Microbiology attachment

Details

Title

Microbiology attachment

Type

Stage Two

Module code

HLS284

Requirement

Optional

Module objective

By the end of the training period trainees will, in respect of be able to:

• build upon the understanding of laboratory and clinical aspects of microbiology acquired during the objective-based, structured specialist training prior to the FRCPath Part 1 microbiology/virology examination
• be aware of clinical presentation of infections due to microbial agents other than viruses in the community, hospital and critical care setting
• understand the importance of considering microbial agents other than viruses in differential diagnosis of infection
• advise on appropriate investigations and control of infection measures for commonly seen infections caused by bacteria, fungi and parasites
• understand the basic principles of infection prevention and control for bacterial hospital-acquired infection
• understand the role of the microbiologist in relation to public health
• analyse, synthesise, evaluate and apply knowledge
• perform, adapt and master a range of technical and clinical skills and procedures and
• demonstrate the attitudes and behaviours necessary for professional practice as a consultant clinical scientist dealing with the complexities, uncertainties and tensions of professional practice at this level.

Knowledge and understanding

By the end of the training period the trainee will be able to demonstrate the ability to analyse, evaluate and synthesise relevant knowledge and its application to their professional practice in relation to:

• laboratory aspects of clinical microbiology, including:
  • appropriate staining and culture
  • antibiotic susceptibility
  • the role of reference
• clinical aspects of microbiology, including
  • aetiology and clinical presentation of infectious diseases both in the community and hospital setting
  • pathophysiology of infection related disease processes with special reference to the differences between immunocompetent adults and children, immunocompromised adults and children, pregnancy,
  • optimum treatment (including in neonates, children and pregnant women) of commonly seen infections and how to access current guidelines
  • relevance of assaying levels of antimicrobial agents in ensuring safe levels and effective levels
  • common infection problems in the ICU setting, e.g. ventilator-associated pneumonia, line infections, septicaemia
  • Pathophysiology of serious sepsis and rationale for intervention
  • common causes of infection in returning travellers with measures for preventing such infections
  • public health and epidemiology
  • epidemiology and distribution of important tropical infections, e.g. malaria, schistosomiasis, onchocerciasis, filariasis, trypanosomiasis, gastrointestinal (GIT) parasites, tuberculosis (TB), enteric fever, cholera, dysentery,
  • epidemiological consequences of different infections and of the systems available for control
  • the general principles involved in immunisation programmes, occupational and travel health, agents of biological terrorism
  • the relevance of food, environmental and water (FEW) microbiology for public health
  • hospital-acquired infection (HAI) and control, including:
  • reservoirs, sources, routes of transmission and portals of entry of common HAIs
  • the interactions between the microbe and the patient, appreciating risk factors e.g. devices, antimicrobial exposure, underlying conditions
  • the importance of HAI in total quality management and clinical governance. The importance of screening for HAIs and monitoring alert organisms
  • disinfection and sterilisation in the hospital and primary care setting. The roles and responsibility of infection control team (ICT) and committee (ICC)
  • clinical waste, laundry and kitchen: their relevance and importance in HAI prevention and control
  • ventilation and airflows: importance of this in the theatre, isolation rooms and other relevant areas
  • the process and limitations of all routine microbiology specimens received in the laboratory
• understand current techniques for susceptibility testing
• provide clinical advice based on interpretation of the above
• determine specimen referral or comply with the indications for referral of specimens to reference facilities
• show ability to:
  • assimilate clinical, laboratory and epidemiological information and to use this to differentiate between infections and other conditions
  • select and interpret appropriate tests
  • liaise between clinicians and laboratory
  • recognise and manage specific infection problems in the critically ill
  • justify a course of action
  • recognise the consequences of severe infection including sepsis syndrome
  • investigate and arrive at diagnosis for infections in returning travellers
• be able to:
  • advise on travel vaccination and prophylaxis for prevention of specific travel related infections
  • make accurate risk assessments and to recognise when urgent epidemiological action is required
  • understand methods of vaccine delivery, surveillance of immunisation programmes and evaluation of vaccine efficacy
  • give basic health and travel advice and able to refer to sources of information
  • recognise abnormal patterns of infection and to deal with the unexpected
  • use the FEW microbiology to support public health measures
• show ability to:
  • describe the dynamics of common HAIs
  • distinguish infection from colonisation
  • participate in, and reflect on, surveillance and audit cycles
  • conduct a root cause analysis in instances of HAI
  • describe the disinfection and sterilisation processes, their indications, advantages and disadvantages
  • describe the role of ICT and ICC
  • describe these, including audit approaches
  • describe the principles of HAI and their importance.

Technical and clinical skills

By the end of the training period the trainee will be able to demonstrate a critical understanding of current relevant research, theory and knowledge and its application to the performance, adaptation and mastery of the following technical procedures and laboratory skills:

• knowledge of laboratory aspects of clinical microbiology, including:
  • appropriate staining and culture techniques
  • antibiotic susceptibility testing
  • the role of reference centres
  • the relevance of assaying levels of antimicrobial agents in ensuring safe levels and effective levels
  • the process and limitations of all routine microbiology specimens received in the laboratory
• current techniques for susceptibility
• specimen referral or comply with the indications for referral of specimens to reference facilities
• ability to select and interpret appropriate tests.

By the end of the training period the trainee will be able to apply knowledge of microbiology to perform, adapt and master the clinical skills necessary to manage:

• the aetiology and clinical presentation of infectious diseases both in the community and hospital setting
• the pathophysiology of infection related disease processes with special reference to the differences between immunocompetent adults and children, immunocompromised adults and children, pregnancy, etc.
• the optimum treatment (including in neonates, children and pregnant women) of commonly seen infections and how to access current guidelines
• the relevance of assaying levels of antimicrobial agents in ensuring safe levels and effective levels
• common infection problems in the ICU setting, e.g. ventilator-associated pneumonia, line infections, septicaemia
• serious sepsis and rationale for intervention
• common causes of infection in returning travellers with measures for preventing such infections

Public health and epidemiology:

• Epidemiology and distribution of important tropical infections, e.g. malaria, schistosomiasis, onchocerciasis, filariasis, trypanosomiasis, gastrointestinal (GIT) parasites, tuberculosis (TB), enteric fever, cholera, dysentery, etc
• epidemiological consequences of different infections and of the systems available for control
• the general principles involved in immunisation programmes, occupational and travel health, agents of biological terrorism
• the relevance of food, environmental and water (FEW) microbiology for public health

Show sound knowledge of Hospital-acquired infection (HAI) and control, including:

• The reservoirs, sources, routes of transmission and portals of entry of common HAIs
• The interactions between the microbe and the patient, appreciating risk factors, e.g. devices, antimicrobial exposure, underlying conditions
• The importance of HAI in total quality management and clinical governance. The importance of screening for HAIs and monitoring alert organisms
• Disinfection and sterilisation in the hospital and primary care setting. The roles and responsibility of infection control team (ICT) and committee (ICC)
• Clinical waste, laundry and kitchen: their relevance and importance in HAI prevention and control
• Ventilation and airflows: importance of this in the theatre, isolation rooms and other relevant areas.

Show ability to:

• assimilate clinical, laboratory and epidemiological information and to use this to differentiate between infections and other conditions
• select and interpret appropriate tests
• liaise between clinicians and laboratory
• recognise and manage specific infection problems in the critically ill
• justify a course of action
• recognise the consequences of severe infection including sepsis syndrome
• investigate and arrive at diagnosis for infections in returning

Be able to:

• advise on travel vaccination and prophylaxis for prevention of specific travel related infections
• make accurate risk assessments and to recognise when urgent epidemiological action is required
• understand methods of vaccine delivery, surveillance of immunisation programmes and evaluation of vaccine efficacy
• give basic health and travel advice and able to refer to sources of information
• recognise abnormal patterns of infection and to deal with the unexpected
• use the FEW microbiology to support public health

Show ability to:

• describe the dynamics of common HAIs
• distinguish infection from colonisation
• participate in, and reflect on, surveillance and audit cycles
• conduct a root cause analysis in instances of HAI
• describe the disinfection and sterilisation processes, their indications, advantages and disadvantages
• describe the role of ICT and ICC
• describe these, including audit approaches
• describe the principles of HAI and their importance
• a broad knowledge of the aetiology and clinical presentation of infectious diseases both in the community and hospital setting.