FRCPath Medical Microbiology exam guidance
Practical help for Part 1 and Part 2, with curated resources, exam tips, and structured learning pathways.
If you want to know more about the exam, click on the buttons below. This is based on my 12 years of experience supporting trainees in the UK and guiding numerous overseas trainees.
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Daily newsletter
Microregistrar Infection NewsletterMicroregistrar Infection Newsletter · Monday 12 October 2026
UK Joint Societies issue new national guideline on suspected encephalitis in adults.
The new guideline in the Journal of Infection (online 11 Oct, open access; endorsed by ABN, BIA, UKHSA and others) replaces the 2012 UK viral encephalitis guideline and covers infectious and autoimmune encephalitis together in adults (>16). Highlights: an HIV test for everyone; minimum CSF PCR for HSV-1, HSV-2, VZV and enterovirus; IV aciclovir 10 mg/kg tds within 6 h for ≥14 days (21 if immunocompromised or still PCR-positive), with no oral step-down; and first-line immunotherapy for autoimmune encephalitis started before antibody results. Elsewhere, the DRC’s own SitRep 149 reports 8,978 / 4,336, ahead of WHO and ECDC, which are unchanged at 8,728 / 4,205.
11New journal items, from 6 journals1New on Microregistrar Moodle1/9Watched pages with something new23Source links in this issue1New UK national guideline (adult encephalitis)5Coverage gaps we could not closeCounted from today’s digest. New journal items are the ones listed as new in the Journals tab (1 J Infect, 4 CID, 3 OFID, 1 JID, 1 Lancet Microbe, 1 IJID); the two J Infect papers we covered yesterday aren’t counted again. Links are unique content links across the issue, not counting our two website links. Gaps come from the Coverage gaps list. Today’s digest has no sources checklist, so there’s no checks card.
Also today
The other headlines from today’s issue. Each one links through to the full summary. Otherwise the UK is quiet: the flu/COVID week 41 report is still the latest, and week 42 and the England measles update are both due on 15 Oct.
Microregistrar Moodle · 1 newNew on Microregistrar Moodle
Epididymitis (11 Oct 2026), a clinical teaching item.
Ebola · DRC SitRep 149DRC: 8,978 confirmed, 4,336 deaths
The Ministry of Health’s SitRep 149 (report date 10 Oct, published 11 Oct): CFR 48.3%, +64 cases and +21 deaths in 24 h, and 65 of 167 health zones affected.
Not yet confirmed by WHO or ECDC: we read these figures from a mirror of the MoH PDF; WHO and ECDC still show 8,728 / 4,205 (to 6 Oct).
Watch · Irkutsk · unchangedDON620 is still the latest word
No plague, contacts cleared and no travel restrictions.
Still not confirmed: the cause of death remains undetermined.
CDC · MMWRCladophialophora bantiana: about a 4-fold rise
MMWR Notes from the Field, now verified: a brain-abscess mould with rising detections in 2023–25 and a historical CFR of 60–70%. US measles is unchanged at 4,080 cases (as of 8 Oct).
Journals · CID and OFIDCirrhosis, Pseudomonas and M. genitalium
Antibiotic exposure thresholds for MDRO acquisition in cirrhosis, a call for trials before shortening Pseudomonas bacteraemia courses, and 42.7% macrolide resistance in US M. genitalium.
UKHSA · unchangedFlu and COVID-19: still week 41
Hospital PCR positivity: flu 6.5%, COVID-19 9.1%; RSV at baseline. Week 42 is due on 15 Oct at 14:00 BST.
What we could not confirm
The new DRC figures come from a mirror of the Ministry of Health’s SitRep PDF, and WHO and ECDC haven’t republished them yet. On Irkutsk, the cause of death is still undetermined. We couldn’t read several CDC pages, so mid-October MMWR weekly contents aren’t fully verified. Some journal pages and feeds were blocked, so we may have missed papers. We couldn’t find the paediatric companion encephalitis guideline. Journal takeaways are abstract-level only.
Microregistrar Moodle update
New on Microregistrar Moodle since our last issue: one item.
New · 11 Oct 2026 Epididymitis
A clinical teaching item. There’s no further description on the sheet.
The full list is in the Microregistrar moodlecloud sheet ›
Watched pages
We check nine pages every morning for anything new, compared with what we saw last time (checked 12 Oct 2026 08:07 BST; all 9 were reachable). One has something new: the Journal of Infection, with the UK encephalitis guideline. The other eight were quiet, including RCPath exams.
Health Protection Report (UKHSA)
No changeNo new items (still volume 20 issue 9, 24 Sep).
UK SMI News (RCPath)
No changeNo new items.
RCPath Examinations
No changeNo new exam news. None of the watched subpages has changed.
Green Book
No changeNo new or updated chapters.
UKHSA organisation page (GOV.UK)
No changeNo new infection-relevant items overnight.
NICE published guidance
No changeNo new infection/antimicrobial items.
Journal of Antimicrobial Chemotherapy
No changeNo new items.
Journal of Infection
NEW11 Oct: Management of suspected infectious and autoimmune encephalitis in adults – National Guidelines from the United Kingdom Joint Societies. See Guidance changes.
doi:10.1016/j.jinf.2026.106873 › · Full text ›
The Yanggou tick virus and adult ALL antifungal-prophylaxis papers reappeared under different links; they were in our 11 Oct issue, so they aren’t counted as new.
Journal of Hospital Infection
No changeNothing meaningful new: the feed was refilled with the November issue’s compilation of older articles.
Agencies & guidance
The UK adult encephalitis guideline is today’s big change. The DRC’s own Ebola figures have moved ahead of WHO and ECDC; everything else is unchanged.
Guidance changes
UK Joint Societies · national guideline · new Management of suspected infectious and autoimmune encephalitis in adults (Journal of Infection, 11 Oct)
Endorsed by ABN, BIA, UKHSA and others. It replaces the 2012 UK viral encephalitis guideline and covers infectious and autoimmune encephalitis together in adults (>16). A key FRCPath CNS-infection reference.
- Suspect and notify: suspect it on the FLAMES red flags; do an HIV test in all; notify confirmed cases to UKHSA within 3 days; and involve the Imported Fever Service where relevant.
- LP: at the earliest safe opportunity (CT first only if mass effect or raised ICP is suspected); repeat at 24–48 h if non-diagnostic.
- CSF PCR minimum: HSV-1, HSV-2, VZV and enterovirus. Use multiplex panels with caution. Send paired intrathecal HSV/VZV antibodies ≥10 days after onset if PCR is negative and suspicion is high, and consider mNGS (metagenomic sequencing) when undiagnosed or immunocompromised.
- Aciclovir: IV 10 mg/kg tds within 6 h, for ≥14 days (21 if immunocompromised or PCR still positive), with no oral step-down; strongly consider a repeat LP at 14–21 days. Stop when suspicion is low and HSV PCR is negative twice 48 h apart (or once >72 h after onset) and MRI isn’t characteristic. Dose on ideal body weight in obesity.
- Imaging and EEG: MRI ideally within 24 h (certainly within 48 h); EEG within 48–72 h.
- Dexamethasone in HSV encephalitis is left to clinician judgement (DexEnceph showed no overall benefit).
- Autoimmune encephalitis: send serum and CSF neuronal antibodies early; start first-line immunotherapy before the results; escalate to rituximab or cyclophosphamide if there’s no clear response at 2–4 weeks.
- Compared with the ESCMID/EAN guideline (CMI, in our 10 Oct issue): largely concordant. The UK version adds autoimmune encephalitis, favours a repeat LP at day 14 (ESCMID/EAN: not needed if improving), drops ESCMID/EAN’s normal-CSF-WCC requirement for stopping aciclovir, and advises EEG for most patients.
We couldn’t find a paediatric companion guideline.
Full text › · DOI: https://doi.org/10.1016/j.jinf.2026.106873
Other guidance No other changes
No new UK SMI, Green Book, NICE infection guidance or EUCAST changes detected.
UKHSA / England
UKHSA · flu/COVID-19 · unchanged Still the week 41 report (8 Oct; data to 4 Oct)
Flu hospital PCR positivity 6.5% (was 5%), flu admissions 1.97/100,000; COVID-19 PCR positivity 9.1% (was 7.9%), admissions 2.04/100,000; RSV positivity 0.5%, at baseline. The week 42 report is due on 15 Oct at 14:00 BST.
UKHSA: flu and COVID-19 surveillance reports, 2026 to 2027 season ›
UKHSA · NOIDs · week 40 · unchanged Lab notifications rising
Influenza A 1,466 (859 in week 39); SARS-CoV-2 2,031 (1,509).
UKHSA · Outbreaks under monitoring Still at week 40
The week 40 chapter is still the latest; there’s no week 41 chapter yet.
UKHSA · unchanged Everything else
Measles in England: 1,003 lab-confirmed cases 1 Jan–14 Sep, next update 15 Oct. HPR is still 20(9) and Vaccine Update is still issue 376 (September). No new official figures on the Rotherham Legionnaires’ cluster or hepatitis A in Newcastle schools.
ECDC
ECDC · CDTR · unchanged Week 41 is still the latest
Week 41 (3–9 Oct, published 9 Oct); the next one is normally on Friday. No new ECDC risk assessments on 11–12 Oct.
ECDC · Ebola page · unchanged 8,728 confirmed, 4,205 deaths (to 6 Oct)
Last updated 8 Oct 16:25. ECDC rates the risk very low for people living in the EU/EEA and low for EU/EEA residents travelling to affected areas.
Global — Ebola (Bundibugyo)
DRC Ministry of Health · SitRep 149 · new DRC: 8,978 confirmed, 4,336 deaths (report date 10 Oct, published 11 Oct)
CFR 48.3%. In the last 24 h: +64 cases (Ituri 30, Nord-Kivu 25, Haut-Uélé 7, Tshopo 2) and +21 deaths. 945 people in treatment centres, 2,356 recovered, and contact follow-up at 81%. 65/167 health zones in 7 provinces are affected (64 in DON619). The Kenya import framing is unchanged.
Not yet confirmed by WHO or ECDC: we read these figures from a mirror of the MoH PDF, and WHO and ECDC haven’t republished them; both still show 8,728 / 4,205 (to 6 Oct).
WHO and other
Watch · Irkutsk · unchanged DON620 is still the latest
DON620 (Irkutsk, 10 Oct) is still the latest DON, and there’s no newer Ebola DON after DON619 (8 Oct). No plague, no biosecurity incident, contacts cleared; UK returning-case probability is very low.
Not confirmed: the cause of death is still undetermined.
Global · quiet H5N1, cholera, mpox and polio
No genuinely new international figures in the window.
CDC / US
CDC · MMWR · Notes from the Field Molecular detections of Cladophialophora bantiana, US, 2009–2026 (ePub 2 Oct)
Now verified: 48 confirmed and 1 probable detections at a reference lab, 88% from CNS tissue, an about 4-fold rise from 2023 to 2025, and a historical CFR of 60–70%. Consider it in brain-abscess work-up; treatment is antifungals with or without surgical excision.
CDC · measles · unchanged 4,080 US cases in 2026
As of 8 Oct: 42 outbreaks, 96% outbreak-associated. Pennsylvania 1,078 cases and 5 deaths (state figures, 7 Oct).
CDC · quiet HAN, newsroom and EID
No new October health advisory (the latest infection HAN is still the rabies PEP advisory, 10 Sep), no October infection press releases, and nothing new in EID early release since 2 Oct.
CDC · travel health notices · unchanged Travel notices
Level 4 Ebola in Ituri and Nord-Kivu (DRC); Level 3 Haut-Uélé and Tshopo; Level 2 other DRC/Uganda areas and global polio (23 Sep); Level 1 global dengue (2 Oct).
Several CDC pages (MMWR weekly, HAN archive, outbreak index) refused our access; see Gaps.
Journals
Eleven new items from six journals, including the UK encephalitis guideline on our watched Journal of Infection page. Takeaways are abstract-level only.
Journal of Infection — new on our watched page
J Infect · UK guideline · watched Management of suspected infectious and autoimmune encephalitis in adults – National Guidelines from the United Kingdom Joint Societies
Takeaway: the new UK adult standard for encephalitis; the full summary is in Guidance changes.
Clinical Infectious Diseases (CID) — new
CID · AMS · hepatology Antibiotic exposure and emergence of MDR bacteria in liver cirrhosis (prospective, n=256)
Takeaway: new VRE and Gram-negative MDRO acquisition tracked cumulative antibiotic exposure. A 20% probability of VRE acquisition was reached at 9.6 DDDs (lower for BL/BLI, carbapenems and glycopeptides), and new MDRO detection predicted 180-day mortality (HR 2.15). These are quantified stewardship thresholds for hepatology.
DOI: https://doi.org/10.1093/cid/ciag610 · editorial: https://doi.org/10.1093/cid/ciag612
CID · duration Shorter antibiotic duration for Pseudomonas bacteraemia: a call for trials
Takeaway: a post-hoc Bayesian analysis suggests 7-day courses may not behave the same for P. aeruginosa as for other Gram-negatives, so be cautious about extrapolating 7-day data.
CID · review Recurrent and relapsing catheter-related BSI with long-term vascular access
Takeaway: a team approach to remove vs salvage, lock therapy, impregnated catheters and preserving venous access.
CID · HIV Cancer in people with HIV, Spain (1997–2023)
Takeaway: higher in-hospital mortality (aOR 1.83) and more years of life lost (35 vs 18) than in people without HIV.
Open Forum Infectious Diseases (OFID) — new
OFID · STI · AMR Antimicrobial-resistant Mycoplasma genitalium, US population sample (NHANES 2017–18)
Takeaway: macrolide-resistance mutations in 42.7% and no quinolone resistance, which supports resistance-guided treatment.
OFID · bacteraemia Adult Group B Streptococcus bacteraemia, Japan (n=442)
Takeaway: 30-day mortality 9.3%, and 39.3% with streptococcal toxic shock syndrome (aOR 9.16). Immunosuppression, cirrhosis, a respiratory focus and renal dysfunction also predicted death.
OFID · TB · travel TB test conversion in returning travellers (n=5,668)
Takeaway: 2.1 conversions per 100 person-years; travel nearly doubled the odds (OR 1.95), and only 57% of converters started latent TB treatment.
JID, Lancet Microbe and IJID — new
JID · phase I AZD0292, a long-acting anti-Pseudomonas bispecific antibody
Takeaway: well tolerated, with a half-life of 24–47 days; aimed at bronchiectasis with chronic P. aeruginosa.
Lancet Microbe · review The urobiome in UTI
Title-level only.
IJID · TB A 12-year TB recurrence cohort
Title-level only; we couldn’t read the abstract.
Already covered
J Infect Yanggou tick virus and adult ALL antifungal prophylaxis (11 Oct); CMI ESCMID/EAN encephalitis guideline (10 Oct).
On X
One search of the UKHSA, ECDC, WHO, CDC and WHO Director-General accounts (11 Oct onwards).
No breaking infection signals. WHO’s posts were about the World Health Summit in Berlin and the fifth anniversary of the WHO Pandemic and Epidemic Intelligence Hub.
What we could not confirm
We want you to know exactly where today’s issue has limits, so here are the 5 sources we had trouble with and what went wrong.
Source Issue CDC MMWR weekly and Early Release pages, the HAN archive, newsroom pages and the outbreak index refused our access. The items above came from CDC syndication, the travel-notice pages, EID and the newsroom feed; mid-October MMWR weekly contents aren’t fully verified. ECDC Ebola page Not refreshed since 8 Oct; the new DRC figures come from a mirror of the MoH SitRep PDF. UKHSA Week 41 Outbreaks under monitoring and NOIDs, and week 42 flu/COVID, aren’t published yet; England measles is due on 15 Oct. Journals IJID abstracts and the OUP advance pages (JAC, JAC-AMR, CID, OFID, JID) were blocked, so we used DOI records instead and found no new JAC/JAC-AMR items. ASM (AAC/JCM) feeds were blocked; JAMA Network Open’s Monday releases weren’t posted yet; Eurosurveillance’s next issue is on 15 Oct. Paediatric encephalitis guideline We couldn’t find a paediatric companion to the adult guideline. Sources
Today’s digest doesn’t include a sources checklist, so we can’t show ticked and open checks this time. These are the sources it draws on, as described in the issue.
- Watched pages (9 pages, all reachable, checked 12 Oct 08:07 BST)
- Microregistrar Moodle sheet (1 new item)
- UKHSA GOV.UK: flu/COVID week 41 report, Outbreaks under monitoring, NOIDs week 40, measles, HPR
- ECDC: CDTR week 41 and the Ebola outbreak page
- WHO Disease Outbreak News (DON620 and DON619 still the latest) and the DRC MoH SitRep 149 (via a mirror)
- CDC: syndicated MMWR, measles, travel notices, EID, HAN and newsroom feeds (partial)
- Journal sweep plus watched journal feeds
- X: one search of official accounts
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