title: [My accidental discovery].
abstract: We wonder what we should do in medical care besides daily routine work as a laboratory technician. I made a discovery in my routine laboratory work, which gave me a theme for my research. This led to me successfully completing a number of scientific research projects, and these experiences have enabled me to be able to give advice on appropriate treatments for infectious diseases in medical care. It was March 1999 when I identified Escherichia coli (E. coli) in an intra-abdominal abscess resistant to antibacterial agents. The E. coli was producing an enzyme, extended-spectrum-beta-lactamase (ESBL), that breaks down cefem-group antibiotics often used in Japan. Therefore, it was resistant to those antimicrobial agents. Detailed analysis was performed by us and researchers of the National Institute of Infectious Diseases, which revealed that the E. coli had a SHV12 genotype of ESBL. It was the first case report of this type of ESBL-producing E. coli infection in Japan. After this experience, I became interested in searching for the mechanism of resistance to antibiotics with various kinds of approaches, such as a method involving genomic analysis by the polymerase-chain reaction (PCR), therapeutic management of drug-resistant bacterial infection, and so on, through which I learned a series of investigative approaches. Since I had plenty of data and experiences generated from routine work, I could perform novel studies and obtained many interesting findings. I am feeding back these findings to routine work in order to improve my performance. From my experience, we should look for the seeds for research from routine work as much as possible, and knowledge and experience generated by resolving problems teaches us how to perform in a clinical setting. This may lead to the further development of our research, which, in turn, promotes the accumulation of knowledge and experience. This feed-forward cycle enables laboratory technicians to improve their quality of work. This I gleaned from my one accidental discovery.
authors.affiliation: Department of Clinical Laboratory, Kansai Medical University Hirakata Hospital, Hirakata 573-1191, Japan. nakamurt@hirakata.kmu.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D018784:Abdominal Abscess / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology / Q000235:genetics; D005838:Genotype; D013677:Medical Laboratory Science; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; C107198:beta-lactamase SHV-12; D001618:beta-Lactamases