Michel Le Grange

Consultant Pathologist in Microbiology. Laboratory medicine. Lifelong learning. Open to corrections.

[Michel Le Grange @microbelearning]

@JHBWater cnr Judith and beyers naude

[Vindana Chibabhai (she/her) @microbemail]

Come hear about the latest updates in fungal diseases in South Africa #FungalWeek24 @neleshg

[Mia Malan @miamalan]

BREAKING: SA's new #Mpox death - the 2nd in the country - died on Wed, 12 June, the same day on which he tested positive for Mpox, says @heatlhza. The man, 38, was admitted with extensive skin lesions, a headache and sore throat.

[Cefazolin @EmpiricGame]

Enterobacter cloacae after a dose of a ceftriaxone

[Vindana Chibabhai (she/her) @microbemail]

Interested in learning about Tropical Diseases and Hygiene? Come join our @WitsDTMH diploma course at @WitsHealthFac. There is still time to register. Fully online!
Please help spread the word...
More info on the course at https://t.co/J2Wj300tpr

[Michel Le Grange @microbelearning]

The chair shuffling queue at driver liscence or home affairs....is that uniquely South African?

[Vindana Chibabhai (she/her) @microbemail]

Yesss!!!

[Michel Le Grange @microbelearning]

@Microbedoc2 Keyhole effect. ESBL producer.

Also seen when CZA disc near mero or imi and the carbapenemase susceptible to avibactam and between CZA and Aztreonam if it's an NDM (+- an ESBL)

[Michel Le Grange @microbelearning]

@JamesWesleyMac1 @microbemail @Nonku54635540 Heard 1 to 2 months no new stock

[Michel Le Grange @microbelearning]

So.....there is a Zaficefta (cetazidime-avibactam) shortage, just in time for the festive season. Are you getting same report from pharmacists? @JamesWesleyMac1 @microbemail @Nonku54635540

[Michel Le Grange @microbelearning]

@JamesWesleyMac1 @microbemail Wonder if change in antibiotic exposure with intro of CZA, driving carbapenmase evolution. Can we just get Aztreonam-avibactam already....but then who knows what crazy changes will happen

[Michel Le Grange @microbelearning]

I know Halloween is over.....but this is a horror story in three parts. We don't need a new charecter in our local story. @microbemail @JamesWesleyMac1 #AMR #AMS #IPC #IDTwitter

[Michel Le Grange @microbelearning]

@JamesWesleyMac1 @microbemail Purely anecdotal, before these three in 2 weeks (different hospitals, molecular confident no contamination), before that saw only 2 in 18months. In terms of NDM1 and dual OXA48+NDM1, we have similar results. The rest is OXA-48 only.

[Michel Le Grange @microbelearning]

@ShivarSimbu This was a K. pneumoniae. Carbapenemase positive for NDM1+OXA48. No ESBL gene testing done..

[Michel Le Grange @microbelearning]

See these carba and CZA resistant, aztreonam susceptible isolates occasionally. Test either NDM1 or NDM1+OXA48 positive. Would you treat with ATM? (if was avaiable) or still add CZA for avi for a sneaky ESBL? ATM is relatively stable against OXA48 @JamesWesleyMac1 @microbemail

[Michel Le Grange @microbelearning]

@JamesWesleyMac1 @microbemail @Anja2heart See this too. Have no idea where comes from, even after doing a lit search. Some paeds withhold feeds or base neonatal treatment (even if improving on narrow empiric therapy) on results, even if advise otherwise. ?legacy practice. ?extrapolation from breast milk bank screening

[Michel Le Grange @microbelearning]

@Ashka_TxID Low resource setting here. OXA-48+NDM1 not infrequent. If can access we go CZA+ATM after proven "synergy" testing, if no other option. Theory: Avibactam inhibits ESBL +-OXA48. ATM resistant to NDM hydrolysis and CAZ & ATM relatively resistant to OXA48 hydrolysis. No access 2 CFDC

[Vindana Chibabhai (she/her) @microbemail]

#IDTwitter It's World Sepsis Day today. Here's a list of Microbe Mail podcast episodes to listen to.
#microbemail #Microbiology #infectiousdiseases #sepsis #worldsepsisday #MedEd
Can you help share this contagious mail? ... 🙂

[Vindana Chibabhai (she/her) @microbemail]

#IDTwitter NEW collaborative episode with the @IDiots_pod Debunking #bactericidal
superior to #bacteriostatic Find on both platforms & on any podcast player #medicalpodcast #Microbiology #infectiousdisease #MedEd @CallumPMutch
https://t.co/23HEZFm1Wh