Microbe Invader



Version 3.13 changes (4/1/2014)

- Fixed impossible-to-kill ESBL-producing E. coli

Version 3.12 changes (3/26/2014)

- Fixed problems with being stuck after loading save files

Version 3.11 changes (3/21/2014)

- Fixed cryptosporidium treatment (supportive care)
- Additional bug fixes

An Android version is in the works!!

Version 3.10 changes (3/10/2014)

Sorry for the long delay! Lots of updates here!
- Middle age men / women patients
- Replaced antibiotics that aren't used much anymore
- Added more diseases (Stenotrophomonas, C. pneumoniae, C. psittaci, Candida glabrata, Blastomyces, Cryptosporidium, Chagas, Leishmania)
- Added resistant organisms (MRSA/VRE/CRKP/CRAB/CREC)
- Increased the capacity of the backpack
- Added a labor and delivery wing of the hospital
- More conferences and tutorial events! You can access them anytime from the projector.
- Badges slightly adjusted - preferentially picks diseases that weren't treated yet

You can play using the old version here.

Version 3.05 changes (8/23/2013)

Added the option to skip the tutorial when starting a new game.  That way you don't just get UTIs when starting out.


New web site launched (8/20/2013)

I fixed a few mouse controls.  Meanwhile, Microbe invader has a new web site at www.microbeinvader.com!  I'll keep posting updates to both this site and the new site for now...


Version 3.04 changes (8/14/2013)

Added mouse controls - you can click somewhere to go there!  Making the game more tablet friendly.


Version 3.03 changes (8/10/2013)

First day off during my AI...
- Jungle, cave, and desert are in the game now, farther into the wilderness
- More story progression (gastroenteritis, respiratory viruses)
- When ordering a test, it will show you the specimen type you are collecting from
- Reorganized how imaging studies work (CT, MRI)


Version 3.02 changes (6/23/2013)
- Fixed more instances where it wouldn't detect if you defeated a virus/bacteria
- Fixed most of the new antibiotics
- For normal saline fluids, if you use it at the beginning of the treatment you set up a continuous infusion for several turns


Version 3.01 changes (6/22/2013)

Internal medicine shelf exam this week >__<
- Immune system now works more consistently (so viruses should be defeatable now)
- Fixed not recognizing that you defeated a virus
- Fixed Albendazole for worms
- Surgery consult is now more effective for abdominal abscesses, septic arthritis, osteomyelitis, etc

Also, Microbe Invader now has a facebook page!  Updates will be cross-posted there.


Lots of changes (6/16/2013) - Version 3.0!

Finally, it's another update after a very long delay!! (thanks to internal medicine rotation).  There's still have a lot left to do.

- Added more styles of townspeople!
- The attendings now look more unique (no more nurse joy / officer jenny type attendings!)
- Added lots of viruses, fungi, parasites (see the list for more details) - there are now almost double the amount of pathogens and diseases
- Lots more icons for history, symptoms, and tests - Oxidase and Citrate, Stool antibodies / microscopy, plus others for detecting parasites/fungi/viruses
- CT scan for head, chest, abdomen - take longer than the chest X-ray, but can detect things more clearly
- Slightly farther progression in the story - introducing more detail about lung infections, soft tissue infections, Gram positive cocci, etc.  The attendings will page you with quests (might need to start a new game to see this part).
- Some diseases aren't really treated with antibiotics - in this case, you can click the wait button and watch your patient's immune system fight the pathogen!  It's more effective when there's no real antibiotic/antiviral treatment (still a work in progress, right now your neutrophils can phagocytose tapeworms)
- Abdominal abscesses, septic arthritis, and osteomyelitis are best treated with surgical consult - use the pager in battle to summon the surgeon!
- You can now save your progress to a file on your local hard drive!  It took me a while to figure out how Actionscript does this.

Thanks for all of the corrections and suggestions!  Still working on getting everything in.  Since there were a lot of changes, I have kept the old version around in case something broke...


Update on progress (4/8/2013)

Spring break was last week.  Victoria and I created a lot of stuff for the game which will be incorporated soon!  I promise!!
- Viruses, fungi, and parasites
- More antibiotics and drugs for treatment
- More progression in the story


Version 2.14 Changes (3/23/2013)

Sorry about the slowing in updates...  trying to study for pediatrics and ob/gyn shelf coming up this week.
- Fixed elevator words so they aren't cut off
- Resistance badge should work now
- Fixed low glucose finding


Version 2.13 Changes (3/12/2013)

Nothing major...
- Fixed Piperacillin-Tazobactam counting as first-line therapy for Pseudomonas (and other diseases)
- Fixed Staph epidermidis septic arthritis
- Fixed Castaneda media for Brucella
- Hid the test result CSF lymphocytes on LP because there's no viruses or fungi yet

btw if anyone wants to teach me or help adapt the game for other countries with different practices (UK, Iceland, etc :D) let me know!  Maybe I can make an alternative version.


Version 2.12 Changes (3/10/2013)

Just some minor edits...
- Fixed the replenishment of supply shelves and stores!  After about 5 minutes the supply shelves will restock themselves, and occasionally rare antibiotics may appear there too.
- Fixed some icons and diseases
- Can't do wet mount on guys or small children anymore


Version 2.11 Changes (3/9/2013)

I was feeling artistic this week...
- Added 10 new bacteria! (Acinetobacter, Bacteroides, Fusobacterium, Moraxella, Gardnerella, Brucella, Pasteurella, Staph epidermidis, Bartonella, Haemophilus ducreyi)!  Now Metronidazole is less useless...
- Added (more complete) diseases otitis media, septic arthritis, bacterial vaginosis, chancroid, etc (inspired by OB/GYN and peds rotation :D)
- Newly generated patients may have various conditions like G6PD deficiency, cystic fibrosis, sickle cell, etc...
- Fixed a problem that gave you diseases too early (all diseases caused by the enemy were counted).  It's harder to get the badges now....sorry!
- Fixed silver stain, campylobacter issues.  And now there's a reason to use Novobiocin sensitivity testing!


Version 2.10 Changes (3/6/2013)

Mid-week bug fixes!
- Fixed badges so that you get credit for seeing pregnant, alcoholic, etc patients where the offending drugs are contraindicated from the start.
- Fixed function of diphenhydramine in allowing penicillin to be used despite allergy
- B. cereus, C. pefringens, Listeria are now beta hemolytic
- Added two more conference presentations


Version 2.09 Changes (3/3/2013)

This is another big set of updates!  First the bug fixes....
- Fixed some problems with the patient chart
- Able to do full workup of Staph aureus now (oops..misspelled something in the files)
- Fixed the LP results
- Lists are now in alphabetical order
- Doesn't penalize you for not doing silver stain or novobiocin test (these were supposed to be for fungi and staph epi, which aren't in the game yet).

Next, newly added (educational) features!!
- Click on the badges on the info screen to see what else you need (in more detail)
If you take a nap at home, sometimes you may enter a dream world where you can meet some of the bacteria in person!  and they will tell you how to defeat them :D
- There is now a conference room on the fourth floor with educational presentations!  You'll get paged when they happen (but you don't necessarily need to go):
    Grand Rounds - talking about different diseases, how they present, what bacteria cause them
    Morbidity and Mortality - talking about drug resistance, side effects, etc
So far there are only two, and they will repeat over and over, so feel free to ignore them after a while and not go.  You won't be penalized :D


Version 2.08 Changes (2/27/2013)

Looks like the code for reusing patients was sort of buggy... now it has been fixed.  Diagnosing and treating these patients should work again!

Also, I added an option during "treatment" mode to do nothing but wait for a turn.  This could be useful for self-limited diseases that go away by themselves.


Version 2.07 Changes (2/26/2013)
 
I fixed a major bug that made it difficult to generate new patients after you played for a while.  The reason is, after the town has been populated enough, I tried to reuse townspeople/patients and give them new diseases.  Unfortunately there was a mistake in the code for assigning a new disease to an existing patient, resulting in not being able to get new patients or getting them very rarely.  Hopefully it doesn't happen in this version now!
 
- Also, urinalysis and echocardiogram tests have been added!
- Cultures don't include the gram stain automatically anymore.  Otherwise, it wouldn't display whether the culture was negative or not.

Later, I will get around to distinguishing oral vs IV antibiotics.  Anyone have any ideas?


Version 2.06 Changes (2/24/2013)

Edit: fixed the clinic part again >__<

Lots of new features and bug fixes!
- Lumbar Puncture for meningitis
- Urease test for H. pylori and Proteus
- Replaced the disease name "Diarrhea" with the more scientific-sounding "Gastroenteritis"
- Various other specific tests for different bacteria (Green pigment->Pseudomonas, C. diff toxin ELISA, hydrogen sulfide production, etc)
- Vancomycin should work now, other antibiotics should also work more correctly for their specific diseases
- Imipenem is now included in penicillin allergies
- Cultures now automatically include gram stain
- Faster walking
- Added items omeprazole (for H. pylori) and antitoxin (for tetanus, botulism, etc)
- Bonus points for doing a complete workup (ran all necessary tests to confirm disease)
- Bonus points for treating with the first-line therapy (recommended treatment for the disease)
- View patient boards from the records screen, and also your current task (only works for new games)
- View more details about pathogen diagnosis and treatment in the records screen.  This information includes risk factors, diagnostic tests, recommended treatment, resistance mechanisms, etc.  I plan to add something like this for the individual diseases too, eventually.  A lot of this info was from UpToDate hehehe...
- The attending now wants a chest X-ray before you diagnose the pneumonia patient.


Version 2.05 Changes (2/20/2013)

Quick updates:
- Metronidazole works on things it's supposed to work on now
- In the diagnose screen, if there's more history items, symptoms, or test results than space to display them all, you can click the section to switch to the next page to see the other icons.

* NOTE for people who've been playing a while and encountered problems with saving: it's probably because Flash limits how much space is available for each website.  To fix: Right click (or control-click on macs) the game -> Go to "Settings..." -> Go to Local Storage -> Increase the limit from 100kb to 1mb.

btw if you're wondering where all the save data is stored:
- On windows xp: somewhere in C:\Documents and Settings\your_username\Application Data\Macromedia\Flash Player\#SharedObjects\
- On windows 7: somewhere in C:\Users\your_username\AppData\Roaming\Macromedia\Flash Player\#SharedObjects\
- On mac: /Users/your_username/Library/Preferences/Macromedia/Flash Player/#SharedObjects


Version 2.04 Changes (2/18/2013)

More fixes!
- Oops...apparently the code for detecting lab tests for the lab tech badge was all wrong.  It should be fixed now...
- Self-limiting diseases like B. cereus / Staph aureus food poisoning etc now eventually resolve on their own, if you give them enough time.
- Diphenhydramine now enables you to use Penicillin in penicillin-allergic patients!  and same for cephalosporin allergies.
- Fixed more graphics glitches (wrong colors on some people)
- Fixed notes if they are longer than a page.  Haven't tested this on windows or other browsers yet...
- Fixed catalase test for bacteria besides staph: pseudomonas, klebsiella/proteus/salmonella/shigella, listeria, gonorrhea
- Fixed blood culture for Staph aureus (supposed to be beta-hemolytic)
- Alerts you when you can't buy something at the store because your inventory's full
- If an enemy kills you before the antibiotic gets used, you don't waste it anymore.

In case anyone is feeling inspired...the game was programmed in Flash ActionScript using Eclipse and the AXDT plugin, all free.  and the lovely art was mostly done in MS paint by my girlfriend Victoria :D

I'm slightly behind on my reading for peds, so major updates will probably have to wait.  The next thing to add will be more educational scenarios!


Version 2.03 Changes (2/17/2013)

hehe as you can see, this game is still a work in progress... >__<  Thanks for all of the bug reports!  Luckily my weekends are mostly free this month :D

- Fixed treatments for spirochete diseases (Lyme, Leptospira) - doxycycline works now (oops...)
- Added an extra shelf to the pharmacy for rarer antibiotics like Rifampin and Linezolid.  Previously, they only showed up occasionally in the ID board room shelf... they still do, but now it's slightly easier to get them.
- As for money, if you're running low (<$200) then your parents send you some occasionally.  The townspeople and patients get updated every minute, the supply shelves might get restocked around every 5 minutes or so.


Version 2.02 Change Log (2/16/2013)

Thanks for all the support everyone!!

More fixes and changes...
- Fixed more graphics glitches
- Fixed a bug that made it impossible to escape the clinic in certain cases (oops)
- Made it easier to treat Chlamydia and Mycoplasma
- Made it so you can skip the introductory story by leaving the house without eating the custard
- Added more narrative relating to the pneumonia patient at the hospital
- Added loperamide (Imodium) to treat/prevent diarrhea status effect, and diphenhydramine (Benadryl) to treat certain drug allergies

Also, I have added a comment board for submitting ideas, suggestions, bug reports, etc.


Version 2.01 Change Log! (2/12/2013)

Within the last 24 hours I fixed several major bugs:
- Saving and loading in rooms with patients caused them to disappear
- Couldn't leave the clinic in some instances
- Fixed some minor text / graphical formatting glitches

Other changes:
- When you encounter a disease yourself (through tainted food, walking through the woods, etc), the disease and pathogen now appear in the records.  For logging purposes :D
- After three wrong diagnoses in a row, the attending will take pity on you and explain where you went wrong.
- The pharmacy sells more useful antibiotics now.

I think the save files should still be compatible...

Speaking of save files, Flash stores its save data locally, but according to browser / web site.  It seems like signing in and out of google might affect if it can access the save files or not.


Version 2.0 Change Log! (2/11/2013)
  
Microbe Invader is now a role-playing game!  I meant to finish this earlier, but then surgery rotation happened...better late than never?
 
This time, you're a med student treating infectious diseases in the hospital and in the community!  As the one carrying the ID pager in the extremely understaffed local hospital, your task is to:
- Diagnose patients by ordering lab tests and matching the symptoms and history to bacteria that fit the presentation
- Treat patients with appropriate antibiotics for that bacteria.  Watch out for side effects and antibiotic resistance!
- Explore the community and eradicate the infectious diseases lurking in expected places!  You can get sick yourself by eating tainted food, hanging around too close to animals, stepping on rusty nails, etc.
 
As you encounter, diagnose, and treat more pathogens, you collect badges.  Maybe you can get them all?  (the BADGES, not the diseases!)
 
Features!
- 44 different bacteria, each with their own attacks!  At the moment they are all bacteria, but the next version will include fungal and viral diseases (hopefully)
- 24 different antibiotics!  Find them in supply rooms around the hospital, or buy them yourself at the pharmacy.  Currently they don't distinguish between IV and oral types, but that might change...
- Automatically written electronic medical records - No need to type progress notes, they will magically be written for you after you see and treat patients!  Auto-log your patients, diseases, and pathogens seen.  If only real life were this easy...
- You can save your game by accessing the medical records screen (lower left button) under the Save tab.
- Randomly generated patients and townspeople!  As you play you might start seeing the same patients and get to participate in continuity of care!
- See patients in different settings like the hospital, outpatient clinic, or during house calls.
- Eat delicious (virtual) foods like custard, rare steak, raw seafood...
 
List of bacteria, antibiotics, etc: Details (opens a new window)
 
Artwork by Victoria Yeh.
 
Please share any comments, suggestions, and bug reports! (of the computer kind not the infectious kind)
 
Thanks!!
Li Tao
lithiumrxn@gmail.com