Detection of Staphylococcus aureus by 16S rRNA directed in situ hybridisation in a patient with a brain abscess caused by small colony variants.

Kipp F, Ziebuhr W, Becker K, Krimmer V, Höbeta N, Peters G, Von Eiff C. Institute of Medical Microbiology, Hospital and Clinics, University of Münster, Germany. A 45 year old man was admitted to hospital with a right sided facial paralysis and three month history of seizures. Computed tomography showed a left temporal mass including both intracerebral and extracerebral structures. Ten years earlier the patient had undergone a neurosurgical intervention in the same anatomical region to treat a subarachnoid haemorrhage. In tissue samples and pus obtained during neurosurgery, Staphylococcus aureus was detected by a 16S rRNA-directed in situ hybridisation technique. Following long term cultivation, small colony variants (SCV) of methicillin resistant S aureus were identified. The patient was treated successfully with a combination of vancomycin and rifampin followed by prolonged treatment with teicoplanin, with no sign of infection on follow up nine months after discharge. This is the first report in which S aureus SCV have been identified as causative organisms in a patient with brain abscess and in which in situ hybridisation has been used to detect S aureus in a clinical specimen containing SCV. Antimicrobial agents such as rifampin which have intracellular activity should be included in treatment of infections caused by S aureus SCV.

Increasing Staff and Student Capacity to Use the Communication Facility in Queen's Online in Order to Support Learning and Teaching on a BSW Programme

In this article the authors explore and evaluate developments in the use of information and communications technologies (ICT) within social work education at Queen's University Belfast since the inception of the new degree in social work. They look at the staff development strategy utilised to increase teacher confidence and competence in use of the Queen's Online virtual learning environment tools as well as the student experience of participation in modules involving online discussions. The authors conclude that the project provided further opportunity to reflect on how ICT can be used as a platform to support a whole course in a systematic and coordinated way and to ensure all staff remained abreast of ongoing developments in the use of ICT to support learning which is a normative expectation of students entering universities. A very satisfying outcome for the leaders is our observation of the emergence of other 'experts' in different aspects of use of ICT amongst the staff team. This project also shows that taking a team as opposed to an individual approach can be particularly beneficial