When the Beatles sang “The Long and Winding Road” they could have been describing how my career in infection was going to pan out. Starting on this path in 2007, it has taken over a decade to be appointed as a Consultant in Microbiology and Infectious Diseases in Cambridge. At the end of my core medical training I had my mind set on becoming a gastroenterologist. However, I had a change of heart after a Consultant Microbiologist invited me to visit her laboratory at the end of an intensive care ward round. This fateful encounter resulted in being accepted to one of the last (ever) Specialist Registrar training numbers in Nottingham; and so began my training in infection.
After three thoroughly enjoyable years, I embarked on a Wellcome Trust funded Clinical PhD Fellowship at the University of Cambridge to study the global genomic surveillance of Salmonella Typhi (S. Typhi), the cause of typhoid fever. This was followed by a number of clinical research posts, including time as a Clinical Research Associate in Cambridge then a series of NIHR Clinical Lecturer posts, first in London and then in Cambridge, eventually leading to my consultant appointment in 2018.
For me, Medical Microbiology provides the perfect balance of laboratory- and clinical-based medicine. I not only enjoy advising on the most appropriate diagnostic tests to perform, but also interpreting results and recommending the optimal antimicrobial treatment for the patient. I like that the job is dynamic and involves interactions with a wide range of different people, including biomedical scientists, infection control nurses, pharmacists, public health professionals, estate managers, clinical colleagues on the wards, and General Practitioners serving the wider community.
My continued involvement with academic Microbiology has been both exciting and rewarding, with the opportunity to make a lasting influence on the diagnosis and treatment of infection. I was fortunate enough to be involved in genome sequencing of approximately 2,000 S. Typhi isolates as part of my PhD, which led to the development of a simple genotyping assay that is available worldwide for laboratories to track typhoid transmission. I also studied the evolution of multiple drug resistances (MDR) in S. Typhi and described an MDR-specific clade, H58, that is driving this. These findings are particularly pertinent in the context of interest in the spread of antibiotic resistance, yet also translate to my daily role supporting antimicrobial stewardship in the hospital.
At times I find the job challenging and the current Covid-19 pandemic is a case in point. Covid-19 has highlighted the need for microbiologists to be flexible and adaptable, as well as the importance of research for developing new diagnostic tools that can help us tackle this potentially fatal disease.
Despite the apocalyptic potential of the continual threats, such as emerging global pathogens and climate change, a career in Microbiology can be most interesting and fulfilling. As they say, life is all about the journey, not the destination. I definitely have enjoyed my travels so far.