information and bacteria names more suited to winning Scrabble competitions, it’s often difficult to know where to start! However, acquiring a good understanding of microbiology can be life-saving for your patients, so it is well worth doing!!!  Like all aspects of medicine, it is best to adopt a systematic approach to the issue. In the pages that follow, I have provided the basic framework that I still use to approach microbiological issues. Using this framework should help you better understand the […]
- [MCQ set 2](https://microregistrar.com/mcq-set-2/)
- [MCQ set 1](https://microregistrar.com/mcq-set-1/)
- [Leptospira spp.](https://microregistrar.com/leptospira-spp/): This is from a presentation. The pictures were my slides. Feel free to download them if you wish. Leptospirosis, a zoonosis, is caused by a pathogenic Spirochaeta of the genus Leptospira.The name is derived from the Greek leptos (thin) and the Latin spira (coiled). Leptospirosis is a multisystem disease first described by Albert Weil in 1986 (in Heidelberg). It was called infectious jaundice and was often confused with yellow fever. Leptospira was first isolated from an autopsy specimen – the patient was suspected of having yellow fever. Many scientists, like stokes and Noguchi, died trying to isolate the organism. The Bacteria […]
- [Kingella spp.](https://microregistrar.com/kingella-spp/): Bacteria: Fastidious gram-negative coccobacilli that appear in pairs or short chains.Commensal of the mouth and upper respiratory tract.The genus Kingela have species like  – K. kingae, K. denitrificans, Kingella negevensis, K. oralis etc. Identification: It appears as pairs/short chains of plump bacilli (or coccobacilli) with tapered ends.Capnophilic and facultatively anaerobic, nonmotile, non-spore-forming.Beta-haemolytic colonies on blood agar often produce marked pitting of the agar surface.It is catalase, urease, and indole tests negative. It is oxidase positive. Kingella kingae produces 4 different types of colonies- Identification could be made using – API NH, Vitek 2, MALDI-TOF, 16S rRNA gene sequencing. Remel RapID NH kit is not reliable. Pathogenicity: Predisposing factors/association: Varicella […]
- [Leclercia adecarboxylata](https://microregistrar.com/leclercia-adecarboxylata/): While authorising the urine result – I found that a urine sample from the community has grown Leclercia adecarboxylata. The patient is a young female complaining of increased frequency. The number of organisms in the urine was >100,000 organisms/ml.What is the significance? The bacteria  Previously known as Escherichia adecarboxylata, it now belongs to a new genus Leclercia (family Enterobacteriaceae).First described by Leclerc in 1962 as ubiquitous in nature (Food, water etc., animals – snails).It is also a member of the gut flora (commensal). Identification A motile, aerobic, Gram-negative bacillus Positive for Negative for Indole production, methyl red, growth in the presence of KCN, malonate utilization, esculin hydrolysis, gas and […]
- [Infectious mononucleosis and Epstein-Barr Virus](https://microregistrar.com/infectious-mononucleosis-and-epstein-barr-virus/): Cause: Epidemiology: Transmission: Signs and symptoms: Complications Diagnosis If you want to know about a heterophile antibody, see this video. Atypical lymphocytes can also be seen in CMV, HIV, HHV6, rubella, mumps, viral hepatitis, toxoplasmosis, typhus, lead poisoning etc. Differential diagnosis: Treatment:
- [Japanese encephalitis vaccine: study note](https://microregistrar.com/japanese-encephalitis-vaccine-study-note/): Vaccine Inactivated vaccine (IXIARO®), NO live virus.Adjuvant: Aluminium hydroxide (improves immunogenicity).Storage: +2°C to +8°C and protected from light. Administration Primary immunisation Primary immunisation should ideally be completed at least one week before potential exposure to the Japanese encephalitis virus. Full immunity takes up to one week to develop after the second dose. Standard schedule Rapid schedule 1st dose at day 02nd dose at day 28 1st dose at day 02nd dose at day 7 1st dose at day 02nd dose on day 28 Booster dose Age group First booster Second booster 2 months – 18 years A booster dose at 12 months should be […]
- [Infection associated with immune checkpoint inhibitors](https://microregistrar.com/infection-associated-with-immune-checkpoint-inhibitors/): Immune Checkpoint Inhibitors (ICI) are used to treat malignancy (breast CA, bladder CA, cervical CA, lung CA, colon CA, Hodgkin lymphoma etc). There are three types of ICIs Type of ICIs Example Programmed death 1(PD-1) inhibitors Atezolizumab, Avelumab, Durvalumab Programmed death 1 ligand (PD-L1) inhibitors Nivolumab, Pembrolizumab, Cemiplimab, Dostarlimab cytotoxic T lymphocyte-associated antigen 4 (CTLA4) inhibitors Ipilimumab, Tremelimumab How does the ICI work? PD-1 and PD-L1 inhibitors Activated CD4 and CD8 T-cells express PD-1 on their surface. On coming into contact with the malignant cells, T cells secrete pro-inflammatory cytokines (e.g. IFN‐γ). The IFN‐γ upregulate the expression of PD-L1 on tumour […]
- [Infection associated with chronic granulomatous disease (CGD)](https://microregistrar.com/infection-associated-with-chronic-granulomatous-disease-cgd/): Introduction CGD is a rare inherited immunodeficiency disorder where the NADPH oxidase in the phagocytic cells is absent or malfunctioning. Most CGDs are inherited as X linked, while the rest are autosomal recessive. Phagocytes, like neutrophils and monocytes, in the absence of NADPH oxidase, cannot kill the ingested pathogens due to the lack of oxidative burst. As a result, this patient suffers from severe, recurrent bacterial and fungal infections. Chronic infection and inflammation lead to granuloma formation, which may cause obstructive symptoms, especially in the gastrointestinal and urinary systems. CGD most commonly manifests in childhood, but some cases manifest for the first time in adulthood. Pathology Phagocytic cells like neutrophils […]
- [Ibrexafungerp: A novel antifungal](https://microregistrar.com/ibrexafungerp-a-novel-antifungal/): Ibrexafungerp, an enfumafungin derivative, belongs to a new family called triterpenoid antifungals.This is a new class called “-fungerp”. This antifungal class inhibits glucan synthetase required for fungal cell wall synthesis. One of the major antifungal class echinocandins also acts by this mechanism and has been used since 2001. Echinocandins, however, have poor bioavailability and are only available as parenteral preparation. Echinocandins are highly protein-bound and have a large molecular size. The penetration of echinocandins to the CSF and urine is limited. Fungerps are designed to overcome some of these limitations. Mechanism of action Echinocandins bind to the FKS1 domain of β-1,3-glucan […]
- [Human Monkeypox](https://microregistrar.com/human-monkeypox/): Monkeypox is an emerging disease. It was first discovered in 1958 in a captive monkey population, from which it received its name. However, monkeys are not its main reservoir. The largest natural reservoir population is rodents. The full lifecycle and the extent of the reservoir population are still unknown.Monkeypox is a zoonosis. The virus: It is a double-stranded DNA virus.It belongs to the family poxviridae, genus Orthopoxvirus. It has two genetic clades – the West African variant and the Central African variant.The West African clade usually causes milder disease with limited human-to-human transmission compared to the Central African clades. Distribution: The […]
- [How did I prepare for part 2 FRCPath?](https://microregistrar.com/how-did-i-prepare-for-part-2-frcpath/): One of our registrars passed part 2 recently. I asked him about his preparation. He kindly shared with me some useful tips which may help anyone preparing for part 2. What did you read? What I read was a mix of Here are the links to the resources mentioned Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases SMI PHE documents Kucers’ The Use of Antibiotics Comprehensive Review of Infectious Diseases ECMM micro guidelines EUCAST Where did you find questions? No place has adequate questions. However, if you save up the questions from the NEQAS monthly question bank, they cover […]
- [Fusobacterium necrophorum](https://microregistrar.com/fusobacterium-necrophorum/): Bacteria Fusobacterium necrophorum is a Gram-negative, non-motile, non-spore-forming anaerobic pleomorphic bacterium. It may appear in coccobacillus or filamentous forms, which are more common in younger cultures. It is a member of the normal bacterial flora of the oropharynx, genitourinary tract, and gastrointestinal tract. Culture and identification There are 14 species of Fusobacterium, 10 of which are identified from humans. The most commonly isolated species are F necrophorum and F nucleatum. F nucleatum is a spindle-shaped gram-negative rod. F necrophorum is – Identification can be made by API 20A, API rapid ID 32A or MALDI ToF Pathogenicity: Clinical features Pharyngitis Especially in […]
- [Example of short answer questions and OSPE (FRCPath Microbiology part 2)](https://microregistrar.com/example-of-short-answer-questions-and-ospe-frcpath-microbiology-part-2/): A GP has called you about a 2-year-old girl. Her mum noticed scratch marks on the girl’s face in the morning. On questioning, Mum told the GP that she noticed a bat in her room but managed to get it out of the room. She doesn’t know how long the bat was there or if the girl had any contact with the bat. Advise the GP on the right course of action and management. A lady had a normal delivery. Some herpetic lesions were noted in the perineal region during delivery. What would you advise the clinicians regarding the management of mother […]
- [Emergomycosis – an emerging mycosis](https://microregistrar.com/emergomycosis-an-emerging-mycosis/): Emergomycosis is a systemic fungal mycosis caused by a novel dimorphic fungi called Emergomyces species. It is mainly seen in immunocompromised patients. The first case of Emergomycosis was identified in 1994 in Italy; however, the fungus was described in 1998. Disseminated Emergomycosis observed a case fatality rate of 48%. These fungi were initially classified as Emmonsia but later placed under the genus Emergomyces. The fungus in this genus are – The last two are not associated with disseminated fungal mycosis. Cases have been reported from Asia, Africa, Europe and North America. Many cases have been identified in South Africa since the […]
- [Eikenella corrodens](https://microregistrar.com/eikenella-corrodens/): Bacteria: Pathogenicity: Culture and identification: Infection caused by Eikenella: Points to remember Eikenella corrodens is usually susceptible to: Non-susceptible to:
- [Diagnosis of vertebral osteomyelitis (VO)](https://microregistrar.com/diagnosis-of-vertebral-osteomyelitis-vo/): Reference: JBJI review published on 27/1/2022. Read the full paper here – Maamari, J., Tande, A. J., Diehn, F., Tai, D. B. G., and Berbari, E. F.: Diagnosis of vertebral osteomyelitis, J. Bone Joint Infect., 7, 23–32, https://doi.org/10.5194/jbji-7-23-2022, 2022. Biomarkers Imaging Biopsy and Microbiology Serology Novel modalities Flow chart as shown in the above article
- [Culture media and composition](https://microregistrar.com/culture-media-and-composition/): This is a list of some culture media and their composition. MEDIA SUPPLEMENTS TARGET ORGANISMS ABC plates Alpha-galactosidase Salmonella sp. Alkaline peptone water [pH – 8.6 ± 0.2] NaCl, peptone Enrichment of Vibrio spp. Aztreonam Blood Agar Aztreonam, blood agar base Gram-positive, especially fastidious gram-positive organisms BHI Broths Calf brain and beef heart infusion solids, peptone Used for a broad range of pathogens –Fastidious anaerobic organisms, Haemophilus influenza, pathogenic fungi and many other organisms (Streptococcus pneumonia, S aureus,  L monocytogenes, Leishmania promastigotes and C difficile.) Blood Agar tryptic soy agar or Columbia agar base with 5% sheep blood. Generic enrichment media. Charcoal agarwith Bordetella Selective […]
- [Cronobacter sakazakii: pathogen from infant formula feed](https://microregistrar.com/cronobacter-sakazakii-pathogen-from-infant-formula-feed/): What is Cronobacter sakazakii? Cronobacter sakazakii is a gram-negative bacteria that can cause necrotising enterocolitis, septicaemia, and meningitis in infants, particularly low-birth-weight neonates. It has repeatedly been associated with reconstituted powdered infant formula. It can also cause infection in adults, especially in vulnerable groups like older people. Infection in infants is associated with a high mortality rate (40-80 per cent). Adult infections are less severe. What is Cronobacter sakazakii? Cronobacter sakazakii is a gram-negative bacteria that can cause necrotising enterocolitis, septicaemia, and meningitis in infants, particularly low-birth-weight neonates. It has repeatedly been associated with reconstituted powdered infant formula. It can also […]
- [COVID vaccine](https://microregistrar.com/covid-vaccine/): Age-specific recommendations on vaccine type Primary vaccination Based on the JCVI advice, the preference is to use the bivalent mRNA vaccines containing the latest variant (currently BA.4/5), however using a bivalent with a previous variant (such as BA.1) or full dose mRNAvaccine (Pfizer BioNTech 30 micrograms) may be used if there would otherwise be a delay in vaccination.
- [Corynebacterium macginleyi – an under-reported cause of conjunctivitis](https://microregistrar.com/corynebacterium-macginleyi-an-under-reported-cause-of-conjunctivitis/): Corynebacterium macginleyi (CM) is lipophilic, slow-growing, gram-positive bacteria first described in 1995 and was named after Kenneth McGinley, who made an essential contribution to the field of lipophilic coryneform bacteria. CM has been associated with conjunctivitis and other eye-related infections. It has also been implicated in various non-ophthalmic infections as an opportunistic pathogen. It has been proposed that CM is a conjunctiva-specific pathogen that colonises the lipid-rich environment of the meibomian glands/tarsal glands. Image: Henry Vandyke Carter and one more author – Henry Gray (1918) Anatomy of the Human Body (See “Book” section below) Bartleby.com: Gray’s Anatomy, Plate 1205 (Wikipedia) Corynebactrium spp. Corynebacterium is an aerobic gram-positive, non-motile rod, often with […]
- [Catalase test](https://microregistrar.com/catalase-test/): This test detects the catalase enzyme present in most cytochrome-containing aerobic and facultative anaerobic bacteria. The catalase enzyme converts hydrogen peroxide ( H2O2 ) to oxygen and water. This reaction can be observed as the rapid formation of bubbles. The reaction 2 H2O2 → 2 H2O + O2 Catalase positive organisms Gram-positive organisms Staphylococcus, Micrococcus,Aerococcus urinae (Note: Aerococcus viridans is negative),Listeria, Corynebacterium diphtheriaeBacillus (to differentiate from aerotolerant Clostridium. which is negative)NocardiaRhodococcus equi.Mycobacterium tuberculosis Gram-negative organisms Campylobacter fetus, Campylobacter jejuni, and Campylobacter coli.Enterobacteriaceae (Citrobacter, E. coli, Enterobacter, Klebsiella, Shigella, Yersinia, Proteus, Salmonella, Serratia)Pseudomonas Fungus Aspergillus, Cryptococcus Can we get a false-positive or false-negative reaction? False-positive […]
- [Cardiobacterium spp (C hominis, C valvarum)](https://microregistrar.com/cardiobacterium-spp-c-hominis-c-valvarum/): Bacteria: Microaerophilic, pleomorphic gram-negative bacillus often with swelling of one or both ends and retained crystal violet dye at the poles.It is a part of the normal flora of the nose and throat. Culture and identification: Culture API 20NE – may misidentify it as Pasteurella.MALDI ToF16s rRNA PCR Clinical presentation: Antibiotic susceptibility: Variable susceptibility: Treatment is usually a beta-lactam (amoxicillin/ceftriaxone) with/without aminoglycoside or ciprofloxacin.
- [Capnocytophaga spp.](https://microregistrar.com/capnocytophaga-spp/): Capnocytophaga genus belongs to the family Flavobacteriaceae.There are >9 species of Capnocytophaga, which can be divided into two groups – resident of human mouth flora and dog/cat mouth flora. Species found in the human oral cavity C. gingivalis, C. granulosa, C. haemolytica, C. leadbetteri, C. ochracea and C. sputigena Species found in dog/cat oral cavity C. canimorsus and C. cynodegmi Risk factors for Capnocytophaga infection: Disease caused by Capnocytophaga: C canimorsus infection may result in septic shock, fever, disseminated purpura/purpura fulminans, acute renal failure, and confusion. Pathogenesis: Capnocytophaga can evade the immune system, at least at the early stages of infection. These properties have been observed in various […]
- [Candida auris: an emerging multi-resistant fungus](https://microregistrar.com/candida-auris-an-emerging-multi-resistant-fungus/): Introduction Candida auris is a pathogen that has emerged as a global threat in recent years. It is the first human pathogenic fungus subject to international health alerts. The reason behind these concerns are – Public Health England reported in 2017 that almost all the C auris in the UK are fluconazole-resistant. There is also cross-resistance with other azoles like voriconazole. The resistance to echinocandins is about 10%, and polyenes (amphotericin B), 20%. There have been reports where C auris was resistant to all three classes of antifungal – pan-resistant. Epidemiology Candida auris was first reported in 2009 in Japan from […]
- [C difficile Infection guideline – comparison between NICE 2021 and IDSA 2021](https://microregistrar.com/c-difficile-infection-guideline-comparison-between-nice-2021-and-idsa-2021/): What does NICE guideline 2021 say about assessing and managing C difficile infection? Comparison between NICE 2021 guideline and IDSA 2021 update IDSA/SHEA focussed update 2021 NICE 2021 1st episode of CDAD -1st line Fidaxomicin 200 mg BO PO 10 days Vancomycin 125 mg QDS PO 10 days 1st episode of CDAD – 2nd line Vancomycin 125 mg QDS PO 10 days Fidaxomicin 200 mg BO PO 10 days 1st episode of CDAD – Non-severe CDAD or above agents not available Metronidazole 500 mg TDS PO 14 days 1st episode of CDAD -1st and 2nd line ineffective Vancomycin Upto 500 mg […]
- [Brucella](https://microregistrar.com/brucella/): Bacteria There are many Brucella species – not all known to cause human disease. Those known to cause human disease are – B melitensis, B abortus, B suis, B canis and B ceti. Brucella infection is a zoonosis – each Brucella sp is associated with some animal host – Brucella survives in the environment for a long time – water (weeks), soil (months). In animals, they show a predilection for reproductive organs. Brucella is rare in the UK. Most cases are associated with travel to the Mediterranean or Middle Eastern countries. Transmission The infective dose varies based on the species – […]

## Pages

- [How to prepare for Part 1 FRCPath Microbiology.](https://microregistrar.com/preparing-for-part-1-read-this/): Part 1 FRCPath in Medical Microbiology is often the first major hurdle on the FRCPath journey, especially if you are preparing alongside a full-time clinical job or from overseas. This hub brings together my practical advice on eligibility, choosing the right exam route, planning your study time, and using books, question banks, and UK guidelines efficiently, so you are not overwhelmed by scattered information. Whether you are just deciding whether to sit the exam or are already deep into revision, use this page as your starting map. Follow the focused guides linked below. Start here Plan your preparation Further advice Advice […]
- [FRCPath Microbiology part 2 resources](https://microregistrar.com/frcpath-microbiology-part-2-resources/): Part 2 is a complex and challenging examination. It will test your understanding of all aspects of infection at a consultant grade level. You need to know all the theories but that is not enough; you need to apply that theory in situations under pressure (time pressure). You will need lateral thinking and join the dots from different areas to get your answers right. Reading list Before I start telling you the resources – this is of paramount importance. MAKE YOUR READING LIST FIRST. Without the list your preparation is at risk of being haphazard, and there is a good chance […]
- [How to prepare? Tips from successful candidates](https://microregistrar.com/how-to-prepare-tips-from-successful-candidates/): Part 2 FRCPath Microbiology ID:IOTS podcasts on exam
- [FRCPath Microbiology part 1 resources](https://microregistrar.com/frcpath-microbiology-books/): FRCPath microbiology books. Which books should I read for FRCPath Microbiology?
- [Part 2 FRCPath Microbiology - tips and suggestions](https://microregistrar.com/tips-and-suggestions-for-frcpath-microbiology-part-2/): FRCPath Microbiology Part 2 and Part 1 have a fundamental difference. While part 1 tests your breadth of knowledge and you can pass the exam by reading, memorising and recalling information, part 2 demands a lot more from the trainees.  How much do you need to know? Consider this – when I was preparing for part 2, I was told by my consultant that “before the exam, you should have more knowledge than any microbiology consultant”. That much, you should know – you should be capable of working as a microbiologist on your own in a district general hospital.  You will be […]
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- [Contact](https://microregistrar.com/contact/): I would love to hear from you. You can contact me using the – We have a WhatsApp group which you can use to communicate with other trainees or microbiologists preparing for the examination. You can request to join using the Facebook group.
- [About me](https://microregistrar.com/about/): Dr Suryabrata Banerjee, MBBS, FRCPath (Microbiology &Virology) Consultant and Clinical Lead in Medical Microbiology and VirologyNorthumbria Healthcare, United Kingdom (Opinions are my own)Chair, Speciality Reference Group, NENCMember, Generative AI Subgroup, ESGAID, ESCMIDQuestion setter and Reviewer, UEMS European Examination in Medical Microbiology Founder, Microregistrar – an online platform for microbiology education and FRCPath exam preparationCofounder, Microquora India Interests: Infection prevention and control, antimicrobial stewardship, FRCPath education, diagnostic stewardship, AI and large language models in medicine, clinical safety, and digital medical education. Contact me Teaching, Mentoring & Education Microregistrar.com was started in 2012 as my study notes that I can access anywhere. I […]
- [Microregistrar](https://microregistrar.com/): FRCPath Medical Microbiology exam guidance Practical help for Part 1 and Part 2, with curated resources, exam tips, and structured learning pathways Microregistrar.com to Microregistrar.moodlecloud.com Microregistrar began in 2012 as a note-taking site for a microbiology registrar and has since grown into a structured learning platform for FRCPath Medical Microbiology candidates. What could be the next stage – build a more comprehensive learning platform. Microregistrar moodlecloud was started in 2022 to provide exam-focused reading material and questions in one place. Built from my experience as a consultant microbiologist and educational supervisor, Microregistrar MoodleCloud have supported more than 500 trainees from over […]
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