More Than a Piece of History, a Lot About Impact: Why I became a Liveryman of the Worshipful Company of Plumbers

girlymicro General, Leadership , , , , ,

The start of 2026 has me thinking a lot about perceptions of women in science, and after my dive into women in the workplace and the importance of female visibility last week, I thought I would write something on a related topic, both in terms of London history and in terms of relatively recent changes to reflect the diversity of the city in which it is based. So today I’m talking about how I became a member of the Worshipful Company of Plumbers, what Worshipful Companies are, why they still matter, and why I decided to become involved. It felt timely to write this off the back of the one about the Lady Mayor’s parade, as it is the Worshipful Companies that elect the Lord/Lady Mayor and so it may also help you enjoy that post more.

Lead WITH Us: Why making history is important, and not just about walking in a parade

What are the Worshipful Companies?

To start, a little bit of history…

There are 113 Livery Companies as of 2026. The term livery originated in the designed form of dress worn by retainers of a nobleman and then by extension to special dress to denote status of belonging to a trade. They are unique to London and began to be established in the 12th century as a way to guarantee that those who members hired were qualified and the goods they produced were reputable. Not only this however, being a Liveryman offered protection and had added benefits, such as the right to trade within the City of London, now commonly described as the Square Mile, an area of central London around Chancery Lane. The reason that Livery Companies are also known as Worshipful Companies, is because early companies also had religious ties, with a chosen Patron Saint and association with a local church/monastery.

Due to the reason for their creation, most of the Ancient Livery Companies are associated with specific crafts, and were formed from ‘mysteries’ or fellowships of craftsmen. For this reason they also had a role in training, where they oversaw the progression of pathways from apprentice to master craftsman. They also always had a charitable arm, where they cared for members in sickness and old age by providing alms (money, food, clothing, or other necessities given as charity to people in poverty or need, often considered a religious or moral duty).

Ancient Livery Companies continued to be established until the 17th century (1848) when a combination of civil war and growth of trade outside of the Square Mile meant creation of new companies became less viable. A number of companies have been created subsequent to 1926. The term used for these newer Livery Companies is Modern Companies, and their precedence starts with the Worshipful Company of Master Mariners (granted Livery in 1932). The newest Livery Company is the Worshipful Company of Communicators, and was granted livery status in March 2025 making it the 113th City livery company in order of precedence.

The Great Twelve Livery Companies

The Great Twelve Livery Companies were the ones that were considered the most prestigious, ancient, and historically wealthy trade guilds in the City of London, when they were ranked by the Mayor of London in 1515. At that time there were 48 companies and ranking was mostly based on both levels of wealth and level of influence.

The Great Twelve in Order of Precedence:

  1. Worshipful Company of Mercers: General merchants established 1394.
  2. Worshipful Company of Grocers: Originally spice/pepper merchants 1345.
  3. Worshipful Company of Drapers: Wool and cloth merchants 1361.
  4. Worshipful Company of Fishmongers: One of the oldest, dating to 1272.
  5. Worshipful Company of Goldsmiths: Bullion dealer, Regulates gold/silver (hallmarking) 1327.
  6. Worshipful Company of Skinners: Fur traders 1327.
  7. Worshipful Company of Merchant Taylors: Tailors 1327.
  8. Worshipful Company of Haberdashers: Dealers in small wares and fabrics. 1448
  9. Worshipful Company of Salters: Originally traders in salt/chemicals 1394.
  10. Worshipful Company of Ironmongers: Originally iron dealers 1463.
  11. Worshipful Company of Vintners: Wine merchants 1164.
  12. Worshipful Company of Clothworkers: Originally finishers of cloth 1528.

One of the most interesting things about the order of precedence of the Great Twelve, is that numbers 6 and 7 alternate each year. Both the Worshipful Company of Skinners and the Worshipful Company of Merchant Taylors were incorporated in the same year (1327) and grew to be among the most powerful “Great Twelve” guilds. This led to intense rivalry over which should be ranked higher in civic processions and violence broke out in 1484 during the Lord Mayor’s river procession. In order to resolve the dispute, the Lord Mayor (Lord Mayor Robert Billesden) who was a Haberdasher, settled the dispute by requiring that the companies alternate their positions each year, traditionally at Easter. This is supposed to be where the term ‘at sixes and sevens’ originates.

History of the Livery Companies and the Royal Family

The British Royal Family maintains close, historical ties with the Worshipful Companies, with many members serving as Royal Patrons, Liverymen, or Honorary Freemen of these ancient trade guilds. These, often ceremonial, relationships involve Royal charters of incorporation, attendance at banquets, and support for the City of London’s philanthropic and civic initiatives. The relationship between the Liveries and the Royal Family date back to their creation and were an important component of the the Crown interacted with craftsman at the time.

Worshipful Companies with Royal Family Members:

  • Worshipful Company of Shipwrights: King Charles III is the Patron, succeeding the late Queen Elizabeth II in 2024. The Permanent Mastership is also merged with the Crown.
  • Worshipful Company of Brewers: King Charles III is a Liveryman of this company.
  • Worshipful Company of Butchers: The Princess Royal (Princess Anne) is a Past Master.
  • Worshipful Company of Carmen: The Princess Royal is also a Past Master of this transportation-focused guild.
  • Worshipful Company of Saddlers: The Princess Royal holds the unique status of Yeoman.
  • Worshipful Company of Fan Makers: Queen Camilla was clothed as an Honorary Liveryman in 2024.
  • Worshipful Company of Basketmakers: The Duchess of Gloucester serves as an Honorary Liveryman.
  • Worshipful Company of Coachmakers and Coach Harness Makers: The Duchess of Kent is a Liveryman. Historically, this company has included the late Duke of Edinburgh (Prince Philip) and Prince Michael of Kent as Royal Liverymen.
  • Worshipful Company of Drapers: This company has a long history of royal members, including King George VI and King William III.
  • Worshipful Company of Mercers: Liverymen include various members of the royal family, continuing the tradition of the company that ranks first in the order of precedence.
  • Worshipful Company of Master Mariners: King Charles III is the Patron, and the late Duke of Edinburgh served as Admiral and Past Master.

Her Majesty The Queen (formerly HRH The Duchess of Cornwall) was admitted to the Worshipful Company of Plumbers on 26th January 2017.

Worshipful Company of Plumbers

As I said, there are a total of (as of 2026) 113 Worshipful Companies within London, with the Worshipful Company of Plumbers sitting at number 31 in the order of precedence. For interest to see the scope of crafts included, here is the list of the 48 Ancient Livery Companies by Precedence. excluding the Great Twelve:

  • 13 Dyers
  • 14 Brewers
  • 15 Leathersellers
  • 16 Pewterers
  • 17 Barbers
  • 18 Cutlers
  • 19 Bakers
  • 20 Wax Chandlers
  • 21 Tallow Chandlers
  • 22 Armourers and Brasiers
  • 23 Girdlers
  • 24 Butchers
  • 25 Saddlers
  • 26 Carpenters
  • 27 Cordwainers
  • 28 Painter-Stainers
  • 29 Curriers
  • 30 Masons
  • 31 Plumbers
  • 32 Innholders
  • 33 Founders
  • 34 Poulters
  • 35 Cooks
  • 36 Coopers
  • 37 Tylers and Bricklayers
  • 38 Bowyers
  • 39 Fletchers
  • 40 Blacksmiths
  • 41 Joiners & Ceilers
  • 42 Weavers
  • 43 Woolmen
  • 44 Scriveners
  • 45 Fruiterers
  • 46 Plaisterers
  • 47 Stationers and Newspaper Makers
  • 48 Broderers

The company was formed in 1365 in order to regulate plumbers in London and to ensure the quality of the crafting linked to cisterns and sanitation in order to support public health. It was subsequently granted a royal charter in 1611. As well as ensuring quality by providing oversight, and by punishing poor work and ‘unruly behaviour’, it also had an educational role in overseeing the 7 year term of apprentices.

As it is Worshipful Company, it is associated with St Michael as its patron Saint and the St Magus the Martyr church. It retains a focus on charity and education. There are five major committees that form the work of the company: Education & Technical, Finance, Freedom & Livery, Membership, and Social, each chaired by a Court Member

Homepage

Like most Livery Companies, the Plumbers’ Company has a number of different levels of involvement, consisting of:

  1. Freemen – this category recognises that some individuals may not be able to make a full commitment to become a Liveryman when they initially apply. The Freeman membership category limits the functions you can attend, however it gives a good insight into being a full Liveryman and Freeman are encouraged to become a full Liveryman at an appropriate time. Freeman can attend all visits and activities, but not the formal Company functions, unless invited as a guest by a Liveryman. They also cannot vote in the City of London elections.
  2. Liverymen – there are ~three hundred and fifty members of the company, the vast majority of whom are Liverymen. About 70% are connected with the plumbing craft and allied disciplines. The remaining members cover a wide spectrum of interests and professions including engineers, scientists, architects, builders, accountants, lawyers and many others.
  3. Court of Assistants – drawn from within the Livery, it reflects in its membership those disciplines which are needed for the Court to advise and help the Officers of the Company to run its affairs
  4. Officers of the Company – the Master, Upper Warden, and Renter Warden are installed annually in October and serve for one year
  5. Stewards – led by the Senior Steward, they help to ensure the smooth running of functions and organise Company visits. Stewards serve initially for three years, and then either stand-down, or continue on to become Senior Steward.

Although traditionally London based, a third of Liveryman live over 100 miles from London, and charity work is undertaken globally.

There are a number of routes to admission:

  • Redemption: The most common method for new members, where an application is made followed by an interview.
  • Patrimony: If a parent was a Freeman at the time of the applicant’s birth.
  • Young Entry Scheme: Discounted rates (50% off) for those aged 21–40.

Applying involves being proposed and seconded by existing Liverymen, and potential members must be involved in or connected to the plumbing industry. Applications can be made online via the Company website.

How and why did I get involved?

I have been involved in looking at the role of the built environment in transmission of infection, mainly in healthcare, since before doing my PhD. In recent years I’ve been actively involved in writing a number of pieces of water based national guidance, as well as running the Environment Network and associate courses. You can see some of the papers that have come out of this work on the publications page. I also get to put some of this theory into practice by being involved in providing guidance about the design and commissioning of new buildings (hence the delightful cover picture :).

Despite working in this area for over two decades I hadn’t really heard of any Worshipful Companies, let alone the plumbers specifically. I had done a few internationally webinars for the Royal Society of Public Health and linked to this I was fortunate enough to be invited to an awards ceremony, where I met Elaine Waggott, who had just become a Liveryman herself. We started talking and she told me about the Worshipful Company of Plumbers, the work they were doing, and their ambition to get more women involved. The company was one of the first to admit women, and there has been an active push to recruit women from a variety of backgrounds. Elaine talked about the Women in Livery and Diversity (WILD) team as a determined group of members leading a drive to improve the gender balance and increase diversity in the Company, and across the Livery. As someone who cares deeply about female representation this aspect of the company really resonated. This plus both their charitable and education focus really spoke to me and so I decided to throw my name into the hat.

Stages of involvement

Once I decided to get involved there were a number of stages that I needed to progress through in order to become a Liveryman of the Worshipful Company of Plumbers.

First I needed to apply to be a Freeman, have the support of several Liverymen, and go through an interview process. After which I swore the Oath of the Freemen.

Once I became a Freeman, I then had to apply and be awarded Freedom of the City of London. The Freedom of the City of London is a symbolic honour dating back to 1237, originally granting citizens rights like trading within the City and freedom from feudal service. Today, it is a largely ceremonial title recognizing high achievements, contributions to public life, or association with the City (such as being part of a Worshipful Company), and is granted by the City of London Corporation to nearly 2,000 people annually.

This was such fun, the ceremony felt really meaningful, and Mr Girlymicro and I even got to hang out with Florrie the sheep. Recipients are often humorously cited as having the right to drive sheep across London Bridge, carry a sword in public, or be “drunk and disorderly” with safe passage home. The main thing is that being granted Freedom of the City of London is a requirement before being accepted as a Liveryman for a Worshipful Company.

The Freedom process involves completing paper work that is included in the National Archives, as well as agreeing to follow a set of rules of conduct. Both of which give it a very historic feel.

Once all of the prior stages are completed you can then be invested as a Liveryman of the Worshipful Company of Plumbers.

Women in the Livery

By 2020, all City Livery Companies and guilds opened their membership to women on equal terms with men, you read that right, 2020.

Like many surprising parts of the history of women at work I discovered as part of my Lady Mayor’s post, the first female Master was not elected until 1983 (Sylvia Tutt, Chartered Secretaries & Administrators). It feels like the 80’s were the beginning of a watershed change. Another milestone was passed around 2015 when the association of Female Past Masters achieved 100 members – significant because progression to Master often takes 20 years in a Livery Company (irrespective of gender), so these women started their journey to the chair of their respective companies well before the topic of gender inclusivity among the Livery Companies was widely understood or recognised.

There have been three female Masters in the history of the Worshipful Company of Plumbers in the 650 years since its charter. The first of which came into place in 2015:

  • Erica Stary (2015–2016): The first woman to serve as Master of the Company
  • Dame Fiona Woolf (2018–2019): The second female Master; she also served as the second female Lord Mayor of the City of London
  • Sandra Raine (2025–2026): The current Master of the Company

Additionally, Janet Rivers is presently serving as the Upper Warden for the 2025–2026 term, and so is a candidate for election as the next Master,. Every woman makes it easier for the one to follow. As with the Lady Mayor, progress is happening, but the fact that much of this change has happened in the last decade just goes to show both how recent this change in approach has been, and also how far we have left to go.

So why does any of this matter?

Institutions that go back, and are as part of the cultural structure of places like London matter. They matter because they have influence. They matter because they have the capacity to drive change. As organisations with such history are often the slowest to change, the fact that change is now occurring is significant. These groups are involved in electing roles, such as the Lady Mayor, they have the capacity to drive inclusion via their education and charitable work, and they lend legitimacy to wider changes in attitude and position. Being visible matters, being accepted matters. Being both of those things in an organisation that has established links to other established institutions, such as the Royal Family, can only help to move dialogue forward.

I am probably not your typical member. I don’t have a private school education. I am not associated with the armed forces. I am not a lawyer. Yet I have been welcomed. I have been especially welcomed by Sandra Raine both before and now she is Master, who has taken such a lot of time to help me network, to include me, to help me feel like I fit in. There is a lot we can learn from the mentorship and support offered. Having Liverymen who do not fit the mold is important. Changing perceptions of what a Liveryman looks like is key to ensure that the company continues to support the workforce as it looks like now, and that it’s charity and education work remain fit for purpose.

It is easy to think that these types of organisation are not for us. To think of them as part of an establishment that doesn’t have room for someone who looks different, or who comes from a different place. There are however people working actively, passionately, to change the trajectory, whilst still maintaining the history and values that drove the organisation to exist. I for one count myself lucky to have met some of those individuals, and hope to build on the legacy they are putting in place.

All opinions in this blog are my own

Lead WITH Us: Why making history is important, and not just about walking in a parade

girlymicro General, Healthcare Science, Leadership , , , , , , , , , , ,

On 8 November 2025, 200 women from across the worlds of tech and health walked together in the Lady Mayor’s Show answering Dame Susan Langley’s 697 call for change. They formed part of 697 women walking to support the historic shift that Dame Susan is introducing as the 697th Lord Mayor of London.

This post was just going to be about the privilege of being involved in walking in such an amazing historic event, but then an article was published by the New York Times on the 6th November which both changed what I wanted to say, the context of why I think the walk was important, and also required a few weeks of calm reflection before I felt I was ready to write it.

The article was called “Did Women Ruin the Workplace? And if So, Can Conservative Feminism Fix It?” Needless to say it garnered quite the response on social media and across the internet:

If you, like me, don’t have a New York Times subscription, this article summarises it pretty well: https://www.glamourmagazine.co.uk/article/conservative-feminism-new-york-times

Reading and processing my response to both the article and the coverage led me down a number of rabbit holes, both about the history of women in the work place, and women’s right to equality linked to both work and the money acquired as a consequence of that work. Some of which shocked me.

History is important, as it leads us to the present. It also means that we acknowledge the fight it took to get to our current ‘normal’ and prepares us for the role we need to play to make the changes for those that will follow. So, before I talk about how this ties into the Lady Mayor of London and the Lead WITH Us movement, I thought it was important context to share.

Why does having women in the workplace matter?

Access for women to work has not been an easy path, many women had to stand up, be seen, and be counted in order for progress to occur. In my mind, most of this change happened when Queen Victoria was on the thrown, but that assumption was far from correct. Here are some key points of that history:

  • Elizabeth Garrett Anderson was the first female doctor allowed to train and become legally qualified in 1865, no British hospital would accept her qualifications however and so she studied in Paris to gain her formal degree and was eventually admitted to the British Medical Register in 1870. She then worked to bring in the Medical Act of 1876 to formally open the medical profession to women, and co-founded the London School of Medicine for Women which now forms part of UCL
  • The first female MPs were permitted following the Parliament Qualification of Women Act in 1918. The first woman elected was Constance Markievicz, but she didn’t actually take her seat. The first woman to actually sit as an MP was Nancy Astor. Despite this, women could not sit within the House of Lords until after the Life Peerages Act 1958 that permitted Baroness Swanborough, Lady Reading and Baroness Wooten to take their seats
  • Women were not allowed to serve as magistrates or on juries until 1919. Even when the law changed however, juries remained predominantly male for another 40 years. The same act permitted women the right to undertake professional careers, such accountant, or vet, but women did not have protection for the income they earned until much later
  • Women were not allowed into ground combat roles in the UK military until 2016, with the RAF opening up roles in 2017, and the wider military 2018. Women had served in combat prior to this, but were banned from serving in front line military units

Unless you have women in the rooms where decisions are made the voices of women will never truly be heard. This is why the role of women in the workplace is so key. Much of the change that has occurred has been incremental, as it was only when women made it into positions where they could influence change, that that change occurred for the wider population. Even when laws change, culture change takes longer, and so embedded change requires conscious effort for decades after the first shift occurs. We have all seen recently how quickly rights can disappear that had been considered to be part of day to day life, and so there is a continuing need to not take rights that were hard earned for granted.

Why is women working important for both them and society?

Access to work supports both financial and societal freedom, supporting autonomy and decision making. When looking into the history of how work placed change impacted on financial autonomy I was pretty shocked by the fact that the timeline for some of these changes occurred within my lifetime.

  • The first petition for women’s suffrage in parliament was in 1867, but it wasn’t until Parliament Qualification of Women Act of 1918 (the same act that permitted female MPs) that eligible women were granted the right to vote. It wasn’t until 1928 that the Equal Franchise Act passed that gave women equal voting rights to men, making 15 million women eligible to vote
  • The Married Women’s Property act passed within the UK in 1870, which allowed women to become the legal owners of any money they earned. Women could not however inherit property on the same terms as men until 1922, when a property act change meant that that a husband and wife could inherit each others property. Prior to this, women had to give up all rights to their property when they married
  • Women had no legal right to equal pay until the 1970 Equal Pay act which came into being after 850 female workers went on strike at Ford Motor factory in Dagenham. Even so this allowed men to be paid no more than 15% more than women. The Equal Pay amendment act (1983) allowed women to be the paid the same as men for equal work – the pay gap however remains ~15%
  • It took until 1975 for women to be allowed bank accounts in their own names with no counter signatories (when the sex discrimination act came into law). Before then, although no law forbade women from having their own accounts, but many banks and financial institutions still required a male guarantor to open accounts, access credit, or get a mortgage
  • It was not until 1982 that the law changed to mean it was illegal to refuse to serve a woman a drink if she was unaccompanied by a man
  • Statutory maternity introduced in 1987 permitted eligible women to have 6 weeks leave at 90% of their usual earning. This wasn’t expanded to all working women until 1993 as a result of a European directive

It is no coincidence that the right of women to work in professional spaces changed alongside the right of women to have representation and the right to vote. Change often comes with privilege, and not everyone benefits from the changes initially, this can be seen in some of the step wise changes above. It is beholden on those who have access via that privilege to continue the work to ensure that access is widened and available to all, rather than a select few.

What’s the Lady Mayor’s Show and how does this tie in?

The role of Lord Mayor of London has been in place since 1189 when Henry Fitz-Ailwyn first took it up, although the holder wasn’t referred to by the title of Lord Mayor until 1354. Since then there have been 697 Lord Mayors, of which only three have been female.

The first two were:

  • Dame Mary Donaldson, in 1983, who famously fined people for referring to her as Lady Mayoress
  • Dame Fiona Woolf, in 2013, who focused on trying to promote women into senior roles within the City of London

The role of Lord Mayor, these days, changes annually and is based upon an annual election held by the Liverymen (more on that in a separate post to come) who are members of the City of London’s Livery Companies. The process involves Aldermen presenting two candidates, followed by a vote by Liverymen to select the new Lord Mayor, who then serves a one-year term as an ambassador for UK financial services. Only sitting Aldermen are eligible for election, and so even to even be in a position to be nominated is a feat within itself, especially when many Livery Companies are still male dominated. In 2025, Dame Susan Langley was elected at the third ever female Lord Mayor.

It took until my lifetime to have a woman serve as Lord Mayor, and until 2025 to have a Lord Mayor who was happy to represent female visibility enough to call herself Lady Mayor, and set out to embrace difference in order to increase visibility and impact. The parallels between this change and some of those linked to female autonomy and role acceptance have not been lost on me. This change was celebrated as part of the annual parade at the start of the Lord Mayors term, when the parade was renamed the Lady Mayor’s Show.

As part of the principles of her term Dame Susan has focused on something called the “697 call for change” which refers to the fact that she is the 697th person to hold the office of Lord Mayor of the City of London, and the first to use the title “Lady Mayor”. This call includes:

  • Adopting the Title “Lady Mayor”: While she is the third woman to hold the post, she is the first to be officially known by the title of “Lady Mayor”. This decision reflects a commitment to modernising the role and promoting diversity and inclusion within the City’s traditionally male-dominated institutions.
  • The “Lady Mayor’s Show”: In another historic first, the traditional Lord Mayor’s Show was renamed the “Lady Mayor’s Show” for her procession in November 2025.
  • Inclusion in the Parade: The show included 697 women from various City sectors walking in the parade with her, symbolically representing her position as the 697th holder of the office and highlighting women’s roles in the City.
  • “Modern Mayoralty” Initiative: Dame Susan is committed to introducing a “Modern Mayoralty” initiative, a long-term vision to ensure the role’s ongoing relevance and to “un-square the Square Mile” by championing innovation, prosperity, and inclusion. 

Having talked about historically why having women visible and in positions of influence matters to supporting changes and improvement for women more widely, the shift to clearly embracing diversity and incorporating female visibility, feels like an important declaration. It should not be a news worthy moment to include reference to Lady rather than Lord within a title, but it is indicative of a wider agenda which is significant for a role that has existed for 836 years.

Why does it matter?

We may say, well why does this matter? I certainly don’t face the same barriers as a woman of my grandmothers generation, or even those that impacted my mother. I have never been stopped from having a bank account, no one has ever stopped me having a drink in a pub. Those barriers were present in my lifetime however, and just because they are gone does not mean that other barriers do not exist. Within STEM (science, technology, engineering and maths) careers women are still under represented at senior levels, with women making up only 28% of the overall workforce in 2024. Women are still on average paid ~15% less than colleagues for the same job, and so the pay gap is certainly still present and there is still work to do.

Even in my career I have encountered numerous incidents where being a woman was included as part of a value judgement of my career trajectory, including a male colleague congratulating me when they discovered I couldn’t have children as it meant that ‘they could continue to invest in my career’ as I wasn’t going to disappear off and have children. There have been decades of my career where I was utilised to write grants and other work for my male professors, and my name was never included. Some of this is earning your way, but I am aware that there was a definite difference between how some of their male students were treated in comparison. This isn’t whinging, I found my own way. I learnt lessons. I also had the privileged (if you can call it that) to not be managing a family or caring issues which would have meant that life was harder.

This attainment difference due to lack of recognition in science linked to gender is so common that it even has a name, the Matilda Effect. This makes it even more important that women are represented at senior positions within science and tech, not just to show that it is possible, but also to change the dynamics so that some of the embedded cultural norms are subject to change.

Why did I think it was important to walk?


All of this brings me onto why I believed it was it important to walk as part of the 200 women representing science and technology. As the wonderful guys at Lead WITH Us state:

‘This isn’t just a float. It’s a signal. A collective act of visibility. 200 women. One shared purpose. Infinite possibility. A reminder that leadership takes many forms and that women are already leading, shaping, coding, building, healing, innovating, and challenging systems in ways that often go unseen.’

That was the reason that I chose to walk, but the experience was so much more than I had predicted. We walked for 3 miles along a route that was lined with people of all ages, backgrounds, and reasons for being there. The smiles of the children we encountered, the number of high fives requested and given. Walking as a group of women in science and tech, flying my geek flag proudly, being surrounded by a wonderful group of women who shared a goal and were there to support each other. Role modelling leadership in action. Hearing the cheers and feeling the welcome was an amazing reminder of the difference that science makes and how much it is appreciated.

Representation matters

The other great thing about walking with this group of women, was that the group itself was as diverse as those who lined the streets. People brought their parents, sisters, children, friends. I even brought Mr Girlymicro to help with tech and take some photos.

We come from different disciplines and backgrounds:
Some of us are Healthcare Scientist, Allied Health Professionals, nurses and clinicians working in the NHS.
Some are immersed in data and code.
Some lead strategy or drive system change.
Others are disrupting the infrastructure across delivery and design.
And some are just starting out but already creating waves.


We were walking to be visible, but more than that we were walking so others can re-imagine the future. We walked standing on the shoulder of giants who came before. Those who created a momentum. A momentum we want to continue. So much of what we do builds upon the work of those who came before.

There is still change that needs to be made. Representation still needs to be improved so that it leads to real change and that the barriers faced by those that come after us are different again from the ones that we are overcoming.

What will the legacy be?

Plenty of work will be ongoing in 2026 during this one year term and it is well worth keeping an eye on the City of London website. More than that though, there is a real hope that the 697 will become a movement and a legacy of this year. Certainly the 200 of us who walked are still linking in and a community is forming. From Whatsapp groups to a LinkedIn page, spaces are being made where we support each other, share successes, and form connections that will help everyone in their roles and ambitions. If you know a woman in Tech or Health who’s made a difference in your life or career, or if you would like to be involved yourself, then follow the links and get involved. Change can happen, but it happens best and last longest when we make it together.

All opinions in this blog are my own

Looking Back and Looking Forward: A Girlymicro 2025 year in review and looking forward to 2026

girlymicro General , , , , , , ,

This week is the first ‘return to normal’ back at work week for many people, and the reality can hit hard. I’ve been reading articles about how to get over this particular speed bump, mostly because they are everywhere you look right now. Many of them talk about how important reflection is to re-centre yourself and adjust to the change of pace.

Now, I haven’t been off in quite the same way as many but doing a bit of reflection to process 2025 and set up 2026 seemed like not a bad way to manage some of my thoughts that I hadn’t made time to investigate in the chaotic world of the Christmas build up. Doing a bit of mental spring cleaning felt timely. So, in case it helps, I thought I would share the questions I asked to structure my thinking, as well as the answers in case you fancy doing something similar as a way to enter 2026 in a positive mindset.

One thing I’ve learnt

I wrote last week about my journey redefining who I am post pandemic. The thing that triggered this, that maybe everyone but me already knew, is that redefining identify requires work.

Roll on 2026: Being intentional about finding my way back to my full authentic self

The need for redefinition to be an active process that requires purpose, energy and focus, was something I just hadn’t realised. I’d been waiting for it to ‘just happen’, for me to snap back into my pre-pandemic self like some kind of human rubber band. I think I’ve spent some time quietly baffled about the fact that wasn’t happening and questioning how long it would take. After all, as teenagers we don’t define ourselves with purpose, we try on identities like clothes, and finally one sticks.

The same does not seem to be true as a woman in your 40s. In hindsight, having had this revelation, I am glad for the requirement to be purposeful about getting back to the new me, rather than defaulting to the old.

The thing I’m proudest of this year

This year I really feel I rolled the dice on myself. I put something out there which made me both visible and vulnerable, without any idea of how it would be received. I had an idea. I committed. I took that idea and made it into a reality I could hold in my hands. I wrote a book that went out into the world, where I gave up all control of how it would be received, and how those who read it might view me.

The book is called ‘It Shouldn’t Happen to a PhD Student‘ and it is very deliberately not the kind of academic book I have been previously involved in writing. Much to the horror of some of my academic colleagues it is not referenced. It is a practical guide to your PhD journey, everything from what you need to take to your first conference if you are presenting a poster, to how to build confidence in public speaking. It also contains a lot of me, acknowledgement of how I got things wrong in my own PhD and supervisory experience, as well as the things that went well.

I’m so proud of myself for taking the risk. I’m proud of myself for taking some of the commentary in my stride. I’m proud of myself for trying to make a difference, so that others have a better experience when they are taking on a new challenge.

I’m also grateful to everyone who has stood with me, shared, brought, and supported me. It’s when you put yourself in a vulnerable position and see everyone come out to cheer lead that you are reminded of quite how fortunate you are in life.

Something I am still working on

One thing that I am still making very slow progress at, and requires conscious effort, is managing the need for external recognition in order to feel validated. Sometimes, I think that I am something of a Golden Retriever, with a love of people tapping me on the head and telling me I’ve done a good job. In my defense it be because positive reinforcement is not exactly a feature in my day job, I am, after all, often the bearer of bad news, but as a people pleaser this lack of acknowledgement can make it hard to feel safe and heard.

This lack of positive feedback/reinforcement is also a feature of seniority. As you move up the ladder competence is assumed. No one is going to say well done just for doing your job. There is a need to go above and beyond in order to gain that recognition. A lot of my above and beyond is linked to our wider community, and therefore pretty invisible to my day job, or not considered relevant. It’s not a surprise therefore that it doesn’t feature. Building on my own internal capacity for reflection and acceptance is an important way to manage my people pleasing tendencies. I suspect I need to be less dog and more cat, in terms of independence, moving forward in my working life.

A reflective tool to structure my 2026 learning

Towards the end of 2025 I found this reflection tool online which I have found quite useful as a way of entering 2026. Leadership can be a lonely space, and having a structured way to process and explore events that arise can be really beneficial, both for well being, but also for learning.

A lot of the ways I want to approach 2026 are linked to being more targeted and defined in terms of the impact I want to make. I have been fortunate to have this amazing community support me and let me grow, and now I want to think about moving it forward, rather than just drifting and responding. Understanding challenges and moments that I could improve is the first step, alongside reflection on what fulfills me and brings me joy, in making sure that I move forward with purpose. Challenge and conflict are not dirty words in the Girlymicro world, they are opportunities for growth, even if living those moments brings discomfort. Rather than denying they have happened, I would rather be a better person, scientist, and leader as a result.

Three words to carry me forward

The inspiring Tara Birch made this post on LinkedIn before Christmas and it really resonated with me. I knew that I didn’t want to make a standard January post, but instead make some promises to myself, using words which will help keep me on track linked to my aims, values, and passions.

My words for 2026 are Creative. Brave. Redefined.

Creative – as I want to still be writing, writing blogs here, writing to support others, and writing for another project. Science is also a creative endeavour, and it can be hard to be truly creative when tired or overwhelmed. I’m putting things in place to ensure that I can flex my science muscles and re-fill that particular creative cup to allow 2026 to be a launch pad for new scientific projects

Brave – because I want to continue to speak and be heard, whether the message I have is digestible to others or not. Being visible will always come with critics and commentary. Despite the challenges of that I want to maintain being brave enough to stand up and be counted, and hopefully walk even a little taller when owning my space

Re-defined – it is all too easy to let other define us, or for others to speak their truth and get swept up in it. It is also easy to lose sight of who we are in the rapid, challenging, and responsive world we live in. To drift rather than standing firm and looking inside because we are too scared to see ourselves for all we are. I both love and have hope for myself, and I am surrounded by people who see me for all I am and love me anyway. In 2026 I want to use these positive motivations to ensure I can continue to move forward, growing into my future self, rather than a 2019 echo

https://www.linkedin.com/posts/thetarabirch_i-ditched-new-years-resolutions-years-ago-activity-7408770886821941248-xtEg?utm_source=share&utm_medium=member_android&rcm=ACoAAAZjGL0B8K0ce1stGHZAPTgt9H7tGgWKQ8s

One aspiration to keep me focused

The NHS, the world, and science in general, is going through a difficult time right now, so I’ve been thinking what it is that I can do about it. It is easy to feel powerless, but I really do believe we have more power than we acknowledge.

Large scale systematic change is happening all around us, which can be unsettling, and lead to destabilisation of how we feel, as well as the system we sit within. Even if we are not directly impacted, we see how this impacts friends, colleagues, and family. It can make us want to keep our heads down and just keep going. The thing about this kind of change however, is that it is also an opportunity. If we are brave enough the system itself can emerged changed, but hopefully better. If we don’t engage however, the change will lead to the new system looking surprising similar to the old system, and a lot of the discomfort experienced will therefore have had limited value. This is the time, no matter how it feels, to engage rather than withdraw if you can face it, to make all of the disruption worth while.

The rise of science denialism is also everywhere I look. For instance, the impact of the US administration on organisations I’ve liaised with all of my working life, such as the CDC, have made it very clear that none of us can stand by and not challenge this type of commentary when we encounter it. When I say ‘challenge’ I mean it in the sense of questioning, trying to understand drivers, and building of bridges, rather than trolling people on the internet or engaging in insult slinging. I’m talking about getting out there and sharing evidence, and tackling mis-information when it comes in front of you. I acknowledge that there can be a lot of ‘why me’ and ‘surely someone else can do it’. People who are paid science communicators. People who have more time. People who have more strategic power. I feel you, and I’m not saying we should take this on like it’s our full time roll. The thing is, science deniers often have high visibility. They are easy to find. It is often not so easy to find a friendly scientist who will provide the counter position. So this year I will try to be more visible, to be the science ‘phone a friend’ for people who find it helpful. Most of all I will not make myself small for the comfort of others, especially for those who wish there was less diversity in science. Now is the time to stand up and be seen.

A manifestation to work towards

So………I mentioned I had my first book come out in 2025, and despite the fact that it may have been madness to commit to getting a book out in 4 months I’ve rather caught the bug. I have plans to have another book out early October, launching before Halloween. It’s called ‘Don’t Open that Door: A microbiologists’ guide to infection in movies and TV’.

It contains a whole lot of chapters on infection prevention and control, alongside 23 chapters based on a different films or TV series where infection is key to the core theme of the work, split into sections on viruses, fungi, parasites, and bacteria (and other causes). Most of the end of last year was about getting the list of options down from 136 to 23, although I could still do with 2 more fungal examples if any exist, so give me a shout if you have any ideas. It has been so much fun so far, but now the work really begins. I’m really excited about this one, and Mr Girlymicro and I are planning to pick up the mics and also do some podcasting as we go along, so keep an eye out and maybe subscribe to the Girlymicro podcast so you are the first to hear.

A gratitude to end on

One of the things that is always a feature of the Girlymicro community is how grateful I am for all of your support. I feel braver and more creative because I know you all support my endeavours. Everything that I, and this blog, accomplish is because you take the time to read it. In 2026 I am looking for more ways for us to support each other. If you have ideas how please let me know. Whether that is writing me a blog post on something you are passionate about, having a catch up at a conference or event, or that you are starting a new project that you would like support with and you think I can help. Let’s enter 2026 with an ambition to connect and support each other even more than we did in 2026.

For all of you still struggling with the pressure and darkness of January I leave you with this:

All opinions in this blog are my own

Roll on 2026: Being intentional about finding my way back to my full authentic self

girlymicro General, Leadership , , , , , , ,

It’s the Sunday between Christmas and New Year. In theory it was supposed to be a chilled out, relaxed and refuelling week off work. Instead, due to no fault of anyone, it’s been a week full of chaos, and disruption linked to illness, house moves and life changes. All of which will fade into memory but for now are quite at the forefront of my thinking. Subsequently this means that I am entering 2026 less rested and more discombobulated than I had hoped, feeling very much like a Gemma Correll picture.

For full disclosure, it’s not just 2026 I have entered this way. It feels like every New Year since 2020 I have become less and less likely to greet it with joy and moved more and more towards greeting it with a timid ‘hi’ from behind the curtains. It feels like we’ve all been bitten once too often by providing an optimistic welcome and seeing the resulting 12 months turn into another year of trial and trauma, whilst our resilience is no longer worth writing home about.

Add to this the ever present commentary on all social media platforms, where my professional and social peers list all of their successes, the languages they’ve learnt, the places they’ve been, and the skills they’ve picked up, whilst I rot with unwashed hair and wallow in exhaustion. Life can start to feel hard or like you’re failing in comparison, all of which can make it feel difficult to roll out the red carpet to another New Year.

In order to centre myself and navigate through the triggering level of self proclaimed positivism out there I thought that this year I would not focus on making a list of New Years resolutions, but reflect on what went well in 2025. The aim of this is not to make life worse for others by screaming about my successes, but to remind us all that progress is more impactful than tick boxing, and that the small things count, some days even more than the big things. Fair warning, this post contains a lot of ‘I’s, as it is about how I see the world. I hope that despite this it may still be useful to you all.

My big aim for 2025 was to try and feel more like the 2019 version of me. Someone who had hobbies, friends, and could even find time to spend with them, as well as family. To feel like a whole person, and not just a professional avatar, so this is the benchmark I shall be measuring 2025 success against.

I spent time with Mr Girlymicro and my wider family

This sounds like a basic thing, but I had gotten into the habit of working every weekend, catching up on emails or catching up on work in general. I began to have a lot of anxiety if I didn’t, in case there was something life/job ending between Friday night and Monday morning. This has been the year that I deliberately faced that anxiety and forced myself to work through it by not reacting to it, and allowing it to drive me to work more. It’s meant that I have had to find coping mechanisms. At the moment they could be healthier as they involve doing work adjacent things, such as book writing, but they have enabled me to step away. I have also been forced to accept that things will happen, but that I can’t work 24/7, and attempting to do so was leaving me in a very unhealthy place.

The payoff for this has been being able to spend more time with my family. Now, some of this is because Mummy Girlymicro and my brother moved in with us (hence the Xmas house moving chaos as they moved out) but a lot of it was me prioritising spending time on non-work. Mr Girlymicro and I have been able to have, at least, protected movie time on a Sunday, and we’ve even managed some date nights. I need more of this in 2026, just spending time together is healing and I can’t wait to spend more and improve on my 2025 efforts.

I managed to finish a non-work based project (Mr Girlymicro would scream work adjacent at this header)

Talking about that work based distraction and anxiety management, I decided to do something for me, based on my passion. Now, I acknowledge that deciding to write a book in 4 months may not be the healthiest of anxiety managing techniques, but it enabled a fire break, where I could focus that anxiety on something productive and was sufficiently distracting to allow a re-focus away from work. It was also nice to be able to visualise something productive coming out of that anxiety, seeing the word count increase little by little. A lot of my day job is responsive or constantly writing and changing written guidance, it can sometimes be hard to see what you’ve achieved at the end of a day, week, month, and so to see a book come together from a concept felt incredibly validating.

(if you haven’t seen the book, take a look at the Girlymicrobiologist book page, or the Amazon webpage for more details)

The other opportunity that writing the book gave me, was that it started, alongside spending time with family, to allow me to form a new identity. I’ve been in work mode for 5 years, and have become so locked in that I almost couldn’t remember the pre-pandemic me. Developing a project that wasn’t directly linked to work allowed me to ask questions like ‘what brings me joy?’ and ‘what message is it that I have to share?’, ‘what can I add?’, ‘what can I do to make the world easier/better?’. This book on a small scale was the answer to those questions. More to follow though, this was a starter for ten.

I acknowledge that I will not return to who I was before

A key part of building a new identity is acknowledging change and letting yourself grieve for your previous one. 2025 was the year that I finally acknowledged that those of us who worked through the pandemic, lost loved ones and colleagues, probably do carry a certain level of trauma with us. I probably don’t see the world the same way now as I did before. The circle of friends that I hold close is much smaller than before, and they have seen all the sides of me. They are the people I trust to always take a 4am call from me. To let me come and crash at their place with 30 minutes notice, just because I need to escape. They are my ride or dies, and I value them so much.

I think I will be sad for the loss of some of the innocence I had before the pandemic, some of the faith and trust in systems. I think I will continue to miss the naivety. I believe I have emerged on the other side better at my job however, and for those I’m close to a better friend. I see the change as an opportunity to re-define who I want to be and where I want to go. It’s hard to know how much of this is truly pandemic, or just hitting peri-menopause and realising I need to be better at setting boundaries. Either way, although I have moments where I reminisce about hopeful past me, I think I am a better person for the journey. I still have hope, it just lands differently.

I spent time focusing on re-connection

Having said that my world had grown fairly small over the past 5 years, and my social circle really limited to those who I knew love all the sides of me, I’m fortunate in my pre-pandemic life to have had a wide circle of lovely people who occupied all kinds of different hobby/interest spaces. All of whom challenged me, cheered me, and helped me grow as a human being. It felt important to saunter back into those spaces, especially as they would be useful in discovering the new me.

I did things that are probably normal for most of you reading. I went out for drinks. I met people for dinner. I even returned to conventions and shared spaces, which have been triggering for me having spent so much time avoiding crowds for the last several years. I remembered that, although these activities and spaces can make me feel anxious at times, the pay off is so very worth it. I’m not sure I will be returning to hosting afternoon tea for 30+ people any time soon, but I’m certainly up for small group activities and have committed to not defaulting to no or an excuse. I also discovered that many lovely people had kept a door open for me to return, and that was a really meaningful thing to discover.

I returned to some pre-pandemic activities

On the back of this re-connection, I also went back to some of the activities that I used to take for granted pre-pandemic. I went to a literary festival, I went to science events, and I even returned to a gaming convention. These events reminded me of how much joy I find in learning, being intellectually curious and exploring. They reminded me of why I became a scientist in the first place, because even when not science related they reminded me of the joy of being inspired by others.

Being at a gaming convention was both so much scarier, and so much more fun than I remembered. It was lovely to take off my head, my identity, my thought processes, and step into those of someone else. I played a modern day police office in the Rivers of London universe, a teenage aristocrat in musketeers France, and a political leader in 1930s Europe. I dealt with murders, magic, and revolution, and not a single virus or infection was in sight. The experience reminded me that it was OK to prioritise both breaks and escapism, and of the benefits they can lead to in terms of reflection and re-fuelling.

I gave myself permission to feel

Speaking of gaming, it’s a great sandbox to explore emotions and feelings in response to stimuli for you character. It’s a safe space and time limited, so anything you dive into can be dropped at any point, and you will move onto a new character in 4 hours anyway. Life isn’t quite like that and exploring emotions, be they positive or negative, can take its toll. In 2025 I specifically gave myself permission to feel. To stop saying ‘I’m fine’ to those close friends and family who I know would be there come what may.

Sometimes the best way forward is through, and I found that being in responsive mode for so long at work had meant I had stopped processing a lot of the emotional side of what had gone on. I’m normally pretty optimistic and I know that things will be fine, but in 2025 I gave myself permission to acknowledge that the route to fine sometimes sucks, and that that is OK. I reminded myself that it’s OK to just acknowledge the moment and have a good weep, before getting it together and moving on.

BTW it appears that Taylor Swift songs are my favourite weeping companions, for both sad and happy tears, according to Spotify in 2025.

I started to try and look forward

Acknowledging that I have work to do in my emotional processing also enabled me to start to look forward, rather than being stuck in a loop. It enabled me to think about what I want, and where I want to be. What fuels me rather than draining me. I am fortunate enough to have the most amazing husband who will always pick me up, dust me off, and put me back together. So these considerations were mostly work related.

I know it’s a shocker, at least it was a surprise to me, but I’m getting older. I turned 46 this year, which is no age, but as I’m planning to retire and explore new directions at 55 that is an ever shrinking time period to make change and have impact. Don’t worry, this blog, my writing, public engagement and microbiology are going nowhere. I still want to work post NHS retirement, but maybe not the 12 hour days that add to my current exhaustion.

A dear colleague passed away just before Christmas and that brought this message home to me even more strongly.  We can often approach all aspects of our lives as if we have all the time in the world. The reality is that that is never true, and a lot less of it is in our control than we believe. So, I’m giving some time to thinking what is on my list to accomplish and trying to make sure that it doesn’t just drift because of competing demands. This is a newer focus, but one that will definitely continue in 2026.

I expended effort in trying to find my joy

This has all sounded a bit bleak but the truth about authenticity is that includes sharing all aspects of the truth. even those that are not full of pep. The reality is not as bleak as all that, by doing this hard work I have been able to find true unadulterated joy in a number of moments in 2025. Joy I haven’t been able to feel for a long time. Joy so strong that it made me cry happy tears. Joy so real it reminded me why it is important to connect and follow your passions.

The move from survival mode into engaging with life has not been an easy one. There is still a lot of work to be done, and space for recovery needed. The joy however reminds me of why all of that work is worth it, and at a time when working within the NHS can feel even more challenging than during the pandemic, that joy is needed. So give yourself the gift of compassion you would give others. Offer yourself the space you need to heal, and then be brave about stepping into the world as the new (possibly wiser) version of you. I hope the rest of 2025 is kind to you, and that you too will be able to find joy as we enter 2026.

All opinions in this blog are my own

If you are finding this time of year difficult, and you are in the UK, here are some contact details that I hope may help. No one should need to struggle on their own:

Merry Christmas One and All

girlymicro General , , , , , ,

Scrooge was better than his word. He did it all, and infinitely more; and to Tiny Tim, who did not die, he was a second father. He became as good a friend, as good a master, and as good a man, as the good old city knew, or any other good old city, town, or borough, in the good old world. Some people laughed to see the alteration in him, but he let them laugh, and little heeded them; for he was wise enough to know that nothing ever happened on this globe, for good, at which some people did not have their fill of laughter in the outset; and knowing that such as these would be blind anyway, he thought it quite as well that they should wrinkle up their eyes in grins, as have the malady in less attractive forms. His own heart laughed: and that was quite enough for him.

He had no further intercourse with Spirits, but lived upon the Total Abstinence Principle, ever afterwards; and it was always said of him, that he knew how to keep Christmas well, if any man alive possessed the knowledge. May that be truly said of us, and all of us! And so, as Tiny Tim observed, God bless Us, Every One!

A Christmas Carol by Charles Dickens

Merry Christmas everyone, wishing you all love and laughter and excessive amounts of good cheer!

All opinions in this blog are my own

Guest Blog by Julie Russell: And now for something completely different ……or is it? A microbiologists guide to tattoos

girlymicro General, Guest blog, Microbiology (Clinical) , , , , ,

I am so excited by todays’ guest blog post. I’ve been so eagerly awaiting sharing it with you all. I don’t have any tattoos myself but it is something that is common amongst my friendship group, and I get asked about tattoo related infections A LOT. Partly as I was involved in some of the investigations when there was an issue some time back. So, a post that could help address some of the risk assessment and best practices linked to this art form felt very necessary, even though I didn’t feel I was best placed to write one. Then I saw this great article from Julie Russell on LinkedIn and I just had to reach out and see if she fancies writing a guest blog for me, and thankfully she said yes!

I first met Julie as Head of Culture Collection at Public Health England, that has since changed it’s name to the UK Health Security Agency. She was an inspiring microbiologist, who just had so much knowledge, and she became a great phone a friend. Since then she has moved on to work in a really different area where she still gets to put her microbiology and infection prevention and control knowledge to good use, as the director of a tattoo/art studio in Muswell Hill. No one is better placed therefore to answer the questions that I always get asked and have not felt best placed to answer.

Blog post from Julie Russell

After years in NHS microbiology laboratories, I joined the Public Health Laboratory Service, where I provided external quality assessment schemes and reference materials to laboratories worldwide. After that, I decided to do something completely different. I now co-own and manage Old Marine Arts Group, a tattoo studio in Muswell Hill, London.

It hadn’t occurred to me that tattooing, one of the oldest art forms in the world, essentially creates controlled wounds on people to decorate their bodies. I’ve had tattoos since my 20s – my first done in a legalised squat by a friend who’d never tattooed anyone in his life before. There was no personal protective equipment (PPE) involved; it healed beautifully, and I didn’t think about it anymore.

Many thousands of people across the UK have similar stories with no ill effects. Yet infections linked to tattooing have been recognised since the 19th century, and the government quite reasonably seeks to minimise such risks.

Tattooing, Skin, and Infection Risk

Bear in mind that the skin has a rich, diverse microbiome consisting of millions of microorganisms, some of which can cause infections if the skin is broken. Tattooing involves puncturing the skin with needles thousands of times, to a depth of approximately 1.5-2 mm, to place pigment into the dermis, creating a permanent design. Invariably, the tattoo process causes some bleeding, and after it’s finished, short-term redness, swelling and scabbing are normal. Resisting the urge to scratch is essential to minimise the risk of infection.

A July 2024 YouGov1 poll suggests 28% of UK adults – around 15 million people – now have tattoos. The UK Health Security Agency (UKHSA) notes that the true prevalence of tattoo-associated infections is unknown. There are no statutory notification procedures in place for infections specifically caused by tattooing, and no indication that such infections significantly burden the NHS. Various estimates suggest that approximately 1-3% of tattoos become infected in the UK. Most infections are mild local skin infections that can be treated with a single course of antibiotics; severe infections remain rare.

Interpreting the Evidence

Publications on tattoo-related infections must be read with caution. A December 2024 paper in The Lancet Microbe2, “Microbiology of tattoo-associated infections since 1820”, highlights rare severe cases such as necrotising fasciitis, leprosy and atypical mycobacteria outbreaks. The authors state that, “Despite advancements in public health policies and increased awareness of tattoo-related risks, a notable rise in both the number and diversity of microbial infections has been observed with an increase in the population opting for tattoos, particularly since 2000”.  However, they provide no population-level denominators and conflate expected irritation, redness and swelling with true microbial infections. The authors fail to note that severe cases are overrepresented in the literature precisely because they are unusual. The paper may be a useful clinical catalogue, but it is not an incidence study.

A Brief History of Safety

Tattooists and clinicians have long recognised infection risks in tattooing. In the late 1800s, some artists infamously spat into powdered ink and sucked the needles during the tattooing process. Meanwhile, London-based artists in the early 1900s, such as Alfred South, promoted “the most perfect antiseptic treatment, painless and absolutely harmless”, whilst Tom Riley warned: “Caution to Ladies and Gentlemen thinking of being tattooed – First see the work of two or three tattooists then make choice {sic}. See that a complete set of new needles are {sic} used at each sitting as well as antiseptics”. Some early tattooists even wore white coats to convey a clinical level of cleanliness.

Legal regulation, however, arrived much later. It was still legal to tattoo children in the UK until the Tattooing of Minors Act 1969. Some aristocratic families reportedly tattooed babies for identification – in case, for example, their children were hospitalised or kidnapped.

Modern Regulation

Mandatory licensing changed the landscape. Under the Local Government (Miscellaneous Provisions) Act 1982, tattoo studios need to be registered. More recently, there is the British Standard BS EN 17169:2020, which covers safe and hygienic practice, although not many councils use it as a benchmark. This standard covers workplace preparation, equipment sterilisation, PPE, client consultation and aftercare. It requires studio owners to implement a comprehensive hygiene protocol to protect clients and staff, and tattoo artists to provide evidence of continued professional development.

Wales now requires tattooists to complete and pass a regulated Level 2 Infection Prevention and Control Award. Requirements in England and Scotland are less specific. Barnet Council licenses my studio; their Code of Practice 13 details the specific requirements for tattooing activities, in addition to those laid down in the Regulations applicable to all special treatment licensed premises. It notes that tattoo artists who are unable to demonstrate hygiene competence may be asked to complete a Level 2 hygiene certificate.

Reducing the Risk

Infection risk can be reduced through:

  1. Good personal hygiene (artist and client)
  2. Effective cleaning
  3. Separating clean and dirty materials
  4. Correct sterilisation or disposable equipment

Artists must assess clients for skin issues (including rashes, moles and scarring), alcohol or drug use, and relevant health risks (e.g. allergies, immunosuppression, pregnancy). Artists must be vaccinated against Hepatitis B.

Tattoo stations should be treated as clinical areas. Equipment must be protected from contamination; inks must be decanted into disposable cups; distilled water used for dilution of ink and ‘green soap’ (a vegetable-oil-based surgical soap used in the tattoo industry) or for washing the needles between colours.

Dressings applied afterwards are usually transparent, self-adhesive, polyurethane film (known as second skin in the industry), similar to those used for burns and post-operative incisions, or cling film attached to the skin with surgical tape. Clear aftercare guidance should be provided verbally and in writing about how to care for the tattoo whilst it heals (no swimming, spa pools, sunbathing, perfumed soaps or scratching).

Unlicensed Tattooing

Although it is illegal to tattoo in unlicensed premises, this is rarely enforced. Anyone can buy machines and inks online and tattoo friends at home, often with limited knowledge of hygiene.

Inspections across the UK vary, with some councils inspecting only once when the studio opens, while others do so more regularly. Licensing rules differ widely outside the UK. Excellent tattoo studios can be found abroad, but so too can be deplorable hygiene. Getting a tattoo may be a more permanent souvenir of a fun holiday than a fridge magnet, but it can be risky, and alcohol and sunshine don’t help healing.

Final Thoughts

Tattooing in the UK, when performed by licensed professionals, carries a low risk of infection. I believe the demand for tattoos will grow, and I support nationally enforceable, pragmatic safety standards.

Takeaway messages:

  • Tattooing by licensed professionals in the UK is low risk
  • Nationally recognised training and regulation are likely to emerge
  • A tattoo is a controlled wound—so please, as I once observed, don’t let your dog lick it

References

  1. YouGov 16 July 2024: When it comes to tattoos, which best applies to you? | Daily Question
  2. Kondakala, Sandeep et al. Microbiology of tattoo-associated infections since 1820 The Lancet Microbe, Volume 6, Issue 4, 101005

Training For Aspiring Tattoo Artists:

After two years in the tattoo industry, I now work with licensed tattoo artist, TomCatTatt, to provide introductory training for aspiring tattoo artists, covering the basics in safety and hygiene, legislation and licensing, and an introduction to tattooing techniques. Contact me for more information: julieru13@hotmail.com.

All opinions in this blog are my own

My Journey Into Self Publishing: What I’ve learnt getting my first book out there

girlymicro General, Writing , , , , , , , ,

I’ve just dipped my toe into the world of self publishing, so I am far from an expert. That said, one of the reasons it took me a while to move from ‘that is something I’m interested in knowing more about’ to ‘screw it, let’s just give it a go’ is because there is a lot to think about, and there are a lot of options. I thought it might be useful therefore to pull together some of the components that came up for me in an effort to pay it forward, so anyone else thinking about taking a leap can start a little further ahead than I did.

Fair warning, this is a long one as there’s a lot to cover.

The first thing to say, and this now sounds horribly naive, is that I thought that the writing would be the hard part, or the bit that took up most time. How wrong I was.

Do your own research

Before I properly kick off though, one quick word of warning. These are tips and reflections on the steps I took for the type and method of publishing that worked for me and the book I wanted to get out into the world. You will, of course, have your own aims, aspirations, and content type, so you will need to do research that links to the type of book that is in your mind. I found that there is all kinds of great content out there, but it is a bit like a jigsaw puzzle you need to put together to match your own personal needs. I would start by working out what personal resources you already have available to you, then go on an active search for the rest.

Places to consider accessing information include:

  • YouTube
  • Blogs
  • Websites
  • Books
  • Social media
  • Phone a friend

I am really fortunate to have a number of friends who have either written and published books, or who work in/with the publishing industry, and so the phone a friend option was particularly useful for me. I’m hoping that by writing this blog I am helping to pass that good fortune forward to support others.

Even without the assistance of someone who has greater knowledge than you in your friendship circle, I found places like YouTube a great way of learning some of the key phrases and structural terms that then enabled me to move onto more targeted research via other sources.

Writing is the easy part

I don’t know if I’m fortunate or cursed to live with a mind that constantly requires distraction or something challenging to process, but one advantage of it is that I will often arrive at an idea pretty fully formed as I’ve been putting it together in the back of my mind. That means that one day I just woke with a 40 chapter structure for a book that remained pretty much unchanged, even as the word count developed.

Even with this though, in my project plan most of my time was allocated to word count and far far too little of it was allocated to the other tasks. Partly this was because I just had no idea how long they would take in practice until I came to do them. In hindsight though, I think there was a fair amount of denial and ostriching as it was these other parts that triggered my anxiety and fear linked to not really being comfortable with the process. This denial got me to the finish line, but I think the whole book preparation would have gone more smoothly if I had focussed on my discomfort rather than the comfort zone that was the writing process.

What are you planning to publish?

Talking of your project plan. There are some components that it is really helpful if you make decisions about early, as they will impact not only your workload and structure, but also whether self publishing is the right route for you.

The first of these decisions is whether you are working towards a fiction or non-fiction book. I don’t think I’d ever sat down and made a list of the differences between the two until I started to plan both types of content.  The first obvious difference is in the type of the content itself, but beyond the actual words, which may have legal and other impacts for non-fiction, there are differences in everything from word count expectations, to paper type, and book size, if you are thinking of including print versions.

This then brings you onto deciding what kinds of formats you are planning to publish in:

  • Ebook
  • Print:
    • paperback
    • hardback
  • Audiobook

Now, I haven’t done an audiobook so I’m not going to talk too much about that here. For the other format types it’s key to know what formats you are aiming for as this will dictate all of the formatting, cover and costing decisions you will make moving forward. That said, just because you decide to aim for more than one format it doesn’t mean that they all have to come out simultaneously. You could decide to aim for an Ebook first, with a plan to bring print editions later on.

It is worth doing some bench marking with similar book topics at this stage, not because you have to do what everyone else does, but because it can give you some parameters to work with and mean you feel less overwhelmed by the number of decisions you need to make. I ended up launching all content type pretty simultaneously, as that’s what worked for me, you may choose to take a route that is kinder to yourself and launch them in stages. For instance you may launch your Ebook first so you can incorporate feedback before you move to print editions.

What are your success criteria?

The other key thing to do at this point is to decide what does success look like for you? Almost all of your next steps and decision making will depend on what success looks like and what it is that you are wanting to achieve.

No one can tell you what the answer to this is as there are many different reasons people decide to write books, all of which can be valid:

  • To educate and inform
  • To raise awareness of an issue/topic
  • For financial reasons
  • To improve the authors profile
  • To entertain
  • To process experiences
  • To tell a story
  • To connect with others
  • For career development
  • To inspire/empower

Once determined your success criteria should play a big part in determining your approach. If you want to make money or sell thousands of books then you probably need to aim for a traditional publishing approach, and this will then impact the kind of topic that you might choose. If your aim is to get something out there for low cost or in a relatively niche topic, the self publishing is probably a way forward.

You need to be realistic with what you are aiming for. For instance, my book topic is relatively niche as it’s linked to post graduate study, and when I did my research it looked like I could expect to sell 2 copies a month based on amazon purchasing number (I used Book Bolt on free trial to run the numbers). My goals and expectations were therefore based on those figures. My initial goal was to sell 20 books in a year, with stretch goal of selling 60. My success criteria have never been about selling huge numbers or making money, but about finding a different way to support the Girlymicro community, and therefore my goals match that. What’s happened in practice in that I’m over the moon to have reached my stretch goal in the first six weeks since publication, but I am also aware that those numbers are likely to drop off and I can’t use them to continue to judge how well the book has landed. If you don’t want to be disappointed it’s important to choose the right success criteria to match your driver for publishing in the first place.

Traditional vs self publishing

Once you’ve decided what it is you want to write, why you want to write it, and what success looks like, then you need to choose your next steps. The biggest of which is to decide whether to pursue traditional publishing or go for self publishing. Now, don’t get me wrong, both are a lot of work and require a lot of prep, but the steps are very different.

For traditional publishing you will need to start to put together a proposal, which for a fiction book will include the entire manuscript of your book plus some additional information. For a non-fiction book it will usually include at least 2 chapters and chapter outlines with descriptors for the rest of your content, plus information on other things you have written, target audience, and other books on the market taht could be used as benchmarks. The aim is to get an agent who will then pitch your book to a publisher, although for some markets you can approach a publisher directly, who will then take care of onward processes such as editing, formatting, cover production. A lot of the non-writing work is therefore forward loaded. There’s lot of advice out there on how to put together a book pitch and there are websites such as Query Tracker that can help you in finding agents to send your pitch to. For fiction this is still a mainstay of publishing, especially as you are wanting to reach wider audiences and have your book available in book stores and libraries.

In terms of self publishing, a lot of my reading indicates that up to 90% of non-fiction books now go down the self publishing and print on demand routes. Non-fiction book deals either tend to be books that have wide audience appeal, such as general popular science books, or have authors with a pre-established audience, think influencers with a million+ followers. So, although it may be worth your while pursuing a traditional publishing approach, it is well worth considering exploring the self publishing route. The down side of this route is that there a lot of tasks that you will need to organise yourself, which would have been taken care of if you’d traditionally published, so be prepared for a steep learning curve.

One extra thing to think of is how strong is your vision is. If you go down a traditional publishing route there will be co-development of your concept with a number of stakeholders. This will make the idea better, but you need to be prepared to hold onto your concept loosely, especially as a new author, and so it is worth considering this aspect of development as part of your decision making. If you go down the self publishing route you will have to fight harder for the credibility that is given to traditionally published authors however, so both routes have pros and cons to consider.

What kind of content are you planning to include?

OK you’ve decided to go down the self publishing route but what does this mean for your content? Content restrictions weren’t something I had considered when I started drafting It Shouldn’t Happen to a PhD Student, and so I included a load of exercises to support the word count that included tables and other non-text formatting. When I then started to format however, I discovered that the templates are set up for text alone, as novels only include text content. This seems obvious in hindsight I guess. That meant that when I undertook my final formatting I ended up removing this content and setting up a new web page on the girlymicrobiologist.com blog in order to host it, as it felt that it was still important to have. This was a lesson for me in how important it is to consider what type of formats are needed to support your content and embed these considerations from the start, rather than finding an eleventh hour fix.

Books by Girlymicro

Having discovered the format restrictions of book based content I’ve been thinking of maybe putting together an academic journal set of content that can sit alongside the book in order to host some of these exercises, but that requires finding a whole different set of templates or learning waaay more in order to set ones up myself. Honestly I’m not sure I have the mental energy for that right now. One of the things this experience has taught me is to think hard about the payoff for any energy you will need to expend in order to make something happen and be conscious in your decision making and energy allocations.

Choose your budget

Another thing to consider is that there are many ways to accomplish the tasks you will need to tick off in order to self publish, and the decisions may be more complicated than you think. There are a number of steps, each with a number of component parts, all of which could be outsourced, semi-outsourced, or managed by you:

  • Editing
  • Cover
  • Formatting
  • Marketing
  • Printing
  • Publishing
  • Book coaching

If you decide to outsource all of these stages, the process of self publishing could, in fact, cost you thousands of pounds. If, like me, you don’t have thousands of pounds just lying around you may need to think carefully about what you can spend, and on what you are prepared to prioritise spending money on.

https://reedsy.com/blog/guide/how-to-self-publish-a-book/cost-to-self-publish/

I didn’t really have a budget for publishing It Shouldn’t Happen to a PhD student, as I didn’t have the disposable income, even so publishing the book ended up costing me several hundred pounds. Costs included things like buying ISBN numbers as I didn’t want to be completely tied into Amazon as a platform. In addition to direct book costs, you need to think about how you will get the word out there or build your community. For instance, many people aren’t aware that running this blog costs rather providing income, with a few hundred pounds a year in outlay to cover hosting costs, email address etc*, which although not directly book related is the reason the my book came into existence. This can all be important to bear in mind when looking at costing your book, and thinking about marketing exercises such as book launches, as you will have to buy in copies of your book, spend money on food etc, all of which adds to your initial outlay.

If you do have personal budget that you are prepared to invest then it is still worth being discerning with how you invest, and especially being aware of predatory publishers. There are plenty of people out there who will take your money, but spending time to look at freelancers who will undertake components is probably better than paying someone £5000 who offers to do it all, especially if there is limited evidence of what the output would look like. Just like in scientific research, predatory publishers exist, and it is important to have undertaken sufficient research to invest your money well.

*NB a good friend mentioned to me that I don’t advertise the fact that you can help with the costs associated with running this blog through a variety of options, from supporting the annual fees (mentioned on the top of the homepage where is says gift the author a wordpress.com plan), buying me a cup of tea as mentioned on the bottom of the blogs by theme page, or even engaging with my new Patreon page. There you have it, I shall swallow my pride and share the details with no expectations or requirement for anyone who might be interested in offering a helping hand.

Where are you planning to sell?

A number of your outlay and pricing decisions will be linked to how and where you wish to sell your books. Obviously, if you are traditionally publishing, all of these options are somewhat easier as they will try to make sure your book is widely available. If you are self publishing you need to decide yourself where it is that you are prepared to sell. Some simple choices, like whether to use a free Amazon ISBN or buy your own, will have significant impacts on subsequent onward options. If you use a free print ISBN from Amazon, then it limits you to only selling on Amazon. Deciding to invest <£100 on ISBN numbers for each of your print editions means that you can choose to sell on different platforms in addition, but also has requirements about providing editions to the British Library, meaning you have to buy the print copies to send off and pay for postage. If you want your book to be in libraries you also need to select these options on your print on demand platform, but they are much less likely to be taken up than if you were going down a traditional publishing route. There are no right or wrong decisions here, only the decision that is right for your success criteria and the audience you are trying to reach.

If you are happy to go down the print on demand route, there a number of different free options available to you:

The best option will depend on what you are publishing and the countries that you are hoping to publish in. It is worth bearing in mind that some platforms (such as KDP) require you to give exclusive rights for you to be involved in certain marketing options, such as signing up to Kindle Unlimited. This may expand your reader market but will tie you into a specific platform. There are also paid for distributions platforms that you could utilise if you have decided to allocate budget in that direction. Of note, there are some interesting YouTube videos out there where authors compare how much they sell across different platforms which can help you make decisions. Utilising multiple platforms requires you to invest energy across multiple formats, and so it is also worth being honest with yourself about what your energy budget is before committing to more than one, even if that might restrict your sales.

Finding your templates

I’ve talked about deciding on your content, and that’s because formatting is time consuming and essential. You may be a wiz at this, in a way that I am not, but if it doesn’t lie in your skill set then being able to access and utilise pre-existing templates is key. Even this can be a mine field though as there are both free and paid for versions available to you. You also need to know a number of things before choosing your template i.e. is it for print or Ebook, as the templates are very different, but also what size of book are you aiming for, as your paperback version will be a different size to your hardback. I did a bunch of research into what are the most common book sizes for non-fiction hardback and paperback versions, but even this changes by country, so you will need to look into what works best for you. I ended up going for 6 x 9 inches for hardback and 5.5 x 8.5 for paperback.

Having tried a few different options, these happen to be the best templates that worked for me and my brain, you may find others work better for you:

Print templates:

https://kdp.amazon.com/en_US/help/topic/G201834230

Ebook templates:

https://www.amazon.com/Kindle-Create/b?ie=UTF8&node=18292298011

Even with the best templates there is a good deal of fiddling once you’ve imported your content, so make sure you leave plenty of time for this part of the process. I didn’t and it meant a number of 14 hour days whilst on leave trying to ensure I could keep to my self imposed deadline.

Choosing your pricing

I, misguidedly, thought I could price my book at whatever price point I fancied, but rapidly learnt that this wasn’t the case. All of the free self publishing platforms take a cut of any print on demand book, which is how they cover their costs. Everything from number of pages to paper type will impact on what your minimum cost point will be. For Ebooks, if you want your book included in schemes, like Kindle Unlimited to maximise your reach, you will also need to have minimum pricing levels. This is one reason why you need to have decided on where you want to sell and some of the book details before you start to think about pricing. Think about the fact that certain paper types are used more commonly for certain book types, and that choosing between them will impact on cost.

Helpfully, you can use things like the https://kdp.amazon.com/en_US/royalty-calculator in order to play around with likely book parameters to start to think about what your pricing range might be, even before you have fully completed the templates, to know what the final page counts look like. I have included a random example below so you can see the type of information required:

Once you have entered the information, the royalty calculator will tell you what the minimum price point will be, and from that you can think about what price you may need to charge to cover your costs.

If, like me, you are publishing not to make money but merely to cover costs, you should think about charging minimal amounts in order to maximise accessibility for those who may benefit from your book. If you have spent more on bringing your book to market, you are also likely to need to charge more in order to make your accounts balance. This is another reason why I invested my resources in terms of time rather than financial, as I didn’t want to have to charge more which could limit the book reaching those who would benefit most. This aspect may be less relevant to you, depending on your reason for publishing in the first place and so costing is a personal choice.

The book blurb

Once you have your book written, one of the final steps is thinking about what you are going to write on the back cover in order to help it reach its target market. I found this part, well to be honest the cover in its entirety, a bit of a nightmare. So these are the points I thought about when deciding what to write:

  • Keep it 150–200 words — short enough to hold attention, long enough to inform
  • Write in the third person to help you connect directly with the reader
  • Test different versions — your blurb is a sales tool, not just a summary, no matter how uncomfortable that feels

Think about your structure:

  • Start with a hook
    • Open with a single sentence that speaks directly to your reader’s problem
  • Identify the reader’s goal
    • Show you understand their challenge or aspiration. Use empathetic, relatable language and speak to how you will address it
  • Give your unique selling point
    • Briefly explain what your book delivers and why it’s different
    • Be specific
  • Build credibility
    • Mention relevant credentials, or experience
  • Give a taste of what’s inside
    • List 3–5 bullet points of key takeaways
  • Finish with an invitation or call to action

You can then also use this to help write the wording you will need for the websites you are selling on as an expanded version, and even use shortened versions of it as part of your marketing tools, such as on postcards.

Recognise the skills you have and the skill you don’t

The biggest aid in all of this planning was to be very honest with myself about the skills I have and the skills I don’t have. I am not artistic in any way, and so I knew that I would struggle with not only cover formatting, but with cover design. I know that I am able to utilise a word template, but that I don’t have the skills to make a word template. I know that editing is not my thing. All of the components that I recognised as weaknesses I actively sought out support in order to help me address. I roped in a number of people to help with copy editing, including Mummy Girlymicro. I roped in Mr Girlymicro, who is a keen photographer with an artistic eye, who worked with our good friend who works in book design and publishing Alice Wallace, to help with the cover. I found templates that made up for my lack of formatting and design skills for the internal contents. I was prepared to be honest with myself about where I fell short, and I invested time in learning what options were available to compensate. All of these weaknesses could be countered by outsourcing, but that wasn’t a financial option for me, and I feel that I’ve learnt so much in going through the process and the discussions. Something I would have missed out on if I’d paid a third party. That said, the learning feels worth it for me as I have plans to get more books out, if you have budget and you are only doing this once the decision making is likely to be different.

Find your cheer squad and support team

All of this brings me onto the importance of finding your cheer squad. I spent a lot of hours and a lot of leave on turning an idea into reality, and you can never do it alone. I used my ‘phone a friend’ system, my network, and my family, all of which helped with getting this project across the line. They helped me not only with the technical aspects, but also in managing the emotional aspects. There were a lot of highs and lows. To be honest there still are. Putting yourself out there always requires a certain level of bravery. It is always easy for people to find a way to criticise, or use this as a way to comment or target what you’ve tried to achieve. The other side of this coin though is how wonderful it is when people get behind you, cheer you on, and take the time to invest in you and your concept. When people came out for my book launch it meant the world. No one has a lot of time or money right now, so anyone investing in something I care about has such meaning, and makes the whole thing worth it. When I hear negativity, it is that which I focus on to aid in processing my responses.

The nightmare of a cover

Now, I’m just going to use this section to give the biggest ever thank you shout outs to Mr Girlymicro and Alice Wallace. I genuinely believe that there is one part of this process that I couldn’t manage, even if you gave me a month of full time capacity to play with it. I’m talking about The Cover! I’ve attached the guide link below, but even with this I don’t think I could have achieved it. It is the one part that I just couldn’t get my head around.

https://kdp.amazon.com/en_US/help/topic/G201113520

There is so much maths involved, let alone the actual design process. That maths changes based on the precise number of pages, but also what those pages are. Can you believe that cream paper is a different thickness to white. I had no idea.

I mention this in order to be transparent that you too may hit certain components that you just can’t get your head around. That’s OK, you can’t be good at everything. More than that, it’s OK to have things that just fill you with so much anxiety that you can’t face them. For me that was the cover, for you it may be something else. The main thing is to have a plan in order to counter these obstacles before you get to the point where it will impact on your delivery.

The submission process

Once all this is done, it is time to submit. I had thought this process would be much faster than it was, and so now I’ve done it I would recommend allowing at least a month window between submission and having any marketing or other components planned. Nothing is immediate. Once uploaded, and this in itself took a number of attempts, all versions need to be checked out by the platform you upload to. For print versions you will also want to build in time to order proof copies (which will need paying for) in order to check you are happy and that your formatting has worked before you release them out into the wild.

My top tip for this stage is to have pre-completed the boxes and info where possible in order to allow you to focus on just the upload when the time comes. This means that fairly early on in the process you want to have set up accounts, provided registration information, undergone identity checks, so that you can start you populate the appropriate pages. I would do the account setting up as part of the research phase of your book development.

Bits I hadn’t thought about

There were several things I had not even thought about before I started this process. For instance, I didn’t know that you had to buy ISBN numbers, let alone that you need one per format and one per edition, and so you can end up needing to buy quite a few. You don’t need an ISBN for Ebooks but if you don’t want to be tied to Amazon (who will give you a free one for use on the Amazon platform) then you will need to buy them for your print versions from here (if UK based) https://www.nielsenisbnstore.com/.

This brings me onto another thing I didn’t realise. If you have a print book you will need to submit a copy to the British Library within a month of it going live for sale. This will require you to have a copy to send and to pay for postage. They may also request that you send 5 copies to a separate address which means they can then be considered for purchase by libraries. All of which is great, but will require you to have brought enough books to post and has cost implications.

Other outlays I hadn’t thought about were the fact that you need technology to sell books, by this I mean the ability to take card payments. This one completely passed me by until Mr Girlymicro mentioned it, and then thankfully he spent a bunch of time looking at how to make it happen before recommending something. He ended up recommending Zettle, which has worked really well. Again, there was no point in spending a lot of money on this as I wasn’t planning on going to book fairs and selling thousands of copies, however it did mean I could sell copies of my book at the book launch, which made the expenditure worth it.

Finally, I was so focussed on getting the book out there that I don’t think I’d prepared myself for some of the commentary. Now, I’ve been really fortunate so far that almost all of the comments have been positive, but there have been some people who I felt were less happy about me a) getting a book out there and b) it being well received. To be honest the same has been true about this blog on occasion. Questions such as why you? Why should anyone care what you have to say? Don’t you have better things to do with your time? Nothing is going to be universally well received, and at some point someone will no doubt put up a review that breaks my heart. That doesn’t make the endeavor any less worth while. It is better to have something real out there that can support people than wait until it reaches a point of perfection and not putting something out for years. Nothing will please everyone, and so being prepared to cope with critique thrown your way is something to be prepared for.

The discomfort of marketing

Once the book is live is to a certain extent when the real work actually starts. There is no getting around the fact that if you want your book to reach the people it could help or who will find it interesting then you are going to have to tell people about it. It is not comfortable but you have to channel why you decided to do this in the first place and focus on that to overcome the discomfort.

This is one of those things that if you have gone down a traditional publishing route may have been more supported but you would still be expected to drive sales on your own. Make sure that you have an idea of where to show content on social media, make accounts if you don’t have them. Think about using stores like Vistaprint to print postcards, book marks, and in my case giant foam boards of my own head, to help with advertising. Again, this is an initial outlay to be aware of. You will also need to buy a number of copies of your own book so you will have some to sell, and that requires thought as you don’t want a hundred copies that will just sit around and do nothing, so how many is enough?

Think about having an event to kick off and celebrate that you have turned a concept into a reality. I was so worried about having a book launch, but it was actually just a wonderful event. It felt so lovely to see people hold physical copies of the book in their hands for the first time and see their reactions. You can also see the people who are really there to show up for you, and it’s a great way of giving back and thanking the cheer leaders who’ve supported you along the way. Note of caution, this is another one of those things that is lovely but will also cost you money, so be prepared to outlay a few hundred pounds if you are going to do it, as you will need to pay for everything from books to catering.

If you have budget, this is another area where you can choose to invest. There are places on the Kindle Direct Publishing page for your book where you can choose to pay money to have your book featured, social media pages will let you run adverts, and you can even pay companies specifically that do this kind of work. I don’t have the budget to go down that kind of route but if you choose to give it a try let me know what your learning and advice is and I can share in a future post, or better yet write me a guest blog.

The long and short of it is that your book won’t reach the people you’ve written it for if they don’t know about it, so suck it up buttercup and get your marketing hat on. No matter how uncomfortable it makes you, and it makes me very uncomfortable, there is no getting around it. If you can find friends and/or champions who will talk about it on your behalf that is a life saver, but you will not be able to avoid putting yourself out there. You wrote a book for a reason, this is the time to remember that reason and step out bravely in order to make your success criteria happen.

In that vein, if you want to check out the final version of my labour of love, you can find the link below:

All opinions in this blog are my own

Environment Network 2025: Investigating Environmental Outbreaks

girlymicro General, Guest blog, Healthcare Science, Microbiology (Clinical) , , , , , , , ,

It’s the most wonderful time of the year! It’s time for the annual Environment Network meeting, where we get together to talk all things environmental microbiology; sharing new research and experience to improve practice. And your guide for the conference this year, live blogging the morning session, is the token immunologist in the group, Dr Claire Walker.

What is the environment network?

Before we get onto todays’ content, a little introduction to what the Environment Network is.

The Environment Network works to support people in clinical, engineering and scientific roles who are interested in environmental infection prevention and control (IPC) and/or the built environment

Do you want to know more about what to do with your water screening and air sampling results?  Are you keen to understand the evidence behind equipment cleaning and the role of the environment in healthcare associated infection?

Then welcome to the Environment Network! 

This is a network for people in clinical/scientific/engineering roles within the NHS and other associated organisations who are interested in the role of environmental infection prevention and control in preventing infection. 

The aim of the network is to support infection prevention and control professionals involved in commissioning, environmental audit, water, air and surface testing within their Trusts.  By working together we can share best practice between Trusts; as well as circulating the latest evidence and discussing personal experiences. 

What are the aims of the network?

  • To support the development of member networks
  • To provide events where shared learning can be supported
  • To permit sharing of experiences and best practice to improve clinical interventions
  • To support and share research in order to achieve improvements in evidence based practice

What is our remit?

  • Environmental testing and monitoring within healthcare environments
  • Environmental audit and risk assessment
  • Surface decontamination
  • Ventilation within healthcare environments
  • Water management within healthcare environments
  • Environmental outbreak monitoring and control

Check out the website for more details: https://environment-network.com/

On to today. First up we have Gavin Wood, an authorising engineer for water who acts as an independent advisor to Trusts. He is covering the fascinating topic of water associate outbreaks and what we can ask of our water safety groups during an outbreak. There should always be a policy which covers how to organise the estates teams and the water safety groups – covering who is responsible for each area during the outbreak. Regular outbreaks are caused by organisms like Legionella and Pseudomonas, but might include non-tuberculosis causing mycobacteria. Detection of these organisms during routine screening is reported to the water safety group to assess potential risk. Most pathogens that we look at will grow within a certain temperature range, so maintaining cold water as cold, and hot water as hot is essential. What we really don’t want is warm water stagnating in the system as the pathogens can thrive in it. On top of this, we need chemical control of organisms – mostly silver and copper ion systems. Stagnant areas of warm water are pockets where the pathogens might thrive so flushing the system and chemical controls are key in maintaining a healthy water supply in hospitals. Controls that are effective for indicator organisms that we routinely test for, like legionella, tend to be effective for any other outbreak organisms. In an outbreak situation the first port of call is the Legionella risk assessment which considers the efficacy of temperature and chemical control. After this, in line with guidance, all trusts should refer to their Water Safety Plan which is contains the detail on actions to take when results are outside the expected limits. Most of the time the authorised engineer already has the answers because the system is repeatedly routinely tested.

Like any system in a hospital, it is vital that the risk assessment and training is up to date. As Gavin says if we haven’t covered everything in the risk assessment, and if the water policy hasn’t been recently reviewed then the whole system is vulnerable. External audit by authorise engineers ensures the system remains optimal. Investigation of an outbreak focuses on the patient pathway – where has the visitor or patient been on their journey through the hospital. This process finds the clues to identify the source of the environmental outbreak. Surprisingly one of the main pieces of evidence comes from review of training and competence records, is everyone appropriately trained and acting in accordance with policy. If in doubt, going an witnessing monitoring and maintenance tasks can provide essential information in a high pressure outbreak situation. Gavin drives home how important practice is in this – we need this information as much on a random rainy Tuesday as much as we need it during a Legionella outbreak!

Our next talk comes from Karren Staniforth from UKHSA. She is a clinical scientist and UKHSA IPC specialist adviser, and is talking to us about the pros and cons of different outbreak investigation techniques. Karren invites us to imagine painting a busy ward in different colour 10cm squares, every single surface with a cotton tip swab. Imagine how long that could take and just how many squares you would end up with! Even if you took 200 samples, how many squares have you failed to test? Usually we can only take 20-40 samples…. So even if they all come back negative, it doesn’t necessarily mean there isn’t an organism there – its just that the sampling didn’t find it. The chances of going in and finding nothing is quite high, but if you put a patient in that room for a week, they will almost certainly find that organism (not that we recommend that as a testing method!).

Karren reminds us that reading environmental plates is quite an art and different from clinical samples, it’s a different skill and guidance from experts is essential. Clinical diagnostic laboratories aren’t accredited to process environmental samples and the staff aren’t trained to process and analyse this work. Commercial companies can come and do testing for you, and they are extremely good at routine work. Bespoke work is harder to commission, and that’s where knowing the network can really help! So if you have an outbreak of something unusual, it’s hard to find the information on what level of environmental organisms – like aspergillus – are ok, and what constitutes a danger to patients.

The questions becomes, what type of samples do we want to take and why? We need to understand basal levels of indicator organisms to work out when to act. Building on what Gavin has shared this morning, you need to look – really look- at what is happening in your environment. Karren reflects on how useful an audit can be but we don’t go into an outbreak with the information already in front of you, so your audit probably won’t ask exactly the right questions. Epidemiology provides the answers – which organisms and then which patients are affected, where and when? Identifying common exposures can be easy when infections match case distribution e.g. sequential patients with the same infection in the same room. However some are less obvious like laundry delivered to multiple sites causing infection clusters which are miles apart or commercial products that might only impact high risk patients in very low numbers, but at multiple sites across countries. This can be exceptionally difficult to trace. Though remember not every exposure results in colonisation and infection, and even if exposure is universal some patient groups are more likely to develop infections than others.

Knowing what kind of sample to take is essential, especially when sample numbers are limited. Negative results can be just as useful as positive results – and identifying the source of the outbreak is as much detective work as it is learning to read plates! Karren reminds us – ‘You don’t always need sampling, somethings are just WRONG!’.

To close the first session, we have Louise Clarke who knows everything there is to know about proper ventilation. Ventilation is essential the movement of air within a system. The law tells us we must provide ventilation under the Healthy and Safety at Work Act, and building regulations set a minimum standard for ventilation. The main reason for good ventilation is to have a safe and comfortable environment; to remove odours, to control temperature and importantly to protect from harmful organisms and toxic substances. We have natural ventilation (like opening a window!), mechanical ventilation which pushes air around the building and a mixed mode – a combination of the two. The preferred method for ventilating a hospital remains natural ventilation, something which really shocked the group. It might work well on a windy day but it certainly doesn’t cover all areas and some times of year, like winter, it’s really no good at all.

Like Lou says, simple is best. When we talk about ventilation, we need to ask what is the issue we are looking at? Human elements are usually a key element to understanding problems in ventilation – you need to think about when the issue arose and who was involved? Often there is a significant time lag between the problem starting and it’s detection in real time. You can be left scrabbling around for details long after the issue began. Lou walked us through the potential information sources to considering during an outbreak, including design records. Which tend to be a little less useful than you would imagine, considering they often tell you the purpose the room was designed for 30 years ago – perhaps not so relevant now! Echoing the sentiments of Karren earlier, one of the most important things you can do is go physically and take a look – not an audit, just turn up and use all your senses!

To kick off the session after a much needed cup of tea (Earl Grey, hot!) we have Dr Mariyam Mirfenderesky who is talking about the challenges of managing fungal outbreaks. Candidozyma auris (note the new name!) is probably one of the most difficult outbreak causing organism to manage. To help with this a Clinical Expert Reference Group was established in March 2025. Candida species are the dominating fungal pathogens of invasive fungal disease and account for >85% of fungaemia in Europe and the United States. Candidozyma auris was first identified in 2009 from a Japanese patient with ear discharge, and is a critical WHO priority fungal pathogen. It is fluconazole resistant and has a propensity to cause healthcare associated infection outbreaks. There are 6 independent clades, with clade 1 dominating in England. Mariyam walked us through the identification of the first neonatal case of C.auris from an eye swab – it was found in two infants, five weeks apart with no direct contact between the children. Fortunately both were colonisation with the fungus only. She then discussed the safety measures that should be in place to manage this difficult pathogen – particularly focusing on why the current cleaning protocols are insufficient to manage this threat. Her final points considered how to act when you detect C.auris – you must be decisive and act!

If you’d like to know more about C. auris, check out this blog post from earlier this year:

Candidozyma auris the New Kid on the Fungal Block: What is it and why should we care?

Next we have Dr John Hartley who is talking to us about investigating environmental surface mediated outbreaks – what you can’t see may still hurt you. Using the classic movie ‘the fiend without a face’ as a metaphor for IPC, John introduced the idea of modes of transmission between individuals. It feels like a simple problem, its just cleaning and handwashing after all! But we see there is a complex person-organism-environment dynamic system, and as John says, there is always a well known solution to every human problem – neat, plausible and wrong! John highlights the importance of continual surveillance and knowing ‘where the fiend is’. The controls are based on a four pronged approach – clean, replace, destroy or rebuild.

By way of a case study, John told us about his experience of managing adenovirus outbreaks in a paediatric BMT ward. This is a very common virus causing 5-10% of febrile illness in early childhood. Almost everyone has had it, and it can establish latency which can reactivate during BMT. More often it causes severe morbidity and mortality in these patients who can develop hepatitis. What you can’t tell is if the child caught adenovirus from the environment or if it has reactivated post latency. However, whole genome sequencing (WGS) can resolve 1-3 SNPs across genomes – its not like looking for a needle in a haystack, its rather like looking for a needle in the whole of Texas. But WGS can be used to confirm or refute cross infection events.

Of course the next question is, what can be done? Visual assessment is not a reliable indicator of surface cleanliness, John described the varied methods which can be used to detect adenovirus. Then we need to develop the right tools to manage it – including development of environmental PCR as a measure of cleaning efficacy by GirlyMicro herself! Finishing on a Dr Who reference to delight a crowd of scientists is always a win – even if it is comparing adenovirus to the scariest episode, the weeping angels! Of course, when monitoring adenovirus, the most important advice is ‘Don’t Blink’.

To close the morning session we have Dr Sam Watkin discussing research tools to help predict the future of outbreaks. Sam began acknowledging the current challenges facing preventing transmission of environmental organisms. In his PhD he aimed to identify how microbes disseminate through the clinical space, if the starting contamination site determined how is was disseminated and if the usage of space influenced microbial transmission risk. IPC is often retrospective to the aim was to develop research tools to allow the development of prospective knowledge. Sam used cauliflower mosaic virus DNA markers as a surrogate for pathogens, and followed its movement around two different units. It was shocking to see how far this benign organism could spread in such a short time.

I think if we take away anything this morning it’s that nobody likes the new name for C.auris, and death, death to recirculating air conditioning units!

The morning was followed in the afternoon by a series of case discussions in order to help implement the learning from the morning, help everyone get to know each other, and support the sharing of peer to peer learning. The case discussions this year included:

  • Case discussion one (Facilitated by Dr John Hartley):
    • Seek and remove: approaches to source control for environmental surface mediated outbreaks
  • Case discussion two (Facilitated by Professor Elaine Cloutman-Green):
    • How to implement a multi-disciplinary approach to investigation of water borne outbreaks
  • Case discussion three (Facilitated by Louise Clarke):
    • Interpretation of ventilation data and applying it to ventilation risk assessments
  • Case discussion four (Facilitated by Dr Sam Watkin):
    • Determining the role of equipment in outbreaks: how do you investigate?
  • Case discussion five (Facilitated by Karren Staniforth):
    • Introducing new cleaning process: what should you consider?
  • Case discussion six (Facilitated by Dr Claire Walker):
    • Choosing new equipment and furnishings: what questions should you ask?

It was truly inspiring to hear the buzz in the room that all of the discussion created. Thank you to Mr Girlymicro (Jon Cloutman-Green) for being in charge of photography, and to all of our speakers and facilitators for making the day happen. Also, massive shout out to Ant De Souza for pulling the day together, Angela McGee for making sure we all turned up to the right place at the right time, Mummy Girlymicro for running the reception desk, and to Richard Axell for supporting all of the tech on the day.

Now it is all over, the only thing to do is to tap our feet until we all get to meet again in 2026, although the presentations and discussion sheets should go up some time during 2025. Until then however, if you want to know more either head to the Environment Network website to look at info from previous years, or read some of the other blog posts linked to environmental IPC down below.

Environment Network 2024: Environmental risk assessment what do we need to know?
Environmental Matters: Why are environmental risk assessments so tricky?

All opinions in this blog are my own

Guest Book Review: “It Shouldn’t Happen to a PhD Student” by Professor Elaine Cloutman-Green

girlymicro Academic Life, Book Reviews, General, Guest blog, Writing , , , , , , , , , , , , , , ,

I must admit I shed a bit of a happy tear when this arrived unsolicited in my inbox, it’s been a bit of a week. My next thought was that there is no way I could share it, as it would be the epitome of self promotion, and that’s never considered to be a good look. Then I sat and thought, what would I advise a friend to do if they were in the same situation and I decided something. I decided to be proud of what I’d achieved. To be proud of the hours spent to achieve the output earned, and to be proud to have someone so invested they would take the time to write an unsolicited review for this blog. I know that is what I would advise and hope that all of you would do, and so this is my moment I decided to model the advice I would give. We all have the right to own our achievements and not make ourselves small to avoid the commentary of others.

Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on turning criticism into a catalyst for change.

Full disclosure: I wasn’t invited to write this review, I insisted. I also haven’t been paid for it; quite the opposite, in fact. I went out and bought two copies of Professor Elaine Cloutman-Green’s book with my own money: one for me and one for my PhD students to share (or squabble over). And yes, I did get her to sign them. What can I say? I’m a lifelong fangirl.

Professor Cloutman-Green’s It Shouldn’t Happen to a PhD Student is a rare gem in academic literature a compassionate, wise, and profoundly practical guide that feels like a conversation with the mentor every research student wishes they had. Written with warmth, humour, and candour, the book demystifies the PhD journey from start to finish, transforming what can often be an isolating experience into one filled with clarity, community, and hope.

Elaine, known affectionately as my favourite Professor or the GirlyMicrobiologist, draws upon two decades of experience as both scientist and supervisor to craft a guide that balances rigour with humanity. Structured in three accessible sections; getting onto a PhD programme, surviving and thriving during it, and using it as a springboard for the future. The book serves as both a roadmap and a reassuring companion. Each chapter blends actionable advice with reflections that acknowledge the emotional highs and lows of research life, creating a tone that is both authoritative and deeply empathetic.

From the very first chapter, “Knowing Your Why,” Elaine invites readers to pause and reflect on their motivations, an exercise that sets the tone for the entire book. Rather than treating doctoral study as a mechanical career step, she frames it as a personal journey of purpose and growth. As she writes, “A PhD should be a step towards delivering on your aspirations, not just a title to put in front of your name.” It’s a line that perfectly encapsulates her philosophy that research is not about prestige, but about purpose.

What truly elevates this book above other graduate-school guides is its inclusivity and warmth. Elaine writes as a mentor who has seen it all: the sleepless nights, the imposter syndrome, the joy of a successful experiment, and the power of perseverance. Her anecdotes and checklists are peppered with practical wisdom not the vague “work harder” platitudes found elsewhere, but concrete steps to manage deadlines, develop professional skills, and build meaningful academic networks. The inclusion of “Top Tips” sections at the end of each stage provides digestible summaries that make the book easy to dip in and out of throughout the PhD journey.

And it’s not just students who need this book. Supervisors – myself included – will find plenty here that resonates. Elaine reminds us, gently but firmly, that supervisors are people too: flawed, human, and still learning alongside our students. Her reflections on empathy, communication, and shared growth are as valuable for those guiding PhDs as for those undertaking them. Every research group could benefit from having this guide on their shelf, it’s as much a manual for mentorship as it is for PhD survival.

Of course I must acknowledge my own bias, Elaine was my mentor during my own PhD, and many of the insights in this book feel like familiar echoes of the advice that got me through my hardest days. She taught me so much about science but more importantly that research, like life, is all about surrounding yourself with people who lift you up when you falter. It Shouldn’t Happen to a PhD Student captures that same generous spirit, showing that the best kind of academic success is shared success: when mentors and students grow together, celebrate each other’s wins, and keep curiosity at the heart of everything they do. Everyone deserves a mentor like Elaine someone who reminds you that with compassion, courage, and community, the PhD journey can be one of the most transformative experiences of your life. Oh, and she provides the most excellent of snacks, the occasional much needed gin and tonic, and a rousing rendition of ‘Drop it like it’s hot!’… but that’s a story for another time.

All opinions in this blog are my own

Halloween 2025: Let’s talk all things vampirism and infection

girlymicro General, Healthcare Science, Science Communication , , , , , , , , , , ,

I am not a big Halloween girly, to be honest I can take it or leave it because I’m mostly excited about the build up to Christmas. That said, what I do love are movies and TV, and despite never being someone who can tolerate a lot of slasher or gore based horror movies, I love a good vampire movie.

A lot of this may be because I enjoy the world building and lore that seems to be more integral to vampire movies and series. This is because, although they share some of the same rules, depending on how the world is built they always need to explain which of the nuance comes into play in that particular setting. It felt fun this Halloween therefore, to write a blog post that talks about some of those tropes when vampirism is linked to infection, and how those rules compare to the real world.

Common vampire tropes to be aware of and to bear in mind as you read on:

  • Experiencing pain or physical damage in relation to sunlight
  • Needing to consume blood as a protein source
  • Inability to eat or digest food other than blood
  • Avoidance of animals
  • Ability to influence humans to undertake acts that may be against their will
  • Violent reactions to garlic
  • Inability to see themselves in mirrors or via cameras
  • Death only by beheading
  • Death by wooden stakes
  • Damage linked to holy water
  • Aversion to signs of faith
  • Aversion to alcohol or drug use

Not all of these are present in every piece of world building, hence why I find the variety of vampire mythos so interesting. The choice of which ones go together combined with different origin stories and creation processes enable a pretty large tapestry to be created from some similar thematic components.

Mystical, infections or something else?

The place to start I guess is by discussing whether all vampire world building includes infectious transmission? And the answer is a definitive no. Sometimes the way that the creation of new vampires works isn’t discussed. Sometimes the rules about the underlying process is unclear. That said, the fear of becoming something new is a frequently used trope for dramatic purposes and so the process by which a human is turned into or by which vampires exist is discussed pretty frequently as part of world building, and from what I can see there are three main routes:

  • Mystical – some form of occult/magic/cause not routed in science
  • Genetic – vampires are born and exist as a stand alone species
  • Infection – transmission via blood or other infectious transfer, even if the agent is unclear or unspecified

Now, I’m not going to cover the mystical/magically as that’s not anything based in science and the science is what I’m here for. The other two, however, are often based (sometimes loosely) in science as they are often inspired by things that actually exist and so I’m going to talk about both of those in a bit more details.

Genetic

I’m going to kick off by talking all things genetics. There are an increasingly large number of vampire movies and TV series where the vampires that featured were born vampires. This includes movies like Abigail, Perfect Creatures, the finale of the Twilight series, but also TV series such as A Discovery of Witches, First Kill and Vampire Academy. Sometimes within these there are vampires that are made through other means (discussed below) in the same world. Often these genetic vampires exist as a separate species to their Homo sapien neighbours either openly or in hiding.

There is often much discussion about where the vampire myth comes from, and in many way these stories of genetic vampires who are birthed through a similar route to standard human deliveries, links in most with what is considered to be a real world inspiration for many vampire myths. The origin is thought to be linked to a rare inherited condition known as Porphyria, the presentation for which may account for for some of the common components of vampire portrayals.

Porphyria is a rare, inherited blood disorder that occurs when the body can’t convert porphyrins into haeme, a vital component of haemoglobin. The resulting symptoms vary depending on the type of porphyria. Acute porphyria presentations include symptoms such as gastro intestinal pain and symptoms like nausea and vomiting – symptoms that are often portrayed linked to vampires attempting to eat normal food. Whilst cutaneous porphyria symptoms include pain, burning and swelling in response to sunlight, skin fragility and a tendency towards skin blistering – all of which are frequently included as vampire responses to exposure to sunlight.

Porphyria
D. Montgomery Bissell, M.D., Karl E. Anderson, M.D., and Herbert L. Bonkovsky,
N Engl J Med 2017;377:862-872
VOL. 377 NO. 9

Interestingly, in some of the genetic origin vampire stories, the impact of some of the limitations of the lifestyle limitation of traditional vampires are not so extreme. In some of these cases they can be seen in daylight, although not for long and don’t enjoy it, and they may be able to tolerate some, if not all, of human food. They are possibly therefore most aligned to their real world inspirations. I could write pages and pages on this, but infection is where my heart lies so I’m going to crack on.

Virus, parasitic, others?

Now we’ve covered off those born vampires, let’s move onto the most common version of vampirism outside of the traditional Dracula more mystical inspiration, that is vampires who are created linked to transfer of infection by blood or other means.

There are three main ways that this commonly comes into play:

  • Viral causes
  • Parasitic routes
  • Bacteria intoxication

I’m still trying to find a vampire movie where the main infectious agent is fungal, but it seems that most of the movies based on fungi are linked to zombie outbreaks. That makes a lot of sense, due to the fact that fungi are eukaryotes (like us) rather than prokaryotes (like bacteria), and so fungi tend to be linked to changing behaviour linked to interfering with the human nervous system. If you’ve seen a vampire version though please do let me know as I’m collating a list of where different organisms might come into play.

By far the most common route depicted is where the causative agent is a virus. Viruses are featured in movies such as Blade and Daybreakers and TV series such as Ultraviolet. This is because viral transmission in general is associated with transfer of bodily fluids, be that faecal-oral, respiratory via saliva, bodily fluids such as breast milk, or in the case of vampire movies via blood.

The most uncommon causative agent I’ve discovered is the parasitic cause of vampirism as shown in The Strain TV series. During the series transmission of the virus to create a full vampire is via something known as ‘The White’ that contains parasitic worms. These then lead to anatomical changes, including the growth of a proboscis that enables the biting and transmission of the parasite to others.

Bacterial coverage is mostly linked to potential methods of intoxication that supports the control over humans by vampires. Rather than being a direct cause of the vampirism, this seems to be about how transfer of the bacteria releases, or causes anatomical change, which then changes behaviour via things like hormonal or neurological changes. I’ve talked before about why bacteria may feature less in horror movies than other causes, but this can mostly be summed up by the fact that audiences tend to know more about bacteria and therefore it is less tempting for writers, but also horror tends to sit better in ‘the possible but not too close to us’.

Transmission

Obviously it’s not just the infectious agent that is important, but the mode of transmission for that agent. This being all about vampires the biggest mode of transmission is by bite, but it’s not always so straight forward. In mystical vampire movies, there’s usually a whole lot of removing of the original human blood and then transfer of the vampire blood, leading to a mystical baptism and rebirth. Infectious causes are much more one way, any bite could lead to someone turning into a vampire and the most important thing is load related. If someone is in contact for longer, if more blood is drunk and therefore more saliva and fluids exchanged, then the chances of conversion are much higher.

It’s not just blood as a bodily fluid that features in conversion during vampire movies. There are also films, such as Requiem for a Vampire and Trouble Every Day, where vampirism is treated more like a sexually transmitted disease, rather than transfer occurring during feeding on the blood of their victims. It seems that these films have increased since the 1980s, maybe as a result of fear processing linked to the HIV/AIDS pandemic during that time period or maybe because our knowledge about and ability to detect infections has increased and therefore there are a larger part of the collective public awareness. It will be interesting to see how the SAR CoV2 pandemic will impact this further.

The most unusual transmission, and one that aligns most highly with blood borne transmission is the presence of congenital transmission as featured in Blade. Where the main character Blade becomes a vampire hybrid by acquiring the vampire virus at birth, due to his mother being bitten and placental crossing of the virus into his blood stream. As a result, he exhibits some of the characteristics of a vampire due to the virus, but the effects are attenuated linked to his exposure route. It can often be that congenital infection presents differently to primary infection via other causes, and it appears vampirism is no different.

The other variable is linked to the time to turning once the infection has been introduced. I would speculate that this too is load related, as well as the infectious agent behind the symptoms. Viruses, for instance, are likely to reproduce and induce change at a much higher rate than anything linked to bacteria or parasites. This is partly due to their reproductive rate, but also linked to the level of dose that tends to be available. The exception to viruses resulting in the fastest change is likely to be bacterial intoxication and influencing. As the toxin acts immediately, when this is present in media and TV the change is almost instantaneous, but also time limited and therefore requires top up or re-application. Not all impacts are until beheading, some require a more time boundaried set of interventions.

Interventions

Once your characters are aware that vampires exist within their mist, then they will want to look for actions in order to protect themselves. One of the classic ones as featured in many movies, including the classic Lost Boys, is garlic.

In some ways the impact of garlic makes even more sense if you think of vampirism through an infectious transmission route, as garlic has been considered to have anti-infective properties for a long time, although warning you may have to ingest a LOT of it!

Bedir, A.S.; Almasri, R.S.; Azar, Y.O.; Elnady, R.E.; Al Raish, S.M. Exploring the Therapeutic Potential of Allium cepa and Allium sativum Extracts: Current Strategies, Emerging Applications, and Sustainability Utilization. Biology 2025, 14, 1088

Another common feature in vampire movies is the roles that animals play as protectors. For instance, in 30 Days of Night, the vampires kill all of the dogs before they launch their main attack. This kind of thing also often happens in films and TV where vampires are hiding in plain sight. It could be that they are taking out animals as they don’t want to be found, and animals are easier than humans, but I have another proposition. There are a number of infections where animals can be used to sniff out and identify infected individuals. Therefore, if animals could detect vampires they are much more likely to be a risk and warrant removal. Animals could therefore act as a front line of diagnostic defence to enable you to tell friend from foe.

Volume 26, Issue 4, April 2020, Pages 431-435

Having determine that a common weakness of vampires is their damage response to ultraviolet light (UV), films such as Underworld weaponise light against the vampire protagonists. Light, and especially UV-C (200 – 280nm), has been known to impact viruses and bacteria for well over 100 years. When light is in this frequency is can damage both RNA and DNA, resulting in cell death, and it is possible that if the infectious agent is the only thing that is keeping your body moving the damage would be more pronounced. We’ve also discussed how the lack of some biochemical pathways can lead to UV-C causing much larger amounts of pain an damage.

Normally, penetration of the light to cause damage might be an issue, but if you are using bullets or other means this may not impact. The most important thing I have to say here is, that despite what is shown in Blade 2, light does not bend around corners. This is also important for when you are considering using UV-C in hospitals to support cleaning, it doesn’t have good penetration and doesn’t go around corners of work in shadows. Using UV-C may work against your vampires but you are going to need to think carefully about where you use it so it does what you think it can.

Vampire movies have amazing world building and are often my favourite genera in terms of their string internal logic. I love the fact that so many types of infection and route of transmission that reflect real world cases are present as part of these pieces of entertainment. They can actually teach us a lot, even when we don’t realise it, and so much of it has origins in real world knowledge, even if only loosely. So, this Halloween evening find one you haven’t seen before and let me know which intervention you would use to stop your town being turned into creatures of the night!

Before I go, I thought I would share a few of the previous years Halloween blog posts in case you are looking for some more spooky season and infection reading:

Saturday Morning Zombies: how infection is portrayed in the genre

Infection Representation in Popular Culture: Why infection and infection risks, as discussed in movies and TV, may matter more than you think

Would You Let Them In? Celebrating Halloween by discussing what not to do in infection control as modelled in the Alien movies

Let me know your favourite vampire movies and if there are any other infection related Halloween topics I should cover.

All opinions in this blog are my own

Marking the Fifth Anniversary of the Girlymicrobiologist Blog by Launching My First Book – It Shouldn’t Happen to a PhD Student: How to thrive, not just survive, during your PhD

girlymicro Academic Life, Book Reviews, General, Healthcare Science, Microbiology (Research), Research/Academia, Writing , , , , , , ,

This week marks the 5th anniversary of regular posting on Girlymicrobiologist.com. I can’t believe that time has flown by so quickly. I also can’t believe that something that started out with such small expectations has grown to play such an important part in my life, and in my sense of identity. This was all really cemented for me in something that also happened this week, the publication of my first ever book.

Now, it’s been no secret that I have been putting some time aside to try and write something for the last few months. You have all been very patient with me whilst I posted a little less frequently, and I cannot help but give a massive thank you shout out to Dr Claire Walker who has curated some wonderful guest blogs in order to keep the content flowing. It’s a world of different having an idea and starting to write it, to holding the real thing in your hand, and so my brain is still catching up to the reality. I plan to write a bit more of a step by step guide to what the experience has taught me about self publishing, and why I thought self publishing was the right choice for this particular book, but for today I wanted to focus on moving something from a vague wish to a reality you can hold in your hand.

So how did I get here?

Back in 2022 I wrote a post about the fact that I was playing with the idea of writing a book, although I wasn’t quite sure about the direction that book would take, and listing a number of steps:

  • Further formulate the concept i.e. what kind of book? I actually have 2 ideas. One is turning this blog into a book format. The second is that I also have an outline structure for a Pathology murder mystery. I’m excited by both, but right now I think option 1 is more achievable with my current resources
  • Review what I already have. If I go for a non fiction book I need to undertake a gap analysis of what I have, what can be modified and what new content is needed. For the fiction version I need to start getting my concepts down so that I know how viable they are
  • What good resources are available to me? This is an ambition of plenty of people and there is a wealth of information out there. I need to explore, quality assess and curate what there is so I don’t waste time and energy making unforced errors. There is no point in reinventing the wheel, modify it so it works for me, but let’s not start from square one.
  • Undertake some appreciative enquiry.  Success is often about asking the right questions and making the right connections in order to increase your odds. I have some friends in this field but not in the area I’m thinking of working in. I need to be brave and put myself out there to gain insight into the ‘Known Unknowns’
  • Use the knowledge and information gained to put together a project plan. Establish some small steps that can make the project as a whole less overwhelming
  • Establish my success criteria. What does success look like? For right now it’s the process of creating that will feel like a success with a stretch goal of sharing what is produced, but that might change based on what I discover
  • Research your audience. If I decided to include sharing what is produced as part of my success criteria who would like to see such a book? If I were to share the content what would that look like and what would be needed?
Turning a Day Dream into a Reality: Trying out a technique to make concrete steps towards a secret ambition

Taking some baby steps

You’ll notice that those early steps involved a lot of information gathering, and reflection before formulating a plan. Writing that blog post encouraged me to do just that, but more than that it meant that I had made a declaration to all of you and started talking about what the next steps would look like, so I could be held to account by others as well as myself.

One of the things that my research led me to understand with greater clarity, is that to get from where I was to publishing a book required both the formulation of a plan, but also the development and practicing of skills. To a certain extent, the project plan was the easy bit, as long as my research was effective. The skill development piece was harder. It seemed to me, that the best way to go about this was to support others by being involved with their work in order to learn and develop more.

This led to me being involved with everything from textbooks, to a book on the impact of waste on our society. Every encounter taught me something. Every encounter helped me to refine what I was interested in and how I was interested in working. It also supported me in developing an author page so that I had a place where I could sign post others to the work.

Author Page

Choosing a direction

Fairly early on I realised that I didn’t have the time or bandwidth to develop my pathology murder mysteries right now, although I am still drafting plot on the side. The writing style is just too different for me to be able to dip in and out of , and I need to put in many hours of practice to get that style to a point where it would be acceptable.

That left me with content linked to this blog. Many of you will know that I started drafting, and am still working on a book called White Coat Syndrome (or similar). This is still in the works but a wise friend suggested that I keep working on getting it traditionally published, so I need to give it some focussed time. That left me with looking at the content I already have for trying out what the self publishing process could look like. Over 90% of non-fiction books are self published these days, and of the ones that are traditionally published still, most are linked to people in the public eye or with social media followers in the millions. It will be a surprise to no one that I do not fall into either of those categories, and so exploring the process of self publishing felt like the right move, not just for this book but to understand more moving forward.

So why this topic? In a moment of frustration about life, the universe, and everything, I was having a late evening rant and Mr Girlymicro and he said ‘Why don’t you write a book on how to do a PhD? You talk about it all the time. You spend lots of time supporting others through it, and you have already written thousands of words on your blog linked to it’. I just looked at him, went to bed, and woke up with a 40 chapter book outline. It just felt right. Something in my brain just clicked, and so the writing in the end was the easy part. After all, Mr Girlymicro is pretty much always right, and yet again he proved it.

Blog Posts by Theme

Developing in a way that works for me

Once the topic and method of publishing was chosen, then all that was left was pulling it together. It was so important for me that this book came from a place of authenticity, a place where I don’t pretend that things are easy, perfect or even equitable. In fact, it was that sense of inequity as I was writing that became a real motivator for finishing the book. As I reflected and wrote I became increasingly aware of how inequitable access to PhD programmes have become. How the way access routes are set up to be even more challenging if you have health or caring needs, but also if you don’t have access to someone who has done one to advise you on how to apply and what factors might be significant to talk about.

The next factor was to to decide on a time scale. Now, this part might be a little piece of madness but I know how busy IPC gets once we hit winter, and so allowing a 4 month time frame in order to get the book out before winter pressures and to align the release with the start of the academic year seemed like a good idea. I’m not saying that it was a good idea…just that it felt like one at the time. I think tasks take up the time that is allowed to them, however. I think if I’d allowed a year it would have spread to take that much time. It is sometimes better to set a tight timescale and stick to it, rather than allowing a window which could extend the project for longer than is really needed.

I also gradually became aware that providing some practical exercises would add value in a way that I could not include in a book format, and so decided early on that several of the chapters would have these hosted on the Girlymicro website so they would be free to access and download. Providing a holistic, interactive approach was key to my thinking, as was making sure that at its heart the book is about community and supporting each other, the same as this blog. I didn’t want to pretend to be someone else, or write in a way that was more academic, as I think there are enough of those styles of books out there. I wanted this book to support everyone to bring their whole selves to their PhD and their topic, and so it was important to me to write in a way that I also did the same.

Books by Girlymicro

Getting the word out there

Now the book is ready. Now that it is a real thing that I can hold in my hand. There are two main tasks taking up my thinking. The first is trying to work out how to get it to people that it might help, something that I would be grateful for any advice that you can give to me. The second is about how I can help others by sharing the knowledge I’ve picked up myself as part of going through the writing and self publishing process, to make it easier for others to get their voice out there. There are benefits to both ways of publishing, but there is something empowering about being able to feel like you can speak directly to your readers by maintaining more control over the content, rather than it being seen through a commercial lens. I’m not in this for the money after all.

There is still one thing that I talked about on my list of steps, way back when, and haven’t yet addressed, and that was success criteria and decided how to benchmark what success looks like. As I’ve said, I’m not doing this to make money, I’m doing this in the hope that it might assist others, and so for me it has never been about a commercial approach. I still need some way of judging progress however. On doing some reading I discovered that many books never sell more than 20 copies, and most others don’t sell more than 250 copies in their first year. My aspirations are pretty small therefore, as this is something I’m just beginning. I would consider the book a success if I sold more than 20 copies. I would be over the moon if I sold anywhere between 50 and 100 copies in the first year. The topic is fairly niche after all. Mostly I just want to mark the event and use it as my own benchmark for improving during future projects. We all have to start somewhere.

If however, you’d like to add to those 20 I’ve included the link for purchasing below:

Thinking about what’s next

Like everything is life, my first thought when I finish something is to think…what’s next? I have learnt so much and my plan is to take a little time to reflect on that learning and to enjoy focussing on blog writing for a while. That said, I am now going to return some of my focus to the book pitch for the Girlymicro general book, and I do have to admit I have the title of my next book in mind if I decide to try another self publishing exercise. Mostly I would like a few weekends off as it’s been a while since I could embrace the sofa and fully rot for a weekend. So while I cogitate, I intend to treat myself with some truly awful reality TV, and spending quality time with mummy and Mr Girlymicro.

Taking a moment to enjoy, celebrate, and mark the occasion

Before I slob off to the sofa though…you all know that I am a strong believer in celebrating and marking the moments that impact our lives, and this book is no different. To mark the moment I’m a having a small, low key book launch on Friday 17th October and there are just a couple of free tickets still available if you’d like to join.

Whether you can make it or not, I’d love to hear what you think as I’m all about improvement and learning. If you do get the book it would also be amazing if you could leave a review on Amazon with your honest thoughts. Apparently reviews really help increase visibility, whether good or bad, and so it would be wonderful to think that this book is finding its way to those who would need it.

I want to sign off with a thank you. I would never have gone through the process of thinking about writing a book if it wasn’t for all your support. I wouldn’t have had the content or undertaken the self reflection needed to know what to write if you hadn’t kept reading this blog. Finally, I wouldn’t have had the motivation to get through writing it and working out so very many templates and decisions if I didn’t know you would support me in the effort. So thank you. I appreciate every read, every interaction, and every conversation we have.

Register on Eventbrite

All opinions in this blog are my own

A Delay to Our Scheduled Programming

girlymicro General

Hi Everyone

You’ll notice Friday came and went without me posting. I’m about to head off on leave and it turned out I just had too much work and real life stuff to do to make writing a blog post happen.

I was going to try and write two blog posts today so you could have one on Monday and one this coming Friday, to cover during my time away. Instead I have decided to practice what I preach here and put myself and my wellbeing first.

So, instead, I am going to spend the day gradually packing, watching TV and having a bubble bath to start my de-stress. Normal service will resume on the 3rd October. 

I hope you will forgive the self indulgence

Love

Girlymicro

A Secret Project: Calling everyone thinking about or undertaking a PhD

girlymicro Academic Life, General, Healthcare Science, Leadership, Microbiology (Clinical), Microbiology (Research), Research/Academia, Science Communication, Writing , , , ,

It’s my birthday!

For my birthday in 2014, I celebrated by submitted by PhD thesis for printing. I ripped off the band aid and committed.

For this birthday, 11 years later, I’m taking another leap of faith, and once more rolling the dice on myself. This time it’s still PhD related, but rather different. This time it’s to let you all know that I have written a book, which will hopefully go live on Amazon on Friday the 17th October.

It feels like birthday launches could become a tradition.

I’ve been talking about a super secret project for a while now, and the wonderful Dr Claire Walker has been taking on some heavy lifting in terms of arranging some guest blogs, so that I could write a book on my weekends rather than writing a blog. But what is the book, and why did it come about?

The Book

The book is entitled ‘It Shouldn’t Happen to a PhD Student: How to thrive, not just survive, during your PhD’. It has 40 chapters that take you all the way through from deciding you want to do to PhD, and thinking about where and what type, to submitting your thesis, and what kind of skills you may need to develop during your PhD to maximise your career success after it is done.

Professor Elaine Cloutman-Green, otherwise known as “The Girlymicrobiologist”, is a clinical academic with over 2 decades of experience leading research projects and supporting students at all levels, including PhDs.  She also runs the popular Girlymicrobiologist blog, which aims to de-mystify science and support those wanting to engage with academic careers from A-level all the way through to career enrichment.

In this book, Girlymicro talks about the reality of what it is like to study for a PhD, what gateways you may need to pass through, and how to manage key relationships in order to achieve success. 

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like. 

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper. 

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva.  All of this supported by links to activities on the Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Whether you’re planning your PhD, a healthcare professional looking to develop, or simply curious to know about how the world of academia works, The Girlymicrobiologist offers a refreshing blend of knowledge and relatable experiences. Get ready to laugh, learn, and be inspired to find a way into, what she describes as the best job on the planet.

This is the book I wish that someone had given me when I started on my PhD. I was pretty clueless and spent a lot of time finding my way, and making heaps of mistakes. It seemed only fair to write all of my learning down so that I can share it, not just with my own students but more widely, so that everyone is free to make their own new mistakes, not just repeat ones I’ve already made.

The Why

I’ve been talking about writing a book for ages, and I still have the original Girlymicro book I’d planned going on in the background. I was prompted to do this book now though, after spending an afternoon at an awards event and realising that I could tell you every person who was going to win in every category before the dinner even started. It made me think a lot about access and privilege. That night I came home and I was really glum, and I couldn’t quite process why I was feeling that way.

I slept on it and spent some time speaking to Mr Girlymicro the next day to process my thoughts. I talked about how much access to healthcare professions and even academic training schemes are now based on who you know, to describe the best way to get through gateways like applications and interviews. How, even once you are in them, to feel like you understand how things work and the undisclosed boxes that need ticking, you need to have someone who will let you in and tell you the unwritten rules, and frankly not all supervisors see that as their role. This means that I really feel like we are missing out on some amazing talent. People who would make wonderful PhD students, or academics, because they can’t get across the threshold or see themselves in the role.

Not everyone has strong connections with a university. Still fewer people know someone who has a PhD. The way the system currently feels is that if you can access information you really have such an advantage over those that don’t. I therefore see a lot of my medical colleagues getting access to PhD funding, and yet fewer and fewer of my nursing and scientific colleagues. I increasingly encounter more and more undergraduates who are reaching out because they need help to know why they aren’t being successful, because they don’t know what is expected of them. It has always been hard to get onto PhD programmes, and it should be. What it shouldn’t be is hard because you don’t have access to the right people to give you the knowledge you need to level the playing field.

I realised that was why I was feeling upset and unsettled. I don’t like unfairness. I don’t like inequity. I don’t like realising that I’m part of the problem. Mr Girlymicro commented, as I was off loading, that I had plenty of blog posts that talk about how to apply for and do a PhD, and so why didn’t I take the way I was feeling and turn it into something positive. A book. So, this book concept was born. A book where I set out to play my role in fixing the disparities as I see them.

The Vision

That conversation happened right at the end of May. I gave myself 3 months to take some content form this blog, as well as creating new content, to come up with a book of ~80,000 words that captures the advice I give to my PhD students, and those approaching me floating the concept of applying for a PhD.

Why 3 months? Well, if I allowed myself a year, I would take a year, and remember that other book? I still want that to happen at some point. The other thing was that I wanted it finished as close to the start of the academic year as possible, so that it could start benefiting people right away. We all also know that I have no patience, and so using my birthday as a cut off always felt right.

The book was finished at the end of August, and I’m in final edits before upload at the end of the month. I want it to be the kind of resource that people can dip in and out of, whether they are doing a PhD or not. Chapters, such as developing goals, or on public speaking, should stand alone to benefit even those who are not in academic study. The activities that can be accessed alongside the book, to help things like developing your elevator pitch, should only grow in number over time, and hopefully will be a good general resource for anyone that finds them, not just for those who are studying for a PhD.

My main hope however, is that people who are on a PhD will find it not only helpful, but something that will help them feel a little less alone in the process. There were times, as I was doing my PhD outside of a standard academic department, that I felt really lonely, and sometimes even very lost. Not everyone has a super supportive supervisor, not everyone finds those peers that keep you going. I was lucky that I had great colleagues who picked me, not everyone has that. I hope that this book can act a little like the friend you need, who you can turn to for advice, and to know that others have been there before and found a way to succeed.

What to Expect

I don’t know what to expect to be honest. I’ve never written a book entirely alone before, with thanks to Dr Helen Rickard and Dr Sam Watkin who have contributed text. I know why I needed to write this book, and as I say in the first chapter, knowing your why is the most important thing. I don’t expect it to be perfect, nothing is, but as I say to my students, the main thing is that it is done.

The book should go live on Amazon (depending on their turn around time) on Friday 17th October. It should be purchasable in 3 forms:

  • Ebook for £2.99 or included in your ebook subscription if you have one and free to download
  • Paperback for £9.99
  • Hardback for £15.99

None of this is about making money for me, but Amazon have minimum costs, especially if you want it to be available widely, so there we go.

To mark the occasion, although it is terrifying me at the moment, I’m holding a small book launch event at UCL on the same night. If you fancy, come and join me. After all, we should all do a little something that scares us, and I’m hoping if I feed you wine you will forgive any deficiencies knowing the reasons why this book came into being in the first place.

If you like, I’m kinda hoping you might also tell your friends…

Register on Eventbrite

Guest Blog by Dr Shayda Karimi: Creativity in science

girlymicro General, Guest blog, Writing , , , , , , , , , , ,

I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.

Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including The Clinical Academic Path – From the Lab to the Lectern.

This weeks blog post is from Dr Shayda Karimi, who is a medical doctor and self published author, discussing how important creativity is in science.

Blog by Shayda Karimi

Hello! My name is Shayda.

I’m a medical doctor, specialising in anaesthesia and pre-hospital emergency care. Medicine has always been considered one of the ‘softer’ sciences, but never the less is more of a science than a humanity, and the subject takes pride in adhering to evidence based practice. Creativity lies at the heart of problem solving, and problem solving is key to providing high quality, innovative medical care, especially in dynamic specialities like emergency care. For example, I was recently faced with the dilemma of a man impaled on a large segment of aluminium ladder. The metal couldn’t be removed without a CT scan to determine which structures it had damaged, and due to the angle of penetration, the patient couldn’t fit through the scanner with it in place. The creative solution was to put a 999 call out to the fire service, who with specialist cutting equipment were able to reduce the size on the metal segment. The patient safely had his scan.

Creativity in science should be encouraged. Through my time at medical school, opportunities to be creative were very limited- most lectures were on never changing topics- anatomy and physiology. I took a student component module called ‘medicine in literature’- even that was factual. To resolve this gap in my undergraduate education, in my F3 year (a common point for junior doctors to take a year out of training, having completed two foundation years and before commencing higher specialist training) I decided to complete a masters degree in creative writing. I was the only person on my course with a ‘science’ background.

The dissertation for this course was a long piece of writing. Which for the first time in my post primary school life, could be completely and utterly false. This dissertation turned into my first novel. Writing fiction develops problem solving skills- characters must resolve the obstacles put into their path, and this must be believable with the rules they are living in. I learned about how language can be used to invoke emotions and atmosphere- this is of vital importance when speaking to patients and colleagues. Or even when writing emails! I developed an appreciation that though creativity is not fact- it can also be to a certain degree taught and developed.

The dissertation turned into my first published novel ‘Heirs’, set in a future dystopian London, conjoined twins are born next in line to the throne. They end up separated and in a fight for power. This was fun experience; taking the science I knew as fact, and adding a whole load of fiction to turn it into a familiar but bizarre future.

Creativity and science go hand in hand. We should all endeavour to leave the cold hard world of facts every once in a while and dive into something purely imaginative; an art class or high fantasy novel.

“The true sign of intelligence is not knowledge, but imagination” – Albert Einstein

All opinions in this blog are my own

Guest Blog: Co-creation made by students for students: deconstructing immunological techniques-ELISA

girlymicro Education, Guest blog, Healthcare Science , , , , , , , , ,

I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.

Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Simulating Success – Enhancing Biomedical Science Education through Clinical Simulation. This blog was written by a group of her final year students on their experiences of trying to teach differently.

Blog by Yvana, Nicole and Ellie

We were a small group of three final-year Biomedical students—Yvana, Nicole, and Ellie who were brought together by a shared goal to create something useful for other students by us students. In our final year at the University of Lincoln, we were offered the opportunity to work on a collaborative project focused on improving on how ELISA (enzyme-linked immunosorbent assay) is taught to students- a commonly used technique in the immunology department to quantify and detect biological molecules.

Meet the Team

Yvana

Hello, I’m Yvana – Three years ago, I began my journey as a Biomedical Science student at the University of Lincoln. Like many, I was unsure of the exact career path I wanted to follow, but I knew one thing for certain, I was deeply fascinated by diagnostics and disease. Over time, that interest developed into a love for laboratory work, especially when I had the opportunity to experience clinical simulation sessions led by Dr Claire Walker which stood out to me as they offered a taste of what a real-life clinical lab feels like beyond university.

One of the highlights of my third year was engaging in a unique series of laboratory-based activities known as Laboratory Skills, coordinated by Dr Andy Gilbert. These sessions were designed to strengthen our core technical abilities and confidence in the lab through a series of activities covering microbiology to biochemistry!. After completing 6 weeks of lab skills, Dr Andy Gilbert approached me with an exciting opportunity to collaborate with two other students, Nicole and Elle, also led by Dr Claire Walker on a co-creation lab skills project. Our task? To design a step-by-step resource that would deconstruct one of the most widely used techniques in immunology, ELISA – making it easier for students to understand and perform.

Ellie

Hi everyone, my name’s Ellie! I’m 1/3 of the amazing group that have carried out the ELISA workshop, led by students, for students. During my years at the University of Lincoln, I’ve grown to love the fascinating world of microbiology and I’m even going back this September to do a Microbiology Masters! I have really enjoyed my time at Lincoln and part of that is thanks to Andy Gilbert for putting on his extra lab skills sessions, which allowed me and other students to gain that vital extra laboratory knowledge and practice important techniques.

I’ve just finished the final year of my undergraduate Biomedical Science degree and throughout this year I was able to create something incredible. I, Yvana and Nicole, were given the opportunity to collaborate and develop a practical booklet as a building point of the skills needed to carry out an ELISA. The main reason I agreed to take part in this task is that we, as students, do not get many chances to have such a hands-on experience with many complex techniques, like an ELISA, during this degree. Because of this amazing opportunity, we were able to give students across all years at Lincoln the chance to gain more knowledge and extra practice in learning this crucial technique!

Nicole

Hi, I’m Nicole – one of the final-year Biomedical Science students behind this project. Starting at the University of Lincoln, I wasn’t entirely sure which direction I wanted to take within biomedical science. As the course progressed, I enjoyed the hands-on lab work, particularly how it transformed theoretical knowledge into practical application. This became evident in my second year during Laboratory Skills sessions led by Dr. Andy Gilbert. These weekly sessions focused on core techniques like centrifugation, microscopy, and microbiology.

Co-creating the ELISA workshop booklet felt like more than just a project; it was an opportunity to make lab-based learning more accessible and less intimidating. Since ELISA is a technique, we limited experience with as students, developing this protocol felt was crucial. Working with Ellie and Yvana to bring our ideas together was fulfilling. My favourite part was seeing the complete protocol, knowing it would support students to tackle the ELISA confidentially.

Figure depicting how ELISA works step-by-step

Building the booklet

This project was a collaborative effort and not something we did alone- we brought our own strengths together to create the now called ELISA Team (given by Claire Walker herself!). We spent countless hours in the lab, testing and refining each activity to make sure it worked as intended and delivered the essential skills students would need to confidently complete an ELISA in real time. We held regular meetings, worked on it during lectures (sorry Claire and Andy!), and genuinely had a lot of fun creating something meaningful that we hope will support future students just like us.

Under the guidance of Dr Claire Walker and Dr Andy Gilbert, we set out to create a resource that would feel practical, and genuinely useful for students. We didn’t want a booklet created from a lecturer’s perspective of what students might find helpful. We wanted to build something we would have found helpful when we first encountered ELISA, a step-by-step walkthrough from a student’s perspective.

Overview of ELISA (Enzyme-Linked Immunosorbent Assay) booklet use to educate students

The booklet breaks down ELISA into its fundamental components, from how to properly use a multichannel pipette (which was a nightmare to handle!) to interpreting results and avoiding common mistakes students might fall for. For instance, one key focus was on the washing stages, an often-overlooked step that if done incorrectly, can lead to high background noise and inaccurate results, which in a diagnostic lab can be the difference between a patient receiving an accurate diagnosis or potentially missing one altogether.

What made this project especially rewarding was the opportunity to run our session with real students from first year undergraduates in Biomedical Science to postgraduates in Biotechnology. The feedback we received was overwhelmingly positive. Many said the booklet helped them better understand ELISA both in theory and in practice. We focused heavily on visual learning using diagrams, photos, and annotated guides because we knew from our own experience that clarity and visual support were essential when learning complex lab techniques.

Initial plate setup demonstrating serial dilutions and pipette accuracy during the first activity, comparing multichannel versus single-channel pipetting.

Our final thoughts

Our co-creation project not only gave us a chance to give back to the large community of students, but we were able to bridge a gap that many lectures hadn’t quite managed before, true co-creation between students and lecturers. Together, we created something that students appreciated and benefited from which was entirely made by their peers through mutual experience.

Looking back, we are incredibly proud of what we achieved as a team. It showed us how impactful student-led projects can be when they’re supported by passionate educators and built around supporting the educational needs of the community.

All opinions in this blog are my own

Guest Blog by Callum Barnes: Clinical simulation and virtual reality as a future tool to train biomedical scientists

girlymicro Education, Guest blog , , , , , , , ,

I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.

Callum is a disciple of the biomedical sciences, current master’s student creating a more authentic lab experience for those after me, aspiring consultant microbiologist (the best discipline, sorry Claire – you see he understands, like me, that micro will always trump immunology).

Callum is supervised by Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Exome Sequencing and the Hunt for New Genetic Diseases.

Blog by Callum Barnes

Hello again everyone! It certainly feels weird to be writing another one of these, but my supervisor the lovely Dr Claire Walker thought it would be a great idea considering the outcome of my research that I discussed here.

A small recap for those that don’t want to read two blogposts – I am an Mbio Biomedical Science student at the University of Lincoln and completed my portfolio on a placement year in a local microbiology lab. It was great and I became so much more confident in both my practical and theoretical work, which really showed me the value of clinical placements. The problem is that these placements are too few and too competitive nationwide, and only a fraction of those that want to join the biomedical workforce get to experience them despite their value. Long story short, we created a clinical simulation that was as authentic to a real pathology lab as possible, with patient request cards and a functioning (front-end) LIMS, both seen below:

Can you believe no one got the Star Trek references? Anyway. The results were honestly incredible, with basically everyone that participated getting value out of it. I can’t share too much as we are yet to publish, but here are some quotes that really highlight how the clinical simulation increased confidence and was effective as a learning tool.

“Getting hands on experience in the lab. It gave me the confidence to continue in the lab setting.”

“Overall, the lab practicals have been helpful. I think my lab skills have drastically improved, especially my microscopy skills and interpreting my lab results.”

“I like the opportunity we had to practice new skills and learn about it in the contrast of a case study.”

These results were really good, but during my background research I came to realise that other medical disciplines are ahead of us in utilising learning tools to teach university students – like really ahead. Trainee doctors have actors, manikins, and in the last decade have extensively integrated VR/AR/XR technologies into their teachings. We are left with a couple of practical sessions per discipline to cover the hundreds of different diagnostic processes that biomedical scientists go through. And this is almost entirely down to cost, practicals cost a fortune after all. They take setting up, and time, which staff don’t have enough of as is. Which brings us back to virtual reality…

Virtual reality (can be) cheap, accessible, and most importantly repeatable. Other medical disciplines have already identified this, and there is good data to back up the use of VR in those disciplines. But none in biomedical science, because clinical simulation is only just being recognised as a worthy endeavour.

And so, this is going to be my goal. I am going to develop software to train biomedical scientists in virtual reality. It’s going to be tough, but I do truly believe that this is a sorely neglected part of training the next generation of pathologists here in the UK, and honestly hopefully the world too. And if everything goes well (and even if it doesn’t), I’ll be back here in a year to let you all know how it went.

All opinions in this blog are my own

Marking my 250th blog post: Taking some time to reflect on Girlymicro

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There’s a lot going on right now, and life is busy for everyone. Despite the challenges, this lack of time can mean that reflection and taking a moment to catch your breath can be even more beneficial. I can’t believe this is the 250th post on this blog and so, if you’ll forgive the indulgence, I’m going to be taking my own advice and spending a little time celebrating this milestone by remembering why I started, what I wanted to achieve, whether that has worked out, and where I would like Girlymicro to go in the future.

Where did it start?

When I chose Girlymicro as my twitter handle back in 2012 I had no idea of the decision I was actually making. I didn’t set out to have a ‘brand’, I never imagined that it would exist outside of a platform that I had newly encountered and was trying to learn how to use. That said Girlymicro was chosen with purpose even back then. I wanted something that allowed me to represent, and consciously go against some of the advice that I had heard during my career. Advice that said that I could be good but I would be better if I tried to fit in and not bring my whole self to the table. To accept that fact that I should be a scientist first and a woman second, and that by putting my femineity and female perspective forward I would isolate myself and limit my ability to succeed. That scientists didn’t look like me. I also wanted to show that I can be Girly in a non-traditional way, I don’t wear lots of makeup, I don’t worry about my appearance, but I enjoy being feminine despite all of those things. I wanted to say I like wearing pinks and purples, and I can also still be good at science. So, Girlymicro was born.

Roll forward to the end of my PhD and I had discovered a love for science communication, and how education can be done differently. It didn’t all need to be lectures, where someone knowledgeable stood at the front of the room and gifted knowledge to those who sat passively within the space. That knowledge could be co-produced instead of given.

This inspired me to start thinking about how I could make a difference in this space. In 2015 I didn’t really know what it was that I wanted, I was still very much thinking about options but I hadn’t pinned anything down. For me, looking back, this shows that sometimes having a passion is the best place to start. You don’t have to have all the detail mapped out, and sometimes knowing what you don’t want to do is almost as important.

When I started to investigate the science blogging space, a lot of the blogs were very technical, highly referenced, and very science forward. These were all brilliant blogs, the trouble was I was pretty sure they weren’t what I wanted to write. This was for a couple of reasons, I’d just finished writing a PhD thesis and a whole bunch of papers. I knew that I could write that kind of work but I was aware that writing that every week would be incredibly time consuming, not necessarily teach me new skills, and not reach the audience I wanted to speak to. I also knew that I wanted to keep the Girlymicro mentality of bringing my whole self and so something that felt one dimensional didn’t tick my boxes for a project that I knew would require a big time investment. I knew that wasn’t right for me, but I had yet to work out what right looked like.

Where have I been?

In 2015 I registered the Girlymicrobiologist domain therefore, whilst not completely sure what it was that I wanted to do. Sometimes I knew you just have to get started. I put out my first, very short blog post, and then frankly kind of chickened out.

Hello world!

It wasn’t until the pandemic that I finally crystalised what it was I wanted to write and who it was I wanted to speak to. By the time my second blog post was launched I’d worked with Nicola Baldwin, as a playwright, on the Nosocomial project. I’d really started to find my feet in terms of knowing who I was as a communicator. I had also spent over 6 months doing various radio and comms linked to the pandemic, and I was getting really frustrated at the fact that all of it boiled down to sound bite communication. I didn’t have a space where I could speak without an intermediary, or where I could explore the complexity of what was happening. That dissatisfaction combined with the fact that I was increasingly aware of the fact that there may be people who were interested in engaging with this kind of content, due to questions across social media and from my friends, meant that I finally got over my fear and put out my first real blog post.

Why Have I Waited 5 Years?

You’ll see that these early blogs are all pretty short. They are definitely Girlymicro blogs, but they fit into the expectations of the time when they will written.

We all know I love a bit of research, and when I started writing regularly I obeyed the rules of the time. That was that blogs should be 500 – 900 words and three pictures. I also really felt the need to demonstrate my credibility, to show that I had the right to be writing. I felt I had to prove to people that I was worthy of their time (not that I don’t now, but it feels different). All of this means that the early blogs feel a bit different to the ones I post today.

Happy Birthday Girlymicrobiologist Blog: One year on what I have learnt about writing a blog?

It took me longer than I would have thought to get to the point where I could finally do what I had set up my Girlymicro twitter handle for back in 2012, and that was bring my whole self, good, bad and sometimes mortifying, to my blogs. To share weakness as well as strength, and on occasion to write blog posts that are about things I’m exploring and don’t have any answers to. It took me quite a while to be brave and find the courage to throw it out there and deal with whatever reception happened.

An Homage to Douglas Adams: Reaching 42 and therefore becoming the answer to life the universe and everything

It also took me a while to share the big moments, and to think that was OK, rather than being considered boastful. I clearly remember the anxiety of posting about receiving a New Years Honour, and even making consultant. Despite that anxiety I have chosen to live by ‘you can’t be what you can’t see’. It’s really important to show that someone as normal as me can achieve, and that those routes are open to everyone. It’s not about being special, or exceptional, it’s about bringing your whole self and continuing to show up, even on the bad days. Therefore being out there and visible is important both to show what can happen and options to get there.

Girlymicro’s 100th Post: What I’ve learnt in my 1st year as a consultant

It took me even longer to think of myself (and I’m not entirely sure I still do) as a writer, rather than someone who writes. I don’t think of myself as a particularly good writer, my knowledge of grammar is super weak. What I’ve learnt though is that, if you write from the heart, if you have something to say that is well intentioned and written to support others, then people forgive you for any lack of skill. You also won’t learn and get better if you don’t practice, so I’m practicing in a safe space with a load of supporters who are prepared to think the best of me.

Am I a Writer Yet? Two years in, over 100 posts and finally finding my feet

Over the last 10 years, whether actively writing or not, I’ve learnt a lot about myself, how I want to communicate, and who I want to communicate and build a community with. It is that learning that has helped me develop and build. The feedback and support has been invaluable, and it’s help me to know that it is OK to learn and evolve as I go. It’s then so important to share that learning so that the next person looking to start a blog can build upon knowledge already gained and make something that works for them.

Celebrating my 200th Post: Learning to love science blogging and the do’s and don’ts I’ve picked up along the way

What has made me continue?

Life gets busy for all of us, and it can be challenging sometimes to get a blog out every week, plus we all know that sometimes I fail to deliver. Frequency is key though, both because I don’t want to let everyone down, and because it is all too easy to fall out of the habit of writing if you start skipping weeks. Those were the reasons for posting regularly at the start anyway. If you read any ‘how to start a blog’ page it will tell you about the importance of regular content updates.

I don’t think that’s the reason why I post regularly now and feel unsettled if I miss posts these days however. I think that I have come to find writing an invaluable way of sorting through my thoughts and processing my responses. I started writing a blog for the benefit of others, but I have discovered how much creating a regular space for reflection, as part of writing, has massive benefits for me and my well being. It’s become a habit that I absolutely don’t want to break, plus I have 350 plus posts in draft so it’ll take me time to get through them.

I also feel that as you build and develop you are able to see the vision more and more clearly, and so what you build naturally changes. I didn’t deliberately set out to post on key topics such as Infection Prevention and Control, Healthcare Science, Leadership, Academia/research and personal growth, but looking back now I can’t see that Girlymicro could have been anything but what it is. It started from a place of authenticity, and so what has developed is something that is uniquely me, and I couldn’t be happier.

What’s my current reality?

Talking about what Girlymicro is now, in the world of AI I thought it would be interesting to see what Gemini (Googles AI) thinks of the Girlymicro blog. So If you hit up Google and ask ‘what is the Girlymicrobiologist blog’ it comes up (as of the 22nd June 2025) with the below:

The Girlymicro blog is a science blog written by a Healthcare Scientist and Infection Prevention and Control Consultant named Professor Elaine Cloutman-Green. It focuses on various topics including leadership, academia, Healthcare Science, infection control, and personal experiences, with a strong emphasis on community and raising awareness within these fields. 

Here’s a more detailed breakdown:

  • Focus Areas:The blog covers a range of topics, including leadership, PhD tips, Healthcare Science, infection control and microbiology, personal experiences, and guest blogs/book reviews. 
  • Purpose:The blog aims to demystify science, make it accessible to everyone, and build a supportive community for those working in or interested in these fields. 
  • Community Engagement:The blog actively encourages interaction with the audience, featuring guest blogs to broaden perspectives and inviting feedback to improve content. 
  • Author’s Perspective:The author, Professor Cloutman-Green, shares her expertise as a scientist and consultant while also offering insights into her personal journey and experiences. 
  • Content Style:The blog features a mix of informative posts, personal reflections, and discussions on current issues related to science and healthcare. 

Now I know that AI will scrape a lot of what I wrote and therefore may be seen as just posting positive reinforcement, but I have to say that summary did not make me miserable. I’m pretty happy that it covers a lot of what I hope it would cover. When it is hard to write, it is sometimes nice to reflect and see if whether what you are doing still fits your purpose and the reason you started, so that alignment with my ‘why’ feels pretty good.

What am I proudest of?

Talking about evolution, when I first started I had never considered guest blogs or what they could look like. It took about a year for me to feel like I knew what I was doing enough to put out a call for people who would be willing to write guest blogs. Now, out of the posts published, ~13% are guest blogs, This is so important to me. I’ve always wanted Girlymicro to be a community, a community where we listen to and support each other. Guest blogs are an important component of that as they work to offer others a voice, and to be able to practice within what I hope is a safe and supportive space. Writing guest blogs enables others to feel supported in sharing their views, but also to try out a type of writing that authors may not have done before, and to build confidence. I’m especially happy that many of those who write guest blogs are undergraduates or early post graduates, where developing these skills and potentially raising their profile, might help them in their future.

I know that I asked AI what they thought of the blog, but in order to be a little more thorough I also reached out across social media platforms in order to ask others what they thought. What they liked and found helpful, but also where it could get better. So whilst I’m talking about gratitude, I’m so proud and grateful for the responses received. When everyone is up against it, the fact that people took time to respond and give their thoughts means the world:

What are the lessons I’ve learnt?

One of the thing I’ve discovered when speaking to people about this blog is that people read blogs for all kinds of reasons. Now, I know I said that I don’t write Girlymicro as a hard science blog, but I do always want to include interesting other pieces of reading where I can. Apparently, according to the article below, people read science blogs for a variety of reasons, and you can either try to double down on one of them, or do what I do, and hope to achieve all of the different aspects but at different moments and in different articles. This is probably quite obvious if you spend time thinking about it, but it was not something I had particularly realised. It is however one of the reasons why posting a variety of different types of content seems to work. Every day is a school day.

https://www.fromthelabbench.com/from-the-lab-bench-science-blog/2016/6/24/profiles-of-science-blog-readers-an-infographic

I knew none of those things when I started, and I will always continue to write the things that speak to me in the hope it is helpful to others, rather than trying to hit an algorithm or meet requirements laid out by others. That said, and as food for thought, I thought I would shared some of the lessons I’ve learnt over the last ten years, many of which could be applied to just life in general:

  • You don’t have to have it all figured out, but you need to have a direction of travel and a purpose
  • Things will change so don’t cling to where you started, be open to learning and evolution
  • Just keep showing up, even when you don’t want to, especially when it’s hard
  • Sometimes knowing what you don’t want to do is helpful and shouldn’t be dismissed
  • Take the risk, and make the jump. Nothing is perfect, failure will happen, but you will end up better for it
  • Have a little faith. Have faith in your gut. Have faith that others will be there to catch you and support you when you need it
  • Try to think about your community and building your networks. Focus on what serves them than what serves you only
  • Everything takes longer than you think and nothing is ever finished. Starting a project like this is a commitment of years with no end date. Make sure you have the passion to see you through
  • If you bring your whole self it will always be a success, as it will be truly and uniquely you

What are my hopes and aspirations for the future?

I still aspire to turning the blog into a book, I’m still working on it. I have big dreams and I’m not done yet. Most of my hopes are about continuing to build community though, that’s where my dreams are all seated. What can we do better to learn from each other? How can I do this better in order to help? How can I reach people who might find this useful? People who don’t read blogs in this way or exist on the platforms I use? This blog, like me, is a work in progress, and long may that continue.

The one thing that I am certain of is that I want to continue to be grateful, to see what we are building together and to continue to experience awe that I get to be a part of it. Girlymicro was never meant to be a brand but I’m beyond grateful for the fact that, with the support of all of you, it kind of is, and it’s a platform that I commit to using for the good of all of us. To support, to inform, and hopefully to enable positive change. Thank you so much for being part of this and here’s to the next 250!

All opinions in this blog are my own

Guest Blog by Kate Rennie: What am I growing in my kitchen… a gluten free sourdough journey through the eyes of an IPC nurse

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I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.

Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Microbial Culture: An Immunologist’s Side Project Gone Wild.

This weeks blog post continues this months fungal theme (all things yeast) and is from the absolutely amazing Kate Rennie. Kate is a born microbiologist, even if she was diverted by the world of nursing and has gone on to become a cracking Infection Prevention and Control nurse. Her curiosity and willingness to learn and expand her skill sets, makes it no surprise to me that when she decided to expand her hobbies, she decided to go down a route that touches on all things micro.

Before we get into the sour dough however, let’s start by talking what coeliac disease (the condition that leads to the requirement for gluten free bread) as written for us by Dr Claire Walker, our in-house immunologist:

Coeliac disease is a serious autoimmune condition where eating gluten, a protein in wheat, barley, and rye, triggers the immune system to attack an enzyme in the gut called tissue transglutaminase. This damages the villi, tiny structures in the small intestine that absorb nutrients. The result? Symptoms like bloating, diarrhoea, fatigue, and iron deficiency. But it doesn’t stop at the gut. Some people develop dermatitis herpetiformis, an intensely itchy, blistering skin rash. Others experience neurological symptoms such as brain fog, headaches, and numbness or tingling in the limbs. It’s often misdiagnosed or missed entirely.

Around 1 in 100 people in the UK have coeliac disease, but most remain undiagnosed. Diagnosis usually starts with blood tests (like the tTG-IgA), followed by a small bowel biopsy to confirm intestinal damage. These tests only work if you’re currently eating gluten. So if someone’s already gone gluten-free and are feeling better, they need to reintroduce it for several weeks which can cause symptoms to reappear and puts many people off testing.

There’s no cure and the only treatment is a strict, lifelong gluten-free diet. That means no “cheat days” as even tiny amounts can cause damage. It takes serious commitment: careful label reading, avoiding cross-contamination, and asking awkward questions when eating out. But for most, removing gluten thankfully leads to major improvements in symptoms and overall wellbeing.

Blog by Kate Rennie

What am I growing in my kitchen… a gluten free sourdough journey through the eyes of an IPC nurse

I’m Kate, I’m an infection control nurse at GOSH. I’ve worked in infection control since 2020 (1.5 years in primary care, 9 months in community/mental health and I’ve been at GOSH since April 2022). I was diagnosed with Coeliac disease in 2013 and decided 2025 would be the year of new hobbies and I am bored of gluten free bread that resembles cardboard.

I decided to embark on my sourdough journey (albeit slightly late to the party as I know this was a lockdown thing). I didn’t actually know what I was getting into with making sourdough, I read the first few steps and thought it sounded pretty simple, flour and water in a jar.

My flour and water sat on my kitchen side in a jar for 2 weeks (gross), and I named it Marilyn (Mondough)… I nurtured her and fed her daily, for those who may remember Tamagotchi’s, this is how I can describe it and as a previous Tamagotchi owner, I loved it.

Part of me was obsessed with what have created and look forward to waking up each morning to see how it’s looking (highlight of your late 20s) but the infection control nurse in me is slightly grossed out by it. I’ve read a bit more and learnt a lot, she just needed a little bit of extra love and care (troubleshooting) at a few days old.

HOOCH – I’ve only ever known hooch as this from my late teens/early 20s.

Fast forward to my late 20s, this is a sign that your sourdough starter is hungry, it’s eaten all its nutrients, and you must feed it more frequently. I was reluctant to throw her away and start fresh so I added teff flour in the hope she would perk up and SHE DID.

But she smelt disgusting… A familiar reminder of my 16 year old, pre-nurse self, having my long acrylic nails removed in the salon. ACETONE?? Apparently, it’s a byproduct of fermentation…

So, I wondered if this was actually safe to have something fermenting in my kitchen with absolutely 0 knowledge and thinking I’m probably going to poison myself. After a bit of research, I learnt this is normal and how to fix it, yet again, she’s hungry and I’m a rubbish mother.

Whatever is happening inside that jar is creating its own yeast to make it grow which is quite cool! I’m not sure how many people have actually gone this deep into the thought of a sourdough starter, but my IPC brain is fascinated yet disgusted and I want to know more. Do I want to culture it in the lab? Probably not. Am I going to eat it? Most definitely.

Fast forward 2 weeks… My sourdough journey ended abruptly after my first loaf. I felt disheartened that it didn’t turn out like the GF loaves I’d spent too much time obsessing over on Tik Tok.
The perfectionist I am wanted the perfect loaf to happen first time, so I abandoned sourdough and ventured into making non-sourdough gluten free bread. I popped Marilyn in the fridge for when I decided to revisit sourdough making and there she stayed for a good 3 months. Apparently, this puts it to sleep, and you can later revive it… but after pulling it out the fridge and seeing a layer of black liquid on top of the starter, my IPC brain got the better of me and I decided with my limited knowledge of sourdough and fermentation at home, it probably was best that I didn’t consume this and decided to throw it in the bin and I spared a brief thought for what Marilyn was and could have been if I had more patience.

I’d hoped this would be a success story about my gluten free sourdough rather than a failure but basically, sourdough isn’t easy and gluten free sourdough, really isn’t easy. It truly is a science.

Gluten free bread making in general is a delicate science because it lacks the key protein—gluten—that gives traditional bread its structure, elasticity, and chew. In wheat-based breads, gluten forms a stretchy network that traps gas bubbles from yeast, allowing the dough to rise and hold its shape. Without gluten, you have to rely on a blend of alternative flours—like rice, sorghum, or buckwheat—each contributing unique properties such as starch, protein, or flavour. Binding agents like psyllium husk are also essential to mimic gluten’s elasticity. No single gluten-free flour can replicate all the functions of wheat flour, which is why crafting a successful gluten-free loaf requires a carefully balanced mix rather than just throwing in a single substitute flour and hoping for the best.

I have been successful on a few occasions in making non-sourdough gluten free bread which has still been a real insight into science in everyday life.

To all life’s problems there are solutions if only we are curious and passionate enough to see them and change direction in order to maximise our successes. It appears Kates’ experience with sour dough as part of her coeliac journey is no different.

All opinions in this blog are my own

Guest Blog by Dr Claire Walker: Microbial Culture – An Immunologist’s Side Project Gone Wild

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I am currently in the middle of secret project, which I hope to announce more about in late August/early September. I’m really excited about it but it’s taking a bunch of my time. I’m hoping that you will be just as excited when I can share more details. The wonderful Dr Claire Walker is helping me deliver my passion project by curating the Girlymicrobiologist blog for a few weeks. This means that I hope you all enjoy getting some great guest blogs from a range of topics. Girlymicrobiologist is a community, and all of the wonderful authors stepping up, sharing their thoughts and projects, to support me in mine means the world. I hope you enjoy this guest blog series. Drop me a line if you too would be interested in joining this community by writing a guest blog.

Previous mycology posts have covered how fungal mycotoxins can cause us harm, and how the new yeast on the block, C. auris, is causing problems in healthcare, but the next two posts will talk about how beneficial fungi can be in our every day lives.

Guest Blog by Dr Sam Watkins: The wild world of mycotoxins, maybe not such a fun-gi
Candidozyma auris the New Kid on the Fungal Block: What is it and why should we care?

The blog posts will look at how certain yeasts can be used in something that brings me a lot of joy, bread. Many of you will know I’m dairy free, and although I know I should cut down on carbs, you can take my bread from my cold dead hands. It’s one of the few things I can eat without fear and makes me happy. In celebration of this oft overlooked area of microbiology we shall be talking all things baking over the next two weeks.

The first of these posts is written by Dr Walker who is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for the Girlymicrobiologist, including Exome Sequencing and the Hunt for New Genetic Diseases.

Before I hand over to Claire though, I thought I would talk a little about baking and fermentation. About 50% of all the PhD students I speak to have dreamt at some point of throwing their research out the window, running away and starting a bakery. This may be because baking has a surprising amount of science within it when compared to some other forms of cooking, hence the need to closely align to a recipe. A lot of this is actually because you are working with yeast, a living organism, hence the fact that we are talking about this on the Girlymicro blog, as micro is just cool in so many ways

Fermentation is an anaerobic (occurs without the presence of oxygen) process where microorganisms, like bacteria and yeast, convert sugars into energy and various byproducts, like acids, gases, or alcohol. In baking, it causes yeast and bacteria to convert sugars into carbon dioxide, among other things. This is what causes the dough to rise, as well as adding flavour, and is therefore essential to all things yummy and bread related. The most commonly used yeast is Saccharomyces cerevisiae, and this is one of the reason baking can behave so variably on times of the day or seasons, as both temperature and pH can impact on how well the fermentation process works. It can also mean, if you are impatient like me, you add water at far too high a temperature and effectively kill off your yeast so it doesn’t work at all. Fermentation, and its use in food production, is one of the many examples of how microbiology and microbes impact our every day lives, and of how much poorer our lives would be without them. So I hope you’ll enjoy the next couple of blogs about how baking has both microbiological and immunological links.

Blog by Dr Claire Walker

As I’ve confessed on this blog before,I am, what I like to call, a ‘failed microbiologist’. Many moons ago I completed a master’s qualification in environmental microbiology and dreamed of a career tracking pathogens through our water systems guaranteeing safe water for all. However, I graduated during a recession and started applying for any job that would have me. As luck would have it, I ended up on the immunology clinical scientist training scheme (the story of that fateful application I will save for a later date), and the rest is history. However, I’ve always loved a bit of microbiology and my fascination with all things fermented has taken me on many adventures. Including baking afternoon tea for a GirlyMicro special event!

My treat for finishing my marking this year was a fermentation course at the Welbeck School of Artisanal food learning all about the transformation of food by microorganisms. The word fermentation comes from the Latin fervere meaning ‘to boil’ after Romans watched the bubbles forming when they fermented grapes into wine. Name a scientist who doesn’t love a bit of Latin?  There are several biological processes occurring when we ferment foods like grapes, but essentially it is a process by which large chains of molecules are broken down by enzymes into their smaller, tastier, more nutritious, and more easily digestible parts.

The area of fermentation about which I am really passionate is sourdough. Yes, I lived in East London for many years, and yes, I owned a banneton before it was cool. Sourdough doesn’t just indulge my microbiology side project; it became unexpectedly personal. After picking up a particularly unpleasant microbe while travelling in India, I developed amoebic dysentery, and my gut never fully bounced back. I couldn’t tolerate shop-bought bread or much of anything, really. It wasn’t until I began incorporating fermented foods, especially sourdough, into my diet that I noticed slow but steady improvement. (Though let me be clear: this is my experience, not medical advice – if you’re unwell, definitely speak to your clinician!)

For the uninitiated, a sourdough mother, or starter, is a living culture of wild yeast and lactic acid bacteria that needs regular feeding with flour and water to stay active. As a failed microbiologist, I found something oddly fulfilling about sustaining a microbial ecosystem especially one that produces bread with real health benefits. What’s not to love about a culture that feeds you back?

Of course, I’m a dyed in the wool clinical immunologist so I can’t finish up this post without waxing lyrical about the immunology of sourdough. What makes sourdough really special, from an immunologists perspective, is how it supports our gut, which is home to about 70% of our immune cells. By encouraging a healthy mix of gut bacteria, sourdough helps produce bioactive compounds that keep our immune system balanced, strengthening our defenses without overreacting. This means it can help protect us from infections while calming down low-grade chronic inflammation that might otherwise cause problems. So, sourdough isn’t just tasty, it’s a simple, natural way to support a well-regulated immune response. Of course, sourdough isn’t for everyone, especially not for coeliacs. After all, even the most dedicated immunologist moonlighting as a microbiologist hasn’t yet figured out how to turn gluten into something completely safe. Guess some mysteries are still off the menu!

All opinions in this blog are my own

Candidozyma auris the New Kid on the Fungal Block: What is it and why should we care?

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Following on from the wonderful fungal post on fungal toxins (mycotoxins) last week from Dr Sam Watkin, I wanted to follow up with a post on the latest fungi of interest from a clinical perspective, Candidozyma auris. This fungi is getting more and more coverage, as well as becoming more important in healthcare, so I thought I would take a moment to talk about what it is, what it does, how to find it, and what to do when you do.

In a pre-pandemic world, which feels like a long time ago, Professor Lena Ciric was working at a media fellowship, and as part of that work wrote an article for the BBC on Candida auris, which has subsequently been renamed to Candidozyma auris.

https://www.bbc.co.uk/news/health-49170866

This article came out in 2019, so maybe C. auris is not so new but in terms of the numbers of cases we are seeing within the NHS, and the changing prevalence out in healthcare systems more widely, it is definitely more of a feature and a concern than it was back then. Reflecting this change the UKHSA guidance Candidozyma auris (formerly Candida auris): guidance for acute healthcare settings which was originally published in 2016, has been updated recently (19th March 2025). It feels timely therefore to put something out  in order to raise awareness of this organism and the unique challenges it presents.

NB I can neither spell nor pronounce Candidozyma auris and so we’re sticking to C. auris from this point out.

https://www.nejm.org/doi/pdf/10.1056/NEJMra2402635

What is it?

Yeast are a type of fungus, and Candida species are often associated with colonisation (present without causing infection or symptoms) on skin, in the mouth or within the vagina. If they grow up to high levels they can cause an infection called candidiasis, which often causes symptoms like itching or discharge. Common infections include Thrush and nappy rash. Candida albicans is one of the most common yeast infections seen within the healthcare setting, and in this kind of environment more serious infections can be seen, especially those linked to the blood stream, and occasionally serious organ infections.

C. auris was originally believed to be a relatively new species of genus Candida, as it often behaves in a similar way to the other Candida species. The reason for the name change to Candidozyma auris, was because, although in many ways it behaves similarly to its Candida cousins, it does have some differences in the way it behaves. These include features such as intrinsic antifungal resistance and growth conditions, that make it useful to characterise in a way that acknowledges it as a novel genus in its own right.

What is the difference between C. auris and the other Candida species that you know?

Many Candida species can cause severe infections within specific settings, however C. auris has been known to not only cause a wide variety of infections (bloodstream, intra-abdominal, bone and cerebrospinal fluid (CSF) infections), but ones which lead to significant mortality rates, with an estimated rate of 30 – 72% in severe infection reported in the literature.

Infections can occur in any patient group, although UK outbreaks have been most frequent associated with adult settings. Augmented care settings (such as intensive care and transplant settings) are at highest risk due to the vulnerable, long stay nature of many of their patients. Management of any infection occurring is complicated by the fact that C. auris has developed resistance to many available classes of antifungals, with emergence of pan-resistant strains, which add to the mortality risk.

C. auris also appears able to both easily transmit and colonise the skin of patients, with most patients being colonised before they go on to develop any subsequent infection. These colonised patients can then contaminate their healthcare environments, and unlike other yeast species, C. auris is able to survive and represent a continued risk within the environment for prolonged periods, all of which contributes to outbreak risk.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11123812/pdf/microorganisms-12-00927.pdf

Geographic distribution

It was first identified in the ear canal of a patient in Japan in 2009, but has since been found globally, and is now separated into six genetically distinct clades:

  • Clade I = the South Asian clade, first detected in India and Pakistan
  • Clade II = the East Asian clade, first detected in Japan
  • Clade III = the South African clade, first detected in South Africa
  • Clade IV = the South American clade, first detected in Venezuela
  • Clade V = Iran (recent)
  • Clade VI = Singapore (recent)
https://pmc.ncbi.nlm.nih.gov/articles/PMC11123812/pdf/microorganisms-12-00927.pdf

Within the UK from January 2013 – December 2024, 637 C. auris isolates were reported through laboratory surveillance in England, with 59 (9.3%) isolated from blood culture specimens. It should be noted that not all labs report, and for some time many labs could not accurately identify C. auris, or actively screened for it, and so this may represent under reporting. A routine whole genome sequencing service is not currently available for typing, although it can be undertaken linked to specific outbreaks. Hopefully this will be up and running soon to better understand how the different clades discussed above are represented in the UK, and whether any of them are linked to more challenging outcomes than others.

https://www.gov.uk/government/publications/candida-auris-laboratory-investigation-management-and-infection-prevention-and-control/introduction-and-background

Where do we find it?

Due to its global distribution, overseas patients may also be at increased risk of introducing C. auris into UK healthcare settings, with one centre reported 1.6% of their overseas admission detected as colonised, with patients coming from the Middle East, India and Pakistan, showing higher levels of recovery.

UKHSA guidance suggests we should screen any patient who has had an overnight stay in a healthcare facility outside of the UK in the previous year, as well as patients patients coming from affected units in the UK. This sounds relatively straight forward, but it can be challenging to identify patients who have had an overnight stay overseas on admission if they are not being admitted from overseas. It also relies on clear communication from other centres that they have an issue, if we are to screen patients from impacted units. Many centres have therefore decided to screen all patients on high-risk wards, such as intensive care, to address some of this unknown risk.

Risk factors for developing C. auris colonisation or infection should be considered when deciding on screening strategies and the list within the UKHSA guidance includes patients who have experience:

  • healthcare abroad, including repatriations or international patient transfers to UK hospitals for medical care, especially from countries with ongoing transmissions
  • recent surgery, including vascular surgery within 30 days
  • prolonged stay in critical care
  • severe underlying disease with immunosuppression, such as HIV and bone marrow transplantation
  • corticosteroid therapy
  • neutropenia
  • malignancy
  • chronic kidney disease or diabetes mellitus
  • mechanical ventilation
  • presence of a central-venous catheter or urinary catheter
  • extra-ventricular CSF drainage device
  • prolonged exposure to broad-spectrum antibiotic or antifungal use
  • underlying respiratory illness
https://pmc.ncbi.nlm.nih.gov/articles/PMC11123812/pdf/microorganisms-12-00927.pdf

How do we find it?

Screening is undertaken by taking swabs from the axilla (armpit), groin and nose, although different patient groups may require additional screening. Patient surveillance is important for two reasons:

  • 1) to understand which patients are colonised in order to introduce additional precautions to limit risk of transmission to other patients or the environment
  • 2) to support improved patient management but allowing patients to be put on the most effective antifungal if they go on to develop any signs of yeast infection, in order to improve outcomes

If a patient is detected as positive, other screening sites can help manage individual patients and so UKHSA say additional site screening should be considered:

  • urine (especially if there is a urinary catheter in-situ, including intermittent self-catheterisation)
  • throat swab
  • perineal swab
  • rectal swab (in paediatrics we would consider a stool sample instead)
  • low vaginal swab
  • sputum or endotracheal secretions
  • drain fluid (abdominal, pelvic or mediastinal)
  • vascular access sites
  • wounds or broken skin
  • ear
  • umbilical area (neonates)

Swabs should ideally be processed on chromogenic media (colour changing agar plates) and fungal colonies confirmed using MALDI ToF or a validated PCR (my previous post on PCR may help with this). It can also be helpful to incubate plates at 40oC, as C. auris can grow as much higher temperatures than its Candida cousins, which can help with identification. If grown then the yeast should be stored in case you need them for future typing to help in understanding transmissions or outbreaks.

Why should we care about it?

Due to the high mortality rates for patients who develop infections, and the issues with choosing antifungals that work, it is really important that we know when we have patients who are colonised with C. auris. Controlling spread, even if patients don’t become infected, is incredibly important for the individual. This is because if a patient is detected as positive they won’t be de-alerted (have IPC precautions stopped) at any point and so it will impact them for months, if not years. These IPC precautions include isolation (keeping separate from other patients), and sometimes only being nursed by specific members of staff. These patient and staff impacts are so significant they’ve even been acknowledged in popular media, with a three episode arch covering C. auris in The Resident on Netflix (season three, episodes 18, 19 and 20).

Are there differences in how you might treat?

As I’ve already said, C. auris is pretty resistant to treatment compared to its Candida cousins. UK data indicates that isolates are resistant (don’t respond to) to the normal first line treatment of fluconazole, and often to other antifungals within the azole class. Some isolates have been resistant to other commonly used antifungals, such as amphotericin B (20%) and echinocandins (10%). Resistance to other antifungals can also occur whilst infections are being treated, and so it is important to monitor sensitivities (whether the drug works) and send to reference labs in order to understand the most appropriate therapy. Its resistance profile is one of the reasons the WHO have highlighted C. auris as a priority fungal pathogen for further research and to highlight clinical risk.

Its not just antifungals that are important however, antimicrobial stewardship is important in general, as prolonged exposure to broad-spectrum antibiotics and antifungal agents are risk factors for both C. auris colonisation and infection (again this links back to the high risk patient groups impacted). Therefore, doing a better job of monitoring and controlling antimicrobials in general is likely to have a beneficial impact on C. auris risk.

Challenges with environmental control

One of the many things I love about the new C. auris guidance is its focus on multidisciplinary input ‘Healthcare workers are encouraged to work in multi-disciplinary teams, including Clinical Infection Specialists and IPC teams, to risk assess and support the management of patients infected or colonised with C. auris‘. I think this is so important, especially with an organism that is so challenging and can present such a high risk.

Environmental control is a particular issue for C. auris as we know it’s ability to survive and can grow at higher temperatures than many other fungi, means that it is likely to survive well in the environment. It also has the ability to form environmental biofilms, which can mean it is difficult to impact effectively using standard cleaning techniques, and once within the environment has been been detected for 4 weeks.

Within the UKHSA documentation, environmental contamination for C. auris has been found on the following surfaces during outbreaks:

  • beds, bedside equipment, bedding materials including mattresses, bed sheets and pillows
  • ventilation grilles and air conditioning units
  • radiators
  • windowsills and other horizontal surfaces
  • hand wash basins, sink drains and taps
  • floors
  • bathrooms doors and walls
  • disposable and reusable equipment such as ventilators, skin-surface temperature probes, blood pressure cuffs, electrocardiogram leads, stethoscopes, pulse oximeters and cloth lanyards

Basically most of your healthcare environment, whether fixed or movable features. In order to help stop the transfer from patients to the environment, via staff, the use of personal protective equipment is really important. Therefore the use of gowns and gloves is suggested. Single use and disposable equipment should also be used whenever possible, and patients should be kept in single, ensuite rooms, to minimise the risk of C. auris escaping from within the bed space to adjacent clinical environments. Any items within the space should either be cleanable with a disinfectant, or disposed of after a patient leaves. One thousand ppm of available chlorine should be used for cleaning, but needs to be used in concert with an appropriate contact time if it is to be effective.

WHO fungal priority pathogens list to guide research, development and public health action 2022

Outbreaks

Most detections of C. auris cases detected are colonisation rather than infection (though colonisations can lead to subsequent infections). Within the UK there have been 5 significant outbreak of C. auris, each with over 50 cases, in addition to many sporadic introductions of single cases, frequently from overseas. Many of these have been in London or the South of England, and have resulted in considerable disruption to services over a prolonged period of time. This disruption can, in itself, be a risk to patients as it can result in delayed access to care. Outbreaks are also financially significant, with outbreaks reported as costing over £1 million for a service impacted for 7 months.

Although outbreak numbers are currently small, they are becoming more frequent, and even if infrequent have significant impacts. The need to control this risk before it becomes endemic within the UK health system is therefore significant. It is crucial therefore to collect more data and understand transmission routes of C. auris better.

Despite probable under reporting, it is clear that C. auris is becoming more common within UK healthcare settings, and has the ability to both cause significant issues for both individual patients and for services, due to outbreak impacts. Although fairly new on the scene there is increasing recognition of how C. auris could change fungal risks within healthcare, and even long stay residential settings. If we are going to adjust approaches in order to react to the new risks C. auris represents we need to both update our current practices, and invest in research, in order to learn how to do things even better. This is the reason that it feels important to share a post that is a little more technical than normal, both to help myself by learning more, but also to ensure that we are having conversations about an organism that has the ability to impact us all.

jmm001820Download
Summary of recommendations C auris 2025 – GOV.UKDownload
WHO fungal priority pathogens listDownload

All opinions in this blog are my own