Microbe Mail (Vindana Chibabhai)

The interface between the clinician and the laboratory is critical in ensuring appropriate specimen collection, and appropriate processing. In this, our first episode of Microbe Mail, the host of Microbe Mail, Vindana Chibabhai, chats to a Microbiologist and an infectious diseases fellow about the laboratory cycle and how we can bridge the gap between the bench and the bedside in the diagnosis of infections.  

Spotlight feature: 21:30 (Microbe True or False)

Guests: Dr Kessendri Reddy and Dr Lyle Murray

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Dr Kessendri Reddy is a microbiologist working at the National Health Laboratory Services Tygerberg/Stellenbosch University, in Cape Town, South Africa. She completed her MBChB in 2008 at the University of KwaZulu Natal, qualified as a clinical microbiologist in 2017 and graduated with an MSc in Clinical Epidemiology in 2020. While she is enthusiastic about almost all aspects of her discipline, her special interests lie in “knowledge translation” and practical application from the laboratory to the clinical environment, teaching and training of healthcare workers on specific aspects of the discipline, and involvement in research activities. She believes that clinical microbiologists have a major role to play in low and middle income countries where infectious diseases exert a substantial burden on the healthcare system.

Dr Lyle Murray is a specialist physician and a Fellow in Infectious Diseases at Charlotte Maxeke Johannesburg Academic Hospital and Wits University. He completed his MBChB at the University of Cape Town, his MMed at Wits University and his DPhil at the University of Oxford. He has interests in the immunology of infectious diseases including HIV, TB and COVID-19. He believes that the communication between clinician and microbiologist is key to improving the use and interpretation of microbiological investigations.

Upper respiratory tract infections constitute one of the most common acute illnesses evaluated, particularly in the peadiatric outpatient setting. On this episode of Microbe Mial, VIn chats to Dr Nosisa Sipambo about all things upper respiratory - and when antibiotics are indicated...and more importanely, when they are not!

About our Guest:

Dr Nosisa Sipambo is a paediatric infectious diseases specialist.  She is the head of Harriet Shezi Children’s Clinic (HSCC) and head of the paediatric infectious diseases unit at Chris Hani Baragwanath Academic Hospital. HSCC has one of the largest cohorts of HIV-infected children and adolescents, over 9000 to date. The infectious diseases unit offers a services to all the admitted patients at CHBAH as well as running a primary immunodeficiency clinic. She is a passionate advocate of antimicrobial stewardship and infection prevention and control.  

Qualifications: MBBCh (Wits) MMed (Paeds) Wits; FCPaed (SA); Cert ID (SA) Paed

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In this episode of Microbe Mail, we go through everyday things that every healthcare practitioner should and shouldn’t do in infection prevention and control practices.

Guest: Professor Adriano G Duse

Adriano G Duse is the Professor and Head of Clinical Microbiology and Infectious Diseases in the School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.  

He is a passionate about education and teaches under- and postgraduate students in the Faculty.  He is the recipient of teaching awards and nominations such as the Phillip V Tobias Medal/Convocation Distinguished Teacher’s Award, the Daubenton Prize for Distinguished Teaching in Medical Microbiology and the Vice-Chancellor's Teaching Award. 

Professor Duse has also received the James Gear Medal for Academic Excellence. In 2005 he introduced the training of infection control nurses in the form of an ‘Advanced Diploma in Infection Control’ consisting of a two year training course in conjunction with the Department of Nursing, Faculty of Health Sciences.

Prof Duse served as a Southern African Chair for the Global Antibiotic Resistance Partnership (GARP).  GARP is a project of the Centre for Diseases Dynamics, Economics & Policy (CDDEP) which works to create greater awareness among policymakers in low-middle income countries about the growing threat of antibiotic resistance and to develop country-relevant issues. 

Professor Duse expertise in viral haemorrhagic fevers (VHFs) started in 1996 and resulted in him being appointed by the World Health Organisation, Geneva, to act as expert consultant and provide education to health care staff and case management during the 2005 Angolan Marburg viral haemorrhagic fever outbreak and the 2006/7 Kenyan Rift Valley fever outbreak.  In December 2012 he was appointed WHO short-term consultant for the Infection Control Group for the Ebola haemorrhagic fever outbreak response team in Uganda.  In 2014-15 he was deployed to Liberia, Sierra Leone & Nigeria in his capacity as an Ebola haemorrhagic fever expert. Subsequently, Professor Duse was appointed a member of the WHO Global Infection Prevention and Control Task Team. In addition to VHFs, Professor Duse has been actively involved at national level in the South African National Task Team to curb the transmission of tuberculosis and other infectious diseases in detainees in South African prison cells and correctional facilities.

Professor Duse has authored or co-authored over 100 scientific publications, of which close on 80 are PubMed listed, several chapters of textbooks and is an invited speaker and has presented extensively at both local and international scientific conferences. Professor Duse has a special interest in Travel Medicine and is an EXCO member of the South African Society of Travel Medicine and was appointed Chair of the Scientific Organizing Committee for the 2016 (last year) and 2018 international scientific meetings in this discipline.

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Prof Duse:

Website: Wits University

Facebook:

The...

In this episode we have a discussion with ChatGPT focused on the communication of antimicrobial therapy to patients and unpack some of the potential pitfalls of large language model use in medicine.

Our Guest: (Bio generated by ChatGPT)

Our guest is ChatGPT, a machine learning model developed by OpenAI. As an AI, ChatGPT doesn't possess personal experiences or emotions but is designed to process and generate human-like text based on the data it has been trained on up to its last update.

ChatGPT is here to share synthesized information on communicating antimicrobial therapy, and while it strives for accuracy, it's always essential for listeners to consult healthcare professionals for medical advice. This AI model, built on the GPT-4 architecture, is continuously learning and adapting, and it is a part of the ongoing journey to understand the numerous ways artificial intelligence can aid in comprehending and discussing medical knowledge.

Join us as we explore this intersection of AI and medicine, reminding ourselves of the invaluable human element that guides and informs these technological tools in healthcare.

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Pregnancy is a state that makes many clinicians nervous - with disease processes and medication which can harm both mom and baby.

On this episode, I chat to Adj Prof Shastra Bhoora and Dr Jarrod Zamparini about some conundrums in diagnosing infections in pregnant women.

About our Guests:

Dr Bhoora is a specialist obstetrician and gynaecologist with a sub-speciality in critical care. She currently heads the obstetrics critical care unit at Charlottle Maxeke Johannesburg Academic Hospital. She is affiliated with Baylor College in Texas as an Associate professor in maternal critical care.

Dr Bhoora’s interests involve the acute management of obstetrics, gynaecology and trauma emergencies. She has played an instrumental role during the COVID pandemic for obstetric patients. Pregnant women have unique disease processes and if treated timeously are resilient. Dr Bhoora is currently completing her masters in science reflecting on COVID-19 in pregnancy. She promotes IPC principles and AMS among this vulnerable group. She is a master trainer in ESMOE and is passionate about teaching and empowering young minds to advocate for impeccable maternal health care.

Instagram: shastra_bhoora

Twitter: @shastrabhoora 

Jarrod Zamparini is a Specialist Physician in the Department of Internal Medicine at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and a Lecturer in the Department of Internal Medicine at Wits.

Jarrod has a special interest in Obstetric Medicine and is in the process of establishing an Obstetric Medicine Unit at CMJAH which, in addition to providing an inpatient service, provides outpatient services in the Medical Problems in Pregnancy Clinic as well as the PMTCT clinic. Jarrod is a founding and executive member of the Society of Obstetric Medicine of South Africa and a member of the International Society of Obstetric Medicine.

Twitter: @JZamps

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Microscopy, culture and susceptibility testing (MC&S) is the most commonly requested test of a

Microbiology Laboratory. Here, I give you 5 quick tips to remember when interpreting an MC&S report.

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No guest, but a little more about Microbe Mail host, Vindana Chibabhai

Vin is a mother (2 human babies and 1 fur baby), a wife, a daughter and a sister (1 by blood, others by heart).  

She is also a Medical Microbiologist, who qualified in 2011 and has worked at the National Health Laboratory Service Microbiology Laboratory at the Charlotte Maxeke Johannesburg Academic Hospital since qualifying. She also holds an MMed in Microbiology and has recently enrolled for a PhD. She is a senior lecturer in the Department of Clinical Microbiology and Infectious Diseases at the University of the Witwatersrand.

Vin’s research interests are focussed on antimicrobial resistance, antimicrobial stewardship, healthcare associated infections, fungal infections and enhancement of microbiology data analysis and access. She has published several peer reviewed articles ad supervised a number of MMed students.

The Pathology Research and Development Congress (PathRed) is hosted by the National Health Laboratory Service every 2nd year. With a focus on Pathology disciplines, it is a fantastic meeting to learn about diagnostic advancements in Africa.

Ruan and I attended the meeting and were able to snatch a few interviews with speakers and delegates.

To learn more about PathRed, visit the congress website at: https://pathred.nhls.ac.za/

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Syphilis incidence is on the rise in South Africa and globally. How does one sensibly make a diagnose and manage a case of syphilis at the present time. I spoke to Dr Denasha Reddy about this.

About our Guest:

I am a South African consultant in internal medicine and infectious diseases and currently work at the largest tertiary hospital in the southern hemisphere, Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, Johannesburg. My clinical and research interests have been in healthcare-associated infections, antimicrobial stewardship (AMS), HIV-associated infections, tropical and travel-relatedinfections.

Linkedin link: https://www.linkedin.com/in/denasha-reddy-ba5b5254/

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Professor Francois Venter is back in Part 3 of our HIV series in which he continues to address South Africa's battles against HIV. Here he discusses his experience on how and when to initiate antiretroviral therapy, prophylaxis against opportunistic infection, routine monitoring and what the future of HIV management looks like in South Africa.

About our Guest:

Professor WD Francois Venter, MD, FCP, PhD is Executive Director of Wits Ezintsha at the University of the Witwatersrand, Johannesburg, where he received most of his training. His work involves health systems research and clinical trials, most recently involving the antiretrovirals dolutegravir, tenofovir alafenamide, cabotegravir, and doravirine. He leads multiple antiretroviral treatment optimisation studies and is currently working on new access programmes through private pharmacies within South Africa, patient linkage-to-care interventions, self-testing projects, as well as most recently on new large-scale primary care delivery platforms addressing hypertension, diabetes, obesity, hyperlipidaemia and HIV. He has led large PEPFAR-funded HIV programmes in South Africa, focusing on men, women, children, young people, truckers, sex workers, and LGBTI communities. For over 20 years he has been an advisor to bodies such as the South African government, UNAIDS, and WHO, contributing to international, regional, and national HIV guidelines, and recently served as a member of the Ministerial Advisory Committee for COVID-19. He has an active interest in medical ethics and has been involved in several HIV-related human rights cases within the southern African region. He supervises Masters and PhD students and has over 200 publications, including first-author articles in major journals.

Resources:

SA HIV Clinicians society

ADVANCE STUDY

Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults:2023 update

Liverpool HIV Drug Interactions Checker

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In a world of emerging and eradicated pathogens, how has Malaria remained such a successful infection? Since its earliest description as "bad air", this mosquito-driven hazard has remained lethal in some populations and regions. This episode addresses significant updates in its epidemiology, tips on diagnostics, some commentary on the vaccine and a lot more.

About our Guest:

Dr. Jaishree Raman is a molecular biologist by training with a strong interest in malaria and public health. Jaishree currently heads the Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research (ARMMOR) at the NICD. The core focus of ARMMOR is to improve malaria diagnostic and treatment options and to assist South Africa and Africa eliminate malaria. To this end, ARMMOR hosts the South African National Surveillance Programme for Antimalarial Drug and Diagnostic Resistance Monitoring. As the chair of the case management sub-committee of the South African Malaria Elimination Committee, Jaishree has developed and delivered training courses aimed at capacitating the malaria programme staff on case management protocols and practices. She is a member of several regional networks, such as the Elimination 8 and Pathogen Diversity Network Africa, that are aiming to strengthen malaria genomic and bioinformatics capacity across Africa. She co-developed a leadership and management course for malaria elimination targeting malaria programme staff currently being delivered by GIBBS and the University of Pretoria and is also a mentor on the recently launched Pan-African Malaria Control Association (PAMCA) LiftHerUp initiative, which is focussing on increasing African women leaders in science, with a major focus on vector-borne diseases. 

Some resources from this episode:

• R21/Matrix-M vaccine: Phase 3 trial https://pubmed.ncbi.nlm.nih.gov/38310910/
• RTS,S/AS01 malaria vaccine: first results https://pubmed.ncbi.nlm.nih.gov/22007715/
• RTS,S/AS01 malaria vaccine: final results https://doi.org/10.1016/S0140-6736(15)60721-8

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With the state of pregnancy and breastfeeding being such a fragile time, a number of myths have developed surrounding the state.

On this episode, Adj Prof Shastra Bhoora and Dr Jarrod Zamparini help me bust some of these myths.

About our Guests:

Dr Bhoora is a specialist obstetrician and gynaecologist with a sub-speciality in critical care. She currently heads the obstetrics critical care unit at Charlottle Maxeke Johannesburg Academic Hospital. She is affiliated with Baylor College in Texas as an Associate professor in maternal critical care.

Dr Bhoora’s interests involve the acute management of obstetrics, gynaecology and trauma emergencies. She has played an instrumental role during the COVID pandemic for obstetric patients. Pregnant women have unique disease processes and if treated timeously are resilient. Dr Bhoora is currently completing her masters in science reflecting on COVID-19 in pregnancy. She promotes IPC principles and AMS among this vulnerable group. She is a master trainer in ESMOE and is passionate about teaching and empowering young minds to advocate for impeccable maternal health care.

Instagram: shastra_bhoora

Twitter: @shastrabhoora 

Jarrod Zamparini is a Specialist Physician in the Department of Internal Medicine at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and a Lecturer in the Department of Internal Medicine at Wits.

Jarrod has a special interest in Obstetric Medicine and is in the process of establishing an Obstetric Medicine Unit at CMJAH which, in addition to providing an inpatient service, provides outpatient services in the Medical Problems in Pregnancy Clinic as well as the PMTCT clinic. Jarrod is a founding and executive member of the Society of Obstetric Medicine of South Africa and a member of the International Society of Obstetric Medicine.

Twitter: @JZamps

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Who knew that the Duke's criteria could be further modified? In this episode, Vin and Ruan explore this update to the criterion and other critical aspects of diagnosing and managing infective endocarditis with the help of skilled cardiologist, Dr Raeesa Bhorat.

About our Guest:

Dr Raaesah Bhorat is a cardiologist at Sunninghill hospital, working as an interventional fellow under Professor Hellig. She completed her cardiology training at Groote Schuur hospital in 2024; and her interests include structural intervention and research in the application of artificial intelligence to cardiology, particularly the electrocardiogram. She completed her fellowship in internal medicine in 2019 and received her MBChB degree in 2013, cum laude

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The Pathology Research and Development Congress (PathRed) is hosted by the National Health Laboratory Service every 2nd year. With a focus on Pathology disciplines, it is a fantastic meeting to learn about diagnostic advancements in Africa.

Ruan and I attended the meeting and were able to snatch a few interviews with speakers and delegates.

To learn more about PathRed, visit the congress website at: https://pathred.nhls.ac.za/

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Who knew that the Duke's criteria could be further modified? In Part 2, Vin and Ruan continue discussing infective endocarditis with the help of skilled cardiologist, Dr Raaesah Bhorat, this time discussing treatment: empiric, targeted and surgical therapy.

About our Guest:

Dr Raeesa Bhorat is a cardiologist at Sunninghill hospital, working as an interventional fellow under Professor Hellig. She completed her cardiology training at Groote Schuur hospital in 2024; and her interests include structural intervention and research in the application of artificial intelligence to cardiology, particularly the electrocardiogram. She completed her fellowship in internal medicine in 2019 and received her MBChB degree in 2013, cum laude.

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Have you ever played the game "Would you Rather?" - listen to this episode to hear a microbial take on this fun game. And more importantly - is there even a correct answer at all?

About our Guests:

Dr Lauren Richards: I am a specialist physician with a sub-specialty in infectious diseases. I currently work at Helen Joseph Hospital in Johannesburg in the internal medicine and infectious diseases departments. I obtained my MBBCh and MMED at Wits University. I love my job and am still finding my ID niche. I think ID is the most exciting, interesting and surprising specialty out there!

Follow Lauren on Twitter: @lolrichards

Dr Nokukhanya Khaniyle- Lenaka : a registrar in paediatrics at the University of the Witwatersrand, Khanya is also a social media influencer with > 150 000 followers on instagram. She is a keynote speaker, promoting physical and mental well-being . Khanya was nominated as one of the "100 most influential Young South Africans" in the Science and Technology category in 2019.

You can find her at:

• Social media: @dr_khanyile
• Tik Tok: @dr_khanyile_

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Rapid molecular tests may assist in management of patients and assist in the fight against antimicrobial resistance, but they can be overused or misused. In order to optimise the test, there are a few do's and dont's when considering introducing these tests or requesting these tests.

About our Guest:

Dr Mohamed Said is a Clinical Microbiologist based at the

National Health Laboratory Services Tshwane Academic Laboratory in Pretoria,

South Africa. He is also a senior consultant at the Department of Medical

Microbiology at the University of Pretoria since 2016. He did his undergraduate

training at the University of Witwatersrand in Johannesburg, South Africa and

completed specialist training at the University of Pretoria.

He is actively involved in training of specialists in the field

of Medical Microbiology and also supervises Science students. He serves on

numerous committees within the National Health Laboratory Services as well as

the Pharmacy and therapeutics committee of the Steve Biko Academic Hospital in

Pretoria. He has published in peer reviewed journals in the fields of rapid

molecular diagnostics, Group B Streptococcus disease and infection prevention

and control. Dr Said has also presented his work at numerous national and

international conferences in the forms of posters and oral presentations.

Currently he is pursuing a PHD in the field of neonatal sepsis due to Group B

Streptococcus.

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Lower respiratory tract infections are still the world’s most fatal communicable disease. Community acquired pneumonia specifically is one of the most common infections managed by clinicians in daily practice.

On this episode of Microbe Mail, host Dr Vindana Chibabhai speaks to Pulmonologist, Dr Erica Shaddock about diagnosing and managing CAP.

About our Guest: Erica Shaddock is a specialist Pulmonologist Pulmonologist at Charlotte Maxeke Johannesburg Academic Hospital since 2009. Her special interests include COPD, Pneumonia , PCP and Covid-19. She is currently registered for her PhD focussing in the immune response and modulation in Pneumocystis pneumonia patients . She has been an integral member of the Covid-19 team at the Charlotte Maxeke Johannesburg Academic Hospital. She is also a senior lecturer in the Department of Internal Medicine at the University of the Witwatersrand.

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South African  Community Acquired pneumonia guidelines here

Access “Gender differences in community acquired pneumonia” article here

For World Antibiotic Awareness Week 2023, we are focusing on setting up antimicrobial stewardship in low and middle income settings with limited resources and a high burden of antimicrobial resistance.

About our Guest:

Prenika Jaglal is a Clinical Microbiologist having obtained an FC Path(Micro) and a Master’s degree at UKZN. She is currently based at Chris Hani Baragwanath Academic Hospital, Department of Clinical Microbiology and Infectious Diseases, at the National Health Laboratory Services and is also has a joint appointment at the University of the Witwatersrand as an undergraduate/postgraduate lecturer.

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Earlier this year, some of the Microbe messengers attended the 10th FIDSSA Congress held in Johannesburg, South Africa. Besides being presenters themselves, they met and interviewed medical researchers in various infectious disease related fields.

This joint biennial congress hosted by the Federation of Infectious Diseases Societies of Southern Africa (FIDSSA) brings together healthcare professionals from its various societies, where members share research experiences and outcomes.

Let's hope this acts as a catalyst for collaborative work, culminating in comprehensive guidance in the management of infectious diseases.

To learn more about FIDSSA and its member societies visit: https://www.fidssa.co.za/

This episode includes discussions with:

• Professor David Lewis
• Professor Robin Patel
• Professor Lucille Blumberg
• Professor Angela Dramowski
• Dr Tholang Khumalo
• Professor Eric Decloedt

Some resources from this episode:

• Southern African HIV Clinicians Society 2022 guideline for the management of sexually transmitted infections: Moving towards best practice: http://dx.doi.org/10.4102/sajhivmed.v23i1.1450
• Tanapox, South Africa: https://pubmed.ncbi.nlm.nih.gov/37022936/
• NEISSERIA GONORRHOEAE ANTIMICROBIAL RESISTANCE SURVEILLANCE IN GAUTENG PROVINCE, SOUTH AFRICA

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In this episode we discuss Dr Tom Boyles's new book: How to request a test: A clinician's guide to the interpretation and evaluation of medical tests

(https://global.oup.com/academic/product/how-to-request-a-test-a-clinicians-guide-to-the-interpretation-and-evaluation-of-medical-tests-9780192866615?cc=us&lang=en&)

Dr Tom Boyles – Short biography.

Dr Boyles qualified in medicine Oxford University in 2000 and moved to South Africa in 2007, where he spent 3 years as an HIV physician at Madwaleni hospital in the rural Eastern Cape. He trained as an infectious disease specialist in Cape Town from 2010-12 and continued to work at Groote Schuur Hospital until 2017 when he moved to Johannesburg. He currently works for Right to Care, the Clinical HIV Research Unit, and as a consultant at Helen Joseph Hospital. He maintains a passion for rural medicine and his research interests include appropriate diagnostic and treatment strategies for TB and the increased use of machine learning models to advance healthcare delivery in low resource settings.

This episode gives a nod to the show's history while also hinting at the variety of topics discussed. A Journey Through the Microscopic World – Highlights from some memorable episodes

Episodes featured in this recap:

• EP 49: No spleen, how mean! - Asplenia_ Antibiotic prophylaxis
• EP 59: What's all the buzz about_ Malaria diagnostics
• EP 33: Would you rather, the antibiotics version_ Empiric therapy for community acquired meningitis
• EP 50: HIV in the USA _ Diagnosing HIV in the USA
• EP 58: Findings from FIDSSA part 2_ Rabies update and outbreak response
• EP 44: Highlights from the PathRed Congress 2023 - Part 1_Emerging viral infections
• EP 62: Myco-moments: Interviews from the 4th AIDS-related Mycoses Workshop: The immunology of Oral candidiasis
• EP 61: "Prescription Ice cream" Book review and interview: Advice to young medical doctors and students
• EP 53 : Appropriate use of β-lactam - β-lactamase inhibitor combinations _ Rapid genetic testing, know your syndromic antibiograms, and diagnostic stewardship

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A multi- country outbreak of cholera was reported by the WHO in May 2023. Since the beginning of 2023, a total of 24 countries have reported cases. South Africa is among the countries affected by the outbreak.

To aid HCWs in identifying, diagnosing and treating cholera, Microbe Mail has put together this bonus episode on th rapid review of cholera.

About our Guest:

Dr Amanda Khumalo is a clinical microbiologist in the Department of Medical Microbiology NHLS Groote Schuur Hospital and the University of Cape Town. She has a passion for teaching and is involved in undergraduate and post graduate training. Her research interests include paediatric infectious disease and infection prevention and control.

Links to resources on Cholera:

www.nicd.ac.za/diseases-a-z-index/cholera/

https://www.health.gov.za/cholera/

https://www.who.int/news-room/fact-sheets/detail/cholera

https://www.cdc.gov/cholera/index.html

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In this episode Vin talks to experienced microbiologist Dr Jennifer Coetzee about an increasingly urgent issue: multidrug-resistant infections. With resistance to common antibiotics on the rise, the need for novel treatment agents has never been more pressing.

Dr. Coetzee shares her insights on the latest treatments making headway in the fight against multidrug-resistant infections.

About our Guest:

Jennifer Coetzee is a qualified as a Clinical Microbiologist from University of Witwatersrand and spent time working as a Consultant at Chris Hani Baragwanath Hospital. Currently working as a Consultant Microbiologist in the Clinical Microbiology and Molecular biology departments of Ampath’s National Reference Laboratory in Centurion, Gauteng. A member of South African Society of Clinical Microbiology (SASCM) as well as European Society of Clinical Microbiology and Infectious Diseases (ESCMID).Research interests include documenting the emergence of carbapenemases in South Africa, and the epidemiology of invasive fungal infections.

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Microbe Mail reached its first birthday milestone. We've created a recap of the year's episodes with some important snippets from each episode.

Visit the Microbe Mail website to find all the episodes mentioned and to sign up for updates - updates on new episode releases and new storyboards

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This is part 2 of a two- part series detailing decontamination, disinfection and sterilisation in the healthcare setting.

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About our Guest:

Dr Teena Thomas is a clinical microbiologist. Her special interests are in infectious diseases, enhancing

infection prevention and control practices in the healthcare and community settings and improving diagnostic testing in her field. She works at the Infection Control Services Laboratory of the National Health Laboratory Services at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in Johannesburg. She is also a senior lecturer and researcher in the Department of Microbiology and Infectious Diseases at Witwatersrand University.

Contact details: teena.thomas@nhls.ac.za

Researchgate link: https://www.researchgate.net/profile/Teena-Thomas we talk about exactly this!

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Have you ever played the game "Would you rather?" - listen to this episode to hear a virological take on this fun game. And more importantly - is there even a correct answer at all?

About our Guests:

Marvin Hsiao: is an associate professor and consultant virologist at University of Cape Town and Groote Schuur Complex of the National Health Laboratory Service (NHLS). In addition to his virology training, Marvin holds a master’s degree in public health. His research interests are viral diagnostics, surveillance of viral diseases, epidemiology of viral diseases and health systems issues related to laboratory medicine. He received research funding from Poliomyelitis Research Foundation (PRF), SAMRC, NHLS Research Trust and Wellcome Trust. He is currently a member of PRF scientific advisory panel and NHLS virology expert committee.

He can be found on twitter @HsiaoMarvin tweeting virology and COVID-19 related issues or just general nonsense.

Moepeng Maseko: graduated with her MBChB from the University of Cape Town in 2016, she holds a Diploma in HIV Management from the Colleges of Medicine South Africa and is currently working as a Virology Registrar at  the National Health Laboratory Services at Groote Schuur Hospital/ UCT.

You can find her at:

LinkedIn : Moepeng Maseko

Instagram : @moe_eeezy

Simon Fraser: is currently an intern at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). He graduated from the GEMP program at Wits (MBBCh) in 2021, following postgraduate studies in palaeontology as well as theology. He's a husband and father of 3, and also the host of the Dr Coffee podcast, for junior doctors and medical students in South Africa.

You can find him at:

https://linktr.ee/drcoffeeza

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In this episode of Microbe Mail, we tackle 8 common myths related to blood culture collection, processing and interpretation.

Guest: Dr Trusha Nana is a clinical microbiologist based at the Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, South Africa. She has a keen interest in C.difficile infections, antimicrobial resistance and antimicrobial stewardship.

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IDSA Microbiology laboratory guidelines: here 

About our Guest:

Sipho Dlamini completed his medical degree, Internal Medicine training and specialist Infectious Disease training at the University of Cape Town and Colleges of Medicine South Africa. His research interests are in HIV and Tuberculosis, the use of vaccines in persons living with HIV infection and on immune-mediated drug hypersensitivity reactions in persons living with HIV. Sipho’s research and clinical activities have provided him an opportunity to be involved many projects such as a study that identified a new dimorphic fungal infection (Emergomycosis africanus) in persons living with HIV. Professional memberships include FIDSSA, the Colleges of Medicine South Africa (CMSA) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Serves as a member of the National Immunisation Safety Expert Committee (NISEC) an advisory committee to the Minister of Health in South Africa, and member of the Professional Affairs Subcommittee (PAS) for ESCMID.

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Wondering what the microbial "match- made- in- heaven" is? This is the perfect drug - bug...or which antibiotic is best for which specific microbe. Listen to this episode to find out more.

About our Guest:

Michel completed his Undergraduate degree at UCT, and his FC Path(micro) in Dec 2021.  He completed his MMed(micro) in July 2022.  He is currently working as a consultant pathologist microbiology in the East Rand of Johannesburg with Ampath Laboratories.  His main interests are molecular microbiology, antimicrobial resistance mechanisms and the lab-clinician interface. 

Outside of work, he attempts amateur pottery, enjoys moderate outdoor hiking and friendly and competitive board games.

LinkedIn: https://www.linkedin.com/in/michel-le-grange-a5070229

Twitter: @microbelearning

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Since it feels like an overwhelming amount of terminology and complexity, many of us may have a mental block against the terms decontamination, disinfection and sterilisation. But which one is used when? In this 2 part series, we talk about exactly this!

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About our Guest:

Dr Teena Thomas is a clinical microbiologist. Her special interests are in infectious diseases, enhancing

infection prevention and control practices in the healthcare and community settings and improving diagnostic testing in her field. She works at the Infection Control Services Laboratory of the National Health Laboratory Services at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in Johannesburg. She is also a senior lecturer and researcher in the Department of Microbiology and Infectious Diseases at Witwatersrand University.

Contact details: teena.thomas@nhls.ac.za

Researchgate link: https://www.researchgate.net/profile/Teena-Thomas

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Microbe mail turns 3 on the 14th of September, and we wanted to keep things light for this time of the year. In this special episode we flip the script, literally, and swop our usual expert interviews for some team banter as Esther grills the team over a bunsen burner. We promise it’s more fun than a Petri dish!

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In July, Ruan braved the AIDS-related Mycoses workshop held in Cape Town as the lone Microbe messenger. He attended sessions where speakers discussed novel findings in the epidemiology, prevention, diagnosis and therapy for some of the deadliest fungal infections globally. In this episode he and Vin take through some of the brief discussions he had with some of the enlightening researchers.

Meet our Guests:

• Dr Juan Louis Rodriguez Tudela MD, PhD
• Dr Michail Lionakis, M.D., Sc.D.
• Dr Felix Bongomin, M.D., MSc
• Prof Alessandro Pasqualotto, Professor of Infectious Diseases, with special interest in medical mycology and Fellow of the European Confederation of Medical Mycology.
• Dr Trevor Mnguni, MBChB,  FCP(SA), Cert Pulm(SA)
• Prof Joseph Jarvis, Consultant Physician and Epidemiologist at Botswana-UPenn Partnership and Honorary Senior Lecturer, LSHTM

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It's that time of the year again, and most of us have already experience our fair share of the snuffles, so why not discuss it? In this episode Vin and Ruan speak to Associate Professor Diana Hardie about when respiratory infections go viral.... and not in a good way.

About our Guest:

Diana Hardie is a clinical virologist and head of the diagnostic virology laboratory at Groote Schuur Hospital. Her research interests center around viral infections in immuno-compromised patients and the immuno-pathogenesis of viral infections. She has also contributed to the development of various diagnostic assays for viral infections.

She has had many years of experience teaching medical virology and immunology to medical students, honours and post graduate students.

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This is an important episode highlighting the concern of antimicrobial resistance (AMR and how to use antimicrobial appropriately (through antimicrobial stewardship) to combat AMR. In this episode of Microbe Mail, host Dr Vindana Chibabhai (Vin) chats to Sonya Kolman, a clinical pharmacist based at the Nelson Mandela Children’s Hospital in Johannesburg, South Africa about what makes antimicrobials different from other medication, and what the quality indicators are of antimicrobial use.

Read more about the WHO AWaRe classification of antibiotics here

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About our guest Sonya Kolman

Graduated from Wits with a BPharm degree in 1989. She completed her MScMed (clinical pharmacy) 1997.

Sonya was employed at Netcare Linksfield as the clinical pharmacist since Mid-2010 until April 2017. She successfully implemented the antibiotic stewardship programme at Netcare Linksfield in the ICU and roll out to the rest of the hospital is underway. She was part of the Netcare leadership group for antibiotic stewardship.

Sonya moved to the Nelson Mandela Children Hospital as the clinical pharmacist in 2017. There, she is responsible for clinical pharmacy activities in the hospital especially in the NICU and PICU. She is responsible for all antimicrobial stewardship activities in the hospital and is chairperson of the hospital’s AMS committee. Sonya is a founding member of the Society of Clinical pharmacy (SASOCP). She was the chairperson 2011 – 2015, Vice chairperson 2016-2019 and national treasurer from 2019-2021

She is an external examiner for the MscMed clinical pharmacy programme at Medunsa university, a part time lecturer at School Pharmacy Wits University and a member the Gauteng Antimicrobial stewardship committee and part of the guideline subcommittee.

Twitter: @Sonya_kolman

Nelson Mandela Children’s hospital Twitter: @_NMCH_

Nelson Mandel Children’s hospital website

Using aminoglycosides to treat infections often causes major distress amongst clinicians. Here we talk about how they should be used appropriately, in the hopes that we may calm some of this anxiety.

About our Guest:

Dr Veshni Pillay-Fuentes Lorente obtained an MBChB degree at Walter Sisulu University in 2010. Thereafter, completed a 2-year internship at King Edward VIII Hospital, Durban. Worked as a community service medical officer at the former Gordonia Hosptial, Upington. Thereafter, worked as a medical officer over a 4 year period in Internal Medicine at Dr Harry Surtie Hospital, Upington. Completed a 2 year post-graduate diploma in Medicines Development between 2016 - 2017 with the Division of Clinical Pharmacology at Stellenbosch University. Obtained a Masters of Medicine in Clinical Pharmacology and completed a 4-year clinical pharmacology training programme before qualifying as a Specialist Clinical Pharmacologist in 2021. Employed at present as a Clinical Pharmacologist in Tygerberg Hospital, Cape Town, South Africa. Currently an applied pharmacometrics training fellow (APT program) and a PhD candidate in Stellenbosch University Cape Town. My interests are PK in special populations and dose optimization through pharmacometrics.

14847795@sun.ac.za

Twitter: @JennalPillay

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In this episode of Microbe Mail, host Vindana Chibabhai (Vin) chats to Prof Guy Richards about searching for the source of infection. Prof Richards shares his clever and easy to follow mnemonic with listeners as well as a step by step guide to searching for the source.

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Professor Richards: Twitter: @ProfGuyRichards

Professor Guy Richards is Emeritus Professor of Critical Care and Pulmonology at the University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital.

Professor Richards was awarded his medical degree in 1978, specialised in internal Medicine in 1985 and subsequently qualified as a pulmonologist and intensivist. He was awarded his PhD in Medicine in 1992 from the University of Witwatersrand. He was awarded the Mandela Medal in Gold by the president for distinguished service related to the passing of Nelson Mandela: 2014 December

Professor Richards has twice been the Co-Chairman of the South African national Critical Care and Thoracic Society Congress and was chairman again in 2015.  He has been invited to speak at numerous meetings on pulmonology and intensive care and has given well over 500 invited presentations at national and international congresses.

Professor Richards has been awarded best research paper, best presentation and best publication on a number of occasions at congresses of the SA Thoracic Society (SATS) and the SA Critical Care Society of Southern Africa (CCSSA), most recently in 2019.

To date, he has authored 11 book chapters and 206 peer reviewed, indexed scientific papers.  His RG score on ResearchGate is 42.65 and his research has been cited 3793 times. His “h index” is 35 and 34 excluding self citations. He was elected as a member of the SA Academy of Sciences in 2020

He has been Chairman of the Pharmacy and therapeutic Committee at CMJAH and is chairman of the Gauteng Provincial formulary committee for the Provincial Pharmacy and Therapeutic committee. He is currently a reviewer for many international and local journals

Invasive candidiasis (IC)...or evasive candidiasis? This famous fungus somehow managed to cause a great deal of anxiety, especially when it comes to confirming the diagnosis. In this episode, we talk about risk factors for disease, diagnosis and treatment of IC.

About our Guest:

Dr Tari Papavarnavas completed his medical degree at University of Pretoria and trained in General Internal Medicine and subsequently in Infectious Diseases at University of Cape Town.

He was appointed as an Infectious Diseases sub-specialist in the Division of Infectious Diseases and HIV Medicine at UCT in 2022 with a focus on building on an existing Infection Prevention and Control (IPC) service at Groote Schuur Hospital in partnership with IPC nurses, Occupational Health practitioners, Quality Assurance, and ward liaisons

Tari has also taken over as Director of the Cape Town GeoSentinel Travel Surveillance Network Site, which surveys travellers from South Africa and those visiting from abroad who act as sentinels for emerging and re-emerging infection

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Multidrug resistant tuberculosis is a public health crisis. In 2020, only 1 in 3 people with drug resistant TB accessed treatment.

On this epsiode of Microbe Mail, Dr Sarah Stacey and I talk about treatment of MDR TB - why and how the regimens have changed, how to monitor patients on treatment and when to seek advice from an expert.

South African Rifampicin Resistant TB Treatment Guidelines

About our Guest: Dr Sarah Stacey

I am an infectious diseases specialist and I run a busy urban clinic at a tertiary site in Johannesburg and a busy infectious diseases ward – until a fire interrupted our services, that is… We are starting to get up and running again and hopefully will be back to capacity soon. The majority of our admissions to the infectious diseases ward are still HIV related and we still

see advanced disease in patients never on or defaulting ART. I have a broad range of interests within the scope of infectious diseases. I have an interest in improving and simplifying diagnostic tests in TB, particularly in HIV-positive patients in whom TB diagnosis continues to be challenging. I also have a particular interest in advancing proper antimicrobial stewardship and the implementation of programmes to improve antibiotic prescribing. I founded the CMJAH Antimicrobial Stewardship Programme and I and my colleagues on the committee are in the process of expanding the programme at the hospital which can be at times both rewarding and thankless... but a worthwhile fight!

instagram: sarahstacey15

twitter: @SarahLynnStace1

facebook: sarah.stacey.1297

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1.4 million people died from TB-related illnesses in 2019. In this episode of Microbe Mail, we are talking about diagnostic tests for TB – the right test, for the right patient, from the right specimen type, with the right interpretation.

South African TB Guidelines can be found here

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About our Guest:

Dr Nina von Knorring is a Pathologist in Clinical Microbiology (FCPath) at the National Health Laboratory Service/University of the Witwatersrand, Johannesburg. She is based at the Mycobacteriology Referral Laboratory in Braamfontein, Johannesburg, since 2019.

Nina trained in Germany and UK (MRCOG, Diploma in Genitourinary Medicine). Her subsequent employment as research clinician at the Africa Centre for Health and Population Studies, University of KwaZulu Natal and Wits Reproductive Health and HIV Institute.

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Antimicrobial susceptibility testing comes in a number of different formats. On this episode, Microbe Mail host Dr Vindana Chibabhai speaks to Dr Warren Lowman about MICs - minimum inhibitory concentrations...how they are derived, why and when they are important to consider.

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About our Guest:

I am a pathologist in microbiology passionate about bugs with a particular focus on the

clinical application and integration of microbiological diagnostic services in specialized

medical care. Bacteriology is my first love and I have a particular interest in hospital

pathogens and the associated diagnostic and antimicrobial treatment aspects of these

bugs. Surveillance of hospital-acquired infections and the application of data derived

from hospital surveillance systems is another key focus area. I am actively involved in

these activities on a daily basis where I balance my time between laboratory-based

diagnostic work and clinical ward rounds focusing on ICU/transplant-related

microbiology and infection prevention and control aspects. I am actively involved in

numerous academic-related activities, am the current chairperson of the South African

Society of Clinical Microbiology, and am passionate about sharing knowledge in the

field.

Outside of work I am kept busy by my 3 sons, wonderful wife, nature, cooking and the

odd-game of golf!

Microbiological interests:

1. ICU-related antimicrobial therapy

a. Clinical/ patient issues related to pharmacodynamics and

pharmacokinetics.

b. Antimicrobial susceptibility testing and its application to treatment of

critically ill patients

2. Transplant Microbiology and Infectious Diseases

3. Infection Prevention and Control

a. Hospital surveillance systems

b. Healthcare-associated pathogens

4. Antimicrobial Susceptibility Testing

Links:

Wits Donald Gordon Medical Centre LinkedIn and Facebook

Pathcare website and LinkedIn

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Another fun game of "Would you Rather" but this time, we talk about some fantastic fungal options. Which would you rather choose...?

About our Guest:

Dr Lyle Murray is a Lecturer at the University of the Witwatersrand and a Consultant in Infectious Diseases at Charlotte Maxeke Johannesburg Academic in Johannesburg, South Africa. He is a clinician scientist with a particular interest in the immunology of infectious diseases and the impact of HIV infection thereon. He completed his MBChB at the University of Cape Town and his specialist clinical training in Internal Medicine and Infectious Diseases at the University of the Witwatersrand. He did a DPhil (PhD) as a Rhodes Scholar in the Nuffield Depeartment of Clinical Medicine at Oxford University focussing  on the reconstitution of immunity to Mycobacterium tuberculosis in individuals with HIV on antiretroviral therapy.

Dr Michael Vernon Cloete - I’m a Clinical Microbiology registrar based at the NHLS Microbiology Laboratory, University of the Witwatersrand in Johannesburg. I trained as a medical undergraduate at Wits where I obtained my medical degree, going on to work in KwaZulu-Natal and here in Johannesburg for my internship and community service respectively. I’ve worked on national committees for Junior Doctors Association of South Africa and spent a lot of time at NICD here in Joburg in my community service year during the COVID-19 pandemic, where my love for microbiology was founded. I’ve always been fascinated by microbiological life, and am a passionate advocate for antimicrobial stewardship, novel therapy development and multidisciplinary care.

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One Health is a concept which described the health not only of humans, but also of the envionment and animals. Our Guest, Dr Yogandree Ramsamy tells us about its origins, who governs the principles and how it can be applied to antimicrobial resistance and everyday clinical practice.

About our Guest:

Dr Yogandree Ramsamy, a medical doctor with a specialization in medical microbiology (MBChB, MMedPath (Microbiology), FCPath(SA)(Microbiology), PhD), is currently a Senior Pathologist in Medical Microbiology at JDJ Diagnostics. As a recipient of the One Health AMR Fellowship from the Université Paris Cité and Fondation Mérieux, the Institut Mérieux-ICAN Young Investigator Award in antimicrobial resistance (AMR), the L’Oreal-UNESCO for Women in Science Award and the SEDRIC-Wellcome Trust Travel Scholarship, Dr Ramsamy is extremely passionate about AMR and implementation of antimicrobial stewardship programs (ASPs). Currently a member of several local and international committees related to Antimicrobial Stewardship (AMS) and Infection Prevention and Control, Dr Ramsamy is committed to the fight against AMR. She has served on the provincial KZN Antimicrobial Stewardship (AMS) Committee, promoting the concept of AMR and AMS within the KZN public health sector in line with the South African National AMR Strategy. Her Master’s focused on AMR, AMS and surveillance in the South African landscape and her PhD entailed investigating Carbapenem-resistant Enterobacterales (CRE) in a One Health context. She is a honorary research fellow in the Antimicrobial Research Unit at the University of KwaZulu-Natal. Her keen research interest in AMR, AMS and AMR surveillance has culminated in original research generating several publications + local and international conference presentations. Creating awareness of a bleak future without the prospects of lifesaving antimicrobials, mentoring up and coming individuals equally passionate about saving antimicrobials for future generations is one of her greatest ambitions.

You can find Yogandree at:

yogandree@gmail.com

Ramsamyy@ukzn.ac.za

yogandree@jdj.co.za

linkedin.com/in/yogandree-ramsamy-16a74a86

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Time to "idiot proof" the myth of bactericidal being better than bacteriostatic agents on

this collaborative episode with the ID_IOTS podcast.

About our Guest:

Jame and Callum are the hosts of the ID_IOTS podcast, an Infectious Disease podcast.

You can find them through https://idiotspodcasting.buzzsprout.com/share wherever you get your podcasts and also on Twitter as @IDiots_pod

References from this episode:

1. https://idiotspodcasting.buzzsprout.com/1782416/12537247-44-the-basics-of-beta-lactamase-inhibitors
2. Wald-Dickler N, Holtom P, Spellberg B. Busting the Myth of ‘Static vs Cidal’: A Systemic Literature Review. Clin Infect Dis. 2018 17;66(9):1470–4.
3. Use of bacteriostatic agents in Neutropenic fever: DOI: 10.1586/eri.09.11.
4. Jaksic B, Martinelli G, Oteyza JP, Hartman CS, Leonard LB, Tack KJ. Efficacy and Safety of Linezolid Compared with Vancomycin in a Randomized, Double-Blind Study of Febrile Neutropenic Patients with Cancer.
5. Clinical Infectious Diseases. 2006 Mar 1;42(5):597–607
6. https://www.bradspellberg.com/shorter-is-better

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Injection drug use is becoming increasingly common in Sub-Saharan Africa...and with it, the myriad of infectious complications. On this episode, Vin chats to Dr Evan Shoul about infections and some important considerations for managing patients who inject drugs.

About our Guest:

Dr Evan Shoul specialised as a consultant physician in Johannesburg and then completed his infectious diseases fellowship on the Wits circuit. He now works at the Netcare Milpark Hospital in Johannesburg and has a special interest in HIV and travel medicine.

Social media:

Twitter/X: @EvanShoul

Southern African HIV Clinicians Society guidelines for harm reduction:

From Southern African Journal of HIV Medicine https://doi.org/10.4102/sajhivmed.v21i1.1161

https://sahivsoc.org/Files/Southern%20African%20HIV%20Clinicians%20Society%20guidelines%20for%20harm%20reduction.pdf

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We're back with another game of 'Would you rather?' Where we pose a scenario, and our guests give us their views. This episode really challenges the basis of some of the beliefs and practices regarding antimicrobials. Some of the questions are so tricky, who knows if there even is a correct answer. What we do know is... it depends.

About our Guest:

Prof. Andrew Whitelaw worked as a consultant pathologist in clinical microbiology at Groote Schuur Hospital from 2003 – 2012. In December 2012 took up the post of Head of Department of Medical Microbiology at the University of Stellenbosch / Tygerberg Hospital. His early research revolved around molecular characterization of ESBLs in members of the Enterobacteriaceae, and he has been involved in a number of studies and activities related to antimicrobial resistance (AMR) and infection control over the last decade, both for community as well as hospital acquired pathogens. Most relevant among these would be his involvement in the South African Antibiotic Stewardship Programme (SAASP), The Infection Control Society of Southern Africa, and the SA Ministerial Advisory Committee on AMR. 

Ongoing research interests focus on antimicrobial resistance in Enterobacteriaceae and Staphylococcus aureus, including molecular epidemiology and mechanisms of resistance as well as clinical impact and control of AMR. He is also involved in studies describing the human microbiota and in particular the effect of antimicrobials on the microbiota.

Resources from this episode:

SASCM C. difficile infection guidelines

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Don't forget to also have a listen to these featured episodes:

Episode 43: Communicating antimicrobial therapy to patients

Episode 38: Would you rather?: The mycology version

Episode 35: Would you rather?: The virology version

Episode 33: Would you rather?:The Bacterial version

Here we discuss how HIV is diagnosed and managed in the USA.

About our Guest:

Dr Ankita Kadakia, M.D. serves as the Deputy Public Health Officer for the County of San Diego.  Prior to her current role she served as the Chief and Medical Director for the County’s Tuberculosis Control and Refugee Health Branch and is the President of the California Tuberculosis Controller’s Association. Dr. Kadakia is a board-certified Internal Medicine and Infectious Disease specialist.  She has served in leading, coordinating, supervising, and managing operations for Covid-19 as well as coordinating the County Public Health Service’s Tuberculosis Elimination Initiative. Throughout the COVID-19 pandemic, she has played a critical role as a medical subject matter expert and Tri-Chair of the County COVID-19 Vaccine Clinical Advisory Group.

Prior to joining the County, Dr. Kadakia worked at the University of California, San Diego (UCSD) as an Assistant Professor of Medicine with a focus on HIV/AIDS and LGBTQ healthcare while practicing HIV medicine at UCSD Owen Clinic.  While at UCSD, Dr. Kadakia created the first Transgender HealthCare Symposium and became a co- principal investigator for the San Diego Pacific AIDS Education and Training Center. 

Dr. Kadakia’s passion, for serving underserved patients and preventing and treating Tuberculosis, STDs and HIV/AIDS, transcends borders. She has spent time in Uganda serving rural areas, partnering with Ugandans, to build and support schools for AIDS orphans and impoverished children. When she is not working, she immensely enjoys spending time with her two young children and practicing and teaching Kelee meditation.

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Welcome to Microbe Mail - a medical podcast about Microbiology and Infectious Diseases. Here, Vin gives an overview about this podcast and what you can expect to hear on Microbe Mail episodes.

Website: Microbe Mail

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The rampant emergence of antimicrobial resistance, particularly amongst Gram negative organisms, has called for both the discovery of novel agents but also for a review of therapeutics thought to have been long lost in this battle. Enter, the "BLBLIs or BLICs'. In this episode Vin and Ruan speak with the 1st author of the publication "Appropriate use of the new β-lactam - β-lactamase inhibitor combination agents: Ceftazidime-avibactam and Ceftolozane-tazobactam in South Africa", Professor Adrian Brink, and receive a welcomed masterclass on this interesting group of antimicrobials.

About our Guest:

Professor Adrian Brink is Head of the Division: Medical Microbiology, and member of the Institute of Infectious Disease & Molecular Medicine,  Faculty of Health Sciences, University of Cape Town and the National Health Laboratory Services, Groote Schuur hospital, Cape Town, South Africa. 

Prof Brink was founding President of the Federation of Infectious Diseases Societies of Southern Africa and is the founder and currently co-chairs the South African Antibiotic Stewardship Program (SAASP). Prof Brink currently serves on the South African Minister of Health’s Ministerial Advisory Committee (MAC) on Antimicrobial Resistance and representing Africa, is a member of the European Society of Clinical Microbiology and Infectious Diseases International Affairs Subcommittee.

His is main research interests are the clinical and molecular epidemiology of antibiotic-resistant infections, the mechanisms of resistance as a confounder in antibiotic stewardship, the design and implementation of large-scale antibiotic stewardship, diagnostic stewardship and infection prevention and control interventions in low- and middle-income countries. His interests also include the protective, metabolic and immune functions of the gastrointestinal and vaginal biome including the resistome and metabolome. 

Resources from this episode

Best practices: Appropriate use of Beta-lactam/Beta-lactamase inhibitor combinations Ceftazidime-Avibactam and Ceftolozane-Tazobactam)

WHO Priority Pathogens List

Table 1: Data on inhibitor classes, inhibitory mechanisms, and current clinical trial status, Kar D et al., 2023.

Table 6: β-lactam/β-lactamase inhibitor (BL/BLI) combinations in clinical trials or submitted for regulatory approval, Butler et al., 2023

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This week, we sit down with author, Dr Alastair McAlpine, to discuss his compelling book. In this thought provoking reflection, he shares insights into the unique challenges faced by doctors working in the public sector in South Africa. From systematic shortcomings to personal struggles, he takes us back to what inspired it all.

About our Guest:

Dr Alastair McAlpine is a paediatric infectious diseases physician who was born and raised in Johannesburg. His passions include preventing infections in kids, listening to noisy bands and encouraging his colleagues to prescribe ice cream more frequently. His new book Prescription: Ice Cream – A Doctor’s Journey to Discover What Matters is his engaging memoir about the highs and lows of working as a medical doctor in South Africa and how, with a little help from metal music and ice cream, he was able to struggle on, find meaning in the chaos and inspire others.

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The spleen is a poorly understood organ that when functioning well, operates efficiently in the background, but what can happen when medical conditions or trauma result in an impairment in that function? In today's episode Vin talks to Professor Veronica Ueckermann about the spleen. They discuss its various functions including mopping up old or damaged red blood cells and its pivotal role in the immune system.

About our Guest:

Prof Veronica Ueckermann is the head of Infectious diseases at the University of Pretoria/Steve Biko Academic Hospital. She holds a PhD in Infectious diseases, a Fellowship in Critical care, and a Masters in Internal Medicine.  Her research focus is HIV, Tuberculosis, aerobiology, and antimicrobial resistance.   She is actively involved in medical education at the University of Pretoria and other platforms. 

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It's great to find a helpful learning resource. Here, I chat to the author of the book "Bacterial Genetics and Genomics", Prof Lori Snyder about the book, who it will be useful for and why this resource is different from others.

About our Guest:

Prof. Lori A. S. Snyder is a Professor in the School of Life Sciences, Pharmacy, and Chemistry at Kingston University, where she is involved in educating undergraduate and graduate students, as well as leading an active and collaborative research group. Prof. Snyder is also active in science outreach activities, including traveling lab visits, offering work experience to teenagers, and participating in public engagement events. Her research focuses on two main areas: combating antibiotic resistant infections and bacterial genetics and genomics. Her novel antimicrobials to stop infant blindness from multi-drug resistant bacterial infections have been featured in Wired (www.wired.co.uk/article/fight-against-super-gonorrhoea) and on the Sparks children’s charity YouTube channel (https://www.youtube.com/watch?v=rQUl5-kC1OQ). Her use of bacterial genome sequence data to uncover new information about pathogens was featured in an interview on the Thermo Fisher Scientific YouTube channel about use of their sequencing system (https://www.youtube.com/watch?v=Z_ttuJ6l1hI&t=95s) and in 2013 her contributions were recognized by the Society for Applied Microbiology with the W H Pierce Prize (https://sfam.org.uk/resource/wh-pierce-2013-lori-snyder.html).

Prof. Snyder was twice elected to the Prokaryotic Division committee of the Microbiology Society and services on the Editorial Board of its journal Microbial Genomics, as well as contributing by reviewing many research publications and grant applications.

Find Prof Lori Snyder at:

Twitter: @DrLoriSnyder

Senior Editor: @CrumlyChuck

Publisher: @CRCPress

Book: https://www.routledge.com/Bacterial-Genetics-and Genomics/Snyder/p/book/9780815345695

Book – missing content https://s3-eu-west-1.amazonaws.com/s3-euw1-ap-pe-ws4-cws-documents.ri-prod/9780815345695/9780815345695_missing_content.pdf

Book - support materials https://routledgetextbooks.com/textbooks/9780815345695/

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Staphylococcus aureus bacteraemia is associated with high morbidity and mortality but is often not diagnosed or managed appropriately. On this episode, the host of Microbe Mail, Dr Vindana Chibabhai, asks Dr Michelle Venter to answer important questions related to appropriate diagnosis and management of SAB.

Here is a link to the SAASP Guidelines

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About our guest Dr. Michelle Venter

Michelle Venter is an Infectious Diseases Physician based at Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg.

She qualified as a medical doctor at the University of the Witwatersrand in 2007, and completed both her internship and community service training at Chris Hani Baragwanath Academic Hospital. She then specialised as an adult Physician, and subspecialised as an Infectious Diseases Physician at Charlotte Maxeke Johannesburg Academic Hospital.

She then returned to Chris Hani Baragwanath Academic Hospital to work full-time in the Division of Infectious Diseases, within the Department of Internal Medicine, where she is head of the TB program at Chris Hani Baragwanath Academic Hospital.

She is an Arthur Ashe fellow and has research interests in the gut microbiome, antimicrobial stewardship and the interaction between the innate immune system and infectious diseases.

Her lockdown activities include ongoing COVID-19 research, cello playing and a rediscovered appreciation for sago pudding and jazz music.

A very successful pathogen - one that causes a spectrum of disease, from asymptomatic to life-threatening. On this episode we talk about Group A Streptococcus (Streptococcus pyogenes), the various types of infections that it causes and how to manage them.

About our Guest:

Dr Yesholata Mahabeer is a principal pathologist currently based

at National Health Laboratory Service (NHLS) KwaZulu Natal academic complex at

Inkosi Albert Luthuli Central Hospital in Durban. She studied medicine at the

University of KwaZulu Natal. She subsequently completed her fellowship in microbiology

in 1999 followed by Masters in Medical Microbiology in 2015. She has worked in

several laboratories NLHS laboratories in Durban over the past 20 years. She

currently oversees paediatrics, neurosurgery and haematology wards. Her interests

include neurosurgical infections, mycology and antimicrobial susceptibility testing.

She plays an active role in undergraduate and post graduate microbiology

training.

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Do you know the real reason antibiotics are prescribed for 7 days or 14 days at a time? And how much evidence is there for that duration. Listen as host Vindana Chibabhai talks to Dr Kim Pieton (Roberg), an infectious Diseases physician about the length of the antibiotic course as Goldilocks would want it...not too long, not too short, but just right!

About our Guest:

I am the proud mother of two beautiful little girls, age 4 & 5, who provide daily laughter, insight and inspiration!

My work passion is infectious diseases - all infections fascinate me, with particular interest in viruses like Hepatitis C & HIV, bacteria like treponemes and tropical infections like malaria, schistosomiasis, and arboviruses.

I love working out the 'puzzle' - getting to a diagnosis (whether infectious or not) and all the steps it takes to get there. I also love the stories and history behind infections and the treatment of these diseases. Evolution to cure!

An infectious disease specialist remains one of the most fulfilling careers because of the huge satisfaction in diagnosing and being able to cure the vast majority of infections - and if not cure, certainly control to provide a long, happy, healthy, uncomplicated life!

In addition to children and work, I love cooking, flowers and gardening, reading fiction, entertaining friends and travelling to new countries.

Kim is on Facebook and Twitter: @Kim55254631

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Intravenous lines are an integral component of modern medical care. Can we imagine delivering care without it? However, they are not without harm. On this episode, host Dr Vindana Chibabhai talks to Dr Molebogeng Kolojane about catheter related bloodstream infections - what they are, risk factors, diagnosis, management...and of course, preventing them!

About our Guest:

Dr Molebogeng Kolojane is a Clinical Microbiologist at the National Health Laboratory Service and a lecturer at the University of the Witwatersrand, Johannesburg. She is based at the Infection Control Services Laboratory (ICSL) at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa. Molebogeng is practicing as an outreach pathologist in the Johannesburg West Rand and Ekurhuleni District hospitals. Her special interests are in Infectious Diseases, Infection Prevention and Control (IPC), and is involved in outbreak investigation, establishing antimicrobial stewardship (AMS) programs in outreach health care facilities and supports laboratories in district hospitals.

www.linkedin.com/in/molebogeng-conradine-kolojane-18b412124

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What is HIV post exposure prophylaxis , who should get it and how should it be given. Vin and Ruan discuss these and other relevant issues related to this topic.

About our Guest:

Dr Avania Bangalee qualified as a pathologist in virology in 2018 with distinction and was awarded the Coulter Medal for Pathology in the CMSA examination.  She has experience working for large multinational and international organizations including Discovery, Novartis pharmaceuticals and the United States Peace Corps.  She has provided a diagnostic and clinical consultative service while employed with the National Health Laboratory serviceas a registrar and later as a pathologist. She has been instrumental in developing teaching programmes in the departments of Virology at the Universities of Witwatersrand and Pretoria and providing support for registrar teaching and learning including supervision of Master’s students.  She has published work in international and national peer-reviewed journals and presented at key conferences both locally and abroad.

Dr Bangalee currently serves as a Senior Medical Advisor: HIV Programmes at Wits Reproductive Health and HIV Institute

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Best care bundles are a set of practices tied together which are proven to prevent heathcare associated infections. Listen Vin has a chat with Lesley Devenish, a seasoned IPC nurse practitioner and teacher about these bundles.

About our Guest:

My basic nursing training was completed through the Rand Afrikaans University (now U.J.)

and post-grad courses through the University of South Africa. I started in Infection Control 25 years ago in the private sector. After gaining years of hospital experience, I moved into management and was head of Infection Prevention & Control (IPC) at the Netcare Group of hospitals for 11 years. I had loved the teaching part of my role at Netcare head office and pursued a more teaching-related role at Wits University and, although I am now semi-retired, still teach the IPC course through Wits Health Consortium. I am an avid reader and a very happy Granny, with four beautiful grandchildren.

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Did you know that 80% of antibiotic used are actually prescribed outside of the hospital setting? But how does one improve outpatient antibiotic use? Listen to this interview with Dr Gary Reuenson to find out.

Read the article mentioned in the Intro here – “Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis” by Christopher JL Murray et al

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About our Guest:

Gary is a Paediatric Infectious Diseases subspecialist based at Rahima Moosa Mother & Child Hospital, Johannesburg. He heads one of the General Paediatric units at the hospital.

In addition, he holds representative positions with the Federation of Infectious Disease Societies of Southern Africa (FIDSSA), the Colleges of Medicine of South Africa (CMSA), the Ministerial Advisory Committee for Antimicrobial Resistance, the Ministerial Advisory Committee for COVID-19 Therapeutics, and the National Essential Medicines List Committee (NEMLC). He is passionate about practicing and teaching evidence-based medicine within the fields of Paediatrics and Infectious Diseases.

Twitter:@garyreubenson

LinkedIn: https://za.linkedin.com/in/gary-reubenson-6565a626

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Microbe Mail reached its first birthday milestone. We've created a recap of the year's episodes with some important snippets from each episode.

Visit the Microbe Mail website to listen to each of the full episodes mentioned here and also to sign up to receive updates of episode and storyboard releases.

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There are some weird and wonderful things that the Microbiology laboratory technologist/technician sees behind the scenes in the infectious diseases diagnostics process. Here, host Vindana Chibabhai chats to Yola Tatoba, a technician at the Microbiology Laboratory based at Charlotte Maxeke Johannesburg Academic Hospital about these weird and wonderful things.

About our Guest:

I am a Medical Technician at CMJAH Microbiology Laboratory NHLS. I've been working there for 9 years now. I participated in a few validations and EQA's. I also have a Law Diploma and studying towards my law degree. I enjoyed Microbiology up to this far.

I am on Instagram as @yolaokuhle

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Microbe Mail recorded a collaborative episode with the ID:IOTS podcast. Jame, Callum and I talk about the challenge of multidrug resistant Gram negative bacterial infections, particularly from the perspective of a low- middle income setting, with poor access to the newer antimicrobial agents.

Callum is a medical microbiology and infectious diseases registrar working in Edinburgh, Scotland who has recently completed a medical education fellowship. Jame is an ex-Scottish newly Oxford, England, based infectious diseases and clinical pharmacology.

You can find Jame and Callum's podcast here: https://idiotspodcasting.buzzsprout.com/

Links:

References:

• Metallo-β-lactamase resistance in Enterobacteriaceae is an artefact of currently utilized antimicrobial susceptibility testing methods 
• Best practices: Appropriate use of the new β-
• lactam/β-lactamase inhibitor combinations, ceftazidime-avibactam and ceftolozane-tazobactam in South Africa
• Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis
• IDSA AMR Guidance
• ESCMID Gram Negative Treatment Guidelines

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Cryptococcus species causes close to a quater of a million cases of severe disease and > 180 000 deaths...universally fatal if untreated. In this episode of MM, host Dr Vindana Chibabhai, chats to Prof Nelesh Govender about recent changes and expected changes in the diagnosis and management of Cryptococcal disease.

2022 WHO Cryptococcal Disease Management Guidelines here

ACTA Trial

Ambition Trial

About Prof Nelesh Govender:

I run a research group in medical mycology in South Africa, among a select few worldwide working in public health mycology. A major theme of my research is HIV-associated fungal diseases, many of which are life-threatening. My research activities span: 1) laboratory science (including characterisation of established/emerging fungal pathogens and diagnostic test development/evaluation), 2) population-based observational epidemiological studies, 3) cost-effectiveness modelling of public health interventions and treatments and 4) clinical trials. This research is aligned to my work as a centre head at the National Institute for Communicable Diseases (www.nicd.ac.za) where I run South Africa’s national mycology reference laboratory. Our group serves as a World Health Organization Collaborating Centre for antimicrobial resistance. Our public health research is primarily funded through NICD but also partly through grants from the US National Institutes of Health, US Centers for Disease Control and Prevention (CDC), CDC Foundation, Bill and Melinda Gates Foundation, UK Medical Research Council, UK National Institute for Health Research and NHLS Research Trust.

Twitter @neleshg

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Yeasts are commonly isolated in clinical specimens, but they are significant in some specimens and not significant in others. There are also a variety of identification methods which can be used in the laboratory. On this episode, Vin chats to a fellow Microbiology podcaster - Luis Plaza of "Let's Talk Micro" about yeasts in clinical cultures.

About our Guest:

Luis Plaza

Hospital Corpsman in the United States Navy 2002-2010.       

Medical Laboratory Technician – United States Navy 2007-2010

Bachelor’s degree in Medical Laboratory Sciences from the University of Central Florida

(completed 2013)

Master’s in Microbiology and Cell Science – University of Florida (degree in progress)

Senior Medical Laboratory Technologist in Microbiology at Advent Health Orlando,

Florida (2013 -present)

Microbiology Instructor at the University of Central Florida. (2019- present)

Podcast creator and host of Let’s Talk Micro- 2021- present). Explaining Microbiology in simple terms. Meant to be used as an educational tool for everyone in Microbiology, from students to professionals. Available on all podcast platforms.

Contact Luis at: letstalkmicro@outlook.com

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There are so many misconceptions about the diagnosis and management of urinary tract infections!  

On this episode of Microbe Mail, host Vindana Chibabhai speaks to Dr Marianne Black – a Clinical Microbiologist about the 12 myths of UTIs. Marianne is based at the Charlotte Maxeke Johannesburg Academic Hospital NHLS Microbiology Laboratory.  

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About our Guest:

Dr Marianne Black holds an FCPath and MMed in Microbiology, and is a pathologist and lecturer in the Department of Clinical Microbiology and Infectious Diseases (University of the Witwatersrand), based at Charlotte Maxeke Johannesburg Academic Hospital. She is a member of Charlotte Maxeke and Nelson Mandela Children’s hospital AMS committees. She previously held the position of pathologist at the NHLS mycobacteriology referral laboratory in Braamfontein (2016 – 2019).

LinkedIn Profile: https://www.linkedin.com/in/marianne-black-34ba66102/

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Ever wondered what Microbiologists get up to in the laboratory? Is it all about waiting for organisms to grow, "doomsday prophecies" regarding antimicrobial resistance, and asking for a clinical correlation? The feild of Microbiology is vast, and Vin speaks to some well seasoned experts to get their take on a career in Microbiology.

About our Guests:

• Crystal Viljoen, B.Tech Biomedical Technology: Crystal has more than 20 years of laboratory experience, and is currently working as the laboratory manager at the Infection Control Laboratory Services in Johannesburg. She is also an executive member of Legionella Action Group (LAG); and has a wealth of experience with quality management systems, including proficiency testing schemes, laboratory safety procedures and the process of laboratory accreditation, gained at the National Institute of Communicable Diseases (NICD)



• Andrea Prinzi, Ph.D., MPH, SM(ASCP): Dr Andrea Prinzi is currently a field medical director of US medical affairs at BioMérieux (pronounced bee oh merry you). Prior to her work in industry, Andrea was a clinical microbiologist with over 12 years of hands-on bench experience in a pediatric hospital laboratory. In 2014, she obtained her master’s in public health from the Colorado School of public health with a focus in epidemiology. In 2021, she completed a PhD in clinical and translational science from the University of Colorado. As a PhD in Clinical and Translational science, her interests include antimicrobial and diagnostic stewardship (with an emphasis on pneumonia diagnostics and management), development of effective teaching methods for clinicians and the fusion of public health, clinical science and medicine to improve patient outcomes, quality improvement, infectious disease epidemiology, science communication, and implementation science. Dr. Prinzi’s PhD work was clinical and translational, and focused on bridging the gap between the clinical microbiology laboratory and clinical practice. She combined clinical diagnostics, public health, clinical research and science communication to improve the way we think about and use diagnostic tests and antimicrobials. Dr. Prinzi is the clinical and public health community leader for the American Society for Microbiology’s Council on Microbial sciences, as well as a regular blog writer for ASM. She is a reviewing editor for the ASM journal Spectrum, as well as an editorial advisory board member for Open Forum Infectious Diseases. She also enjoys volunteering time to help co-host the Let’s Talk Micro antimicrobial resistance sub-series with her friend, Luis Plaza.

• Dr Keeren Lutchminarain: Dr Keeren Lutchminarain is a clinical microbiologist based at Inkosi Albert Luthuli Central Hospital. Her primary role in the NHLS is to oversee the KZN reference Tb laboratory where she is involved in interpreting routine diagnostic tests; verification of new instruments; teaching and training within the province and TB related research.

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Part 2 of our HIV series addresses South Africa's battles against HIV as we get an account of the complexities of diagnosis, prophylaxis, and managing opportunistic infections from a celebrated HIV clinician, Professor Francois Venter.

About our Guest:

Professor WD Francois Venter, MD, FCP, PhD is Executive Director of Wits Ezintsha at the University of the Witwatersrand, Johannesburg, where he received most of his training. His work involves health systems research and clinical trials, most recently involving the antiretrovirals dolutegravir, tenofovir alafenamide, cabotegravir, and doravirine. He leads multiple antiretroviral treatment optimisation studies and is currently working on new access programmes through private pharmacies within South Africa, patient linkage-to-care interventions, self-testing projects, as well as most recently on new large-scale primary care delivery platforms addressing hypertension, diabetes, obesity, hyperlipidaemia and HIV. He has led large PEPFAR-funded HIV programmes in South Africa, focusing on men, women, children, young people, truckers, sex workers, and LGBTI communities. For over 20 years he has been an advisor to bodies such as the South African government, UNAIDS, and WHO, contributing to international, regional, and national HIV guidelines, and recently served as a member of the Ministerial Advisory Committee for COVID-19. He has an active interest in medical ethics and has been involved in several HIV-related human rights cases within the southern African region. He supervises Masters and PhD students and has over 200 publications, including first-author articles in major journals.

Resources:

SA HIV Clinicians society website

PrEP guidelines

PEP guidelines

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Earlier this year, some of the Microbe messengers attended the 10th FIDSSA Congress held in Johannesburg, South Africa. Besides being presenters themselves, they met and interviewed medical researchers in various infectious disease related fields.

This joint biennial congress hosted by the Federation of Infectious Diseases Societies of Southern Africa (FIDSSA) brings together healthcare professionals from its various societies, where members share research experiences and outcomes. Let's hope this acts as a catalyst for collaborative work, culminating in all-encompassing guidance in the management of infectious diseases.

To learn more about FIDSSA and its member societies visit: https://www.fidssa.co.za/

This episode includes discussions with:

• Dr Nicollete du Plessis
• Dr Jeremy Nel
• Professor James Seddon (@Jamesseddon10 on X)
• Dr Lyle Murray
• Professor Akebe Luther King Abia
• Dr Ribkha Berhanu

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Do you sometimes look at a Microbiology report and wonder if the microbiologist made up the tongue-twister of a microbe name you’re reading on the report? In this episode, we unpack the differences between contaminants, commensals and colonisers in the common specimen types – urine, respiratory samples and blood cultures.

Spotlight feature: mini microbe message

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Guest: Dr Yogandree Ramsamy  

Dr Yogandree Ramsamy is a Clinical Microbiologist at Prince Mshiyeni Memorial Hospital in Umlazi, KwaZulu-Natal (KZN), South Africa. Dr Ramsamy is extremely passionate about AMR and implementation of antimicrobial stewardship programs (ASPs). Currently a member of several local and international committees related to Antimicrobial Stewardship (AMS) and Infection Prevention and Control, Dr Ramsamy is committed to the fight against AMR. Appointed by the Head of Health in KZN to serve on the KZN Antimicrobial Stewardship (AMS) Committee, Dr Ramsamy engages with various stakeholders to promote the concept of AMS within the KZN public health sector in line with the South African National AMR Strategy. As a lecturer and currently pursuing a PhD at the University of KwaZulu-Natal reviewing Carbapenem-resistant Enterobacterales (CRE) in a One Health perspective, she is passionate about making a difference and contributing to academic progress. Creating awareness of a bleak future without the prospects of lifesaving antimicrobials, mentoring up and coming individuals who are equally passionate about saving antimicrobials for future generations is one of her greatest ambitions.

Vaccinations play an important role in both our individual and community health. They help to prevent serious and sometimes deadly diseases by strengthening our immune system. But in recent years this cost effective method of disease prevention has come under the spot light, drawing attention to some myths and misconceptions.

In this episode, Dr Anne von Gottberg dives into the importance of vaccinations, how to handle missed vaccines, vaccine dos and don'ts and recent changes in the Extended Programme onIimmunzation(EPI) in South Africa.

About our Guest:

Dr Anne von Gottberg is currently the laboratory lead at the Centre for Respiratory Diseases and Meningitis at the National Institute for Communicable Diseases, Johannesburg, South Africa; and Associate Professor within the School of Pathology, Faculty of the Health Sciences, University of the Witwatersrand, Johannesburg; and Honorary Professor, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town. She leads a laboratory team responsible for reference diagnostics for respiratory and meningitis pathogens nationally and regionally. The laboratory is the regional reference laboratory for the World Health Organization (WHO) Vaccine-preventable Invasive Bacterial Diseases (VP-IBD) Coordinated Global Surveillance Network for the southern African region; a National Influenza Centre (NIC); and a global WHO RSV and regional SARS-CoV-2 reference laboratory. She is currently a member of several committees and technical advisory groups for AFRO, Africa CDC and WHO. Her main interests include surveillance for meningitis and respiratory pathogens, assessing vaccine effectiveness where relevant. She has authored or co-authored more than 200 articles in peer-reviewed journals. In addition, she supervises a number of Masters and PhD students. Dr von Gottberg obtained her MBBCh and PhD at the University of the Witwatersrand, and trained for her specialisation in clinical microbiology (FC Path[SA] MICRO) at the National Health Laboratory Service (former South African Institute for Medical Research) and at the University of the Witwatersrand.

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