Translating Bacterial Molecular Epidemiology Into Information To Improve Infectious Disease Risk Assessment And Control
Funder
National Health and Medical Research Council
Funding Amount
$494,500.00
Summary
Streptococcus pneumoniae (pneumococcus) and group B streptococcus (GBS) are important pathogenic bacteria, which cause septicaemia and meningitis in young infants, the elderly and people with certain chronic diseases. Both consist of a number of different types, some of which are more likely to cause disease than others. Pneumococcal vaccines that protect against the commonest pathogenic types are used in Australia in people most at risk.Antibiotic resistance is an increasing problem, which shou ....Streptococcus pneumoniae (pneumococcus) and group B streptococcus (GBS) are important pathogenic bacteria, which cause septicaemia and meningitis in young infants, the elderly and people with certain chronic diseases. Both consist of a number of different types, some of which are more likely to cause disease than others. Pneumococcal vaccines that protect against the commonest pathogenic types are used in Australia in people most at risk.Antibiotic resistance is an increasing problem, which should be partly off-set by immunisation. Giving antibiotics during labour, to women colonised with GBS, can reduce infection rates in newborns, but there are many disadvantages of this approach, including the risk of increased antibiotic resistance. Vaccines against GBS are mpt yet available. We have developed methods to identify detailed fingerprints of these bacteria which allow us to identify types, antibiotic resistance and, for GBS, other characteristics which can distinguish highly pathogenic strains from the majority that are carried harmlessly and unlikely to cause disease. The methods are still quite slow and expensive and produce complex patterns,which are difficult to interpret rapidly. We plan to develop a new, rapid and relatively inexpensive, fingerprinting system for these bacteria and computer programs to analyse and interpret the results. They will allow us to check the strains of pneumococci that cause disease to make sure that new ones, not covered by the vaccine, do not become more common and reduce the effectiveness of vaccine and that antibiotic resistance does not increase further. The methods will also allow us to study differences between the small proportion of GBS strains that cause neonatal infection and the majority that are carried harmlessly by pregnant women and are of little risk to their babies. Eventually this should allow doctors to identify women whose babies are most at risk, reduce unnecessary antibiotic use.Read moreRead less
The Clinical Value Of Serology And Molecular Tests For Diagnosing Invasive Aspergillosis In At-risk Hematology Patients
Funder
National Health and Medical Research Council
Funding Amount
$1,095,500.00
Summary
Aspergillus is a fungus found in soil, on farms and on construction sites. In those whose immune system is impaired it causes severe infection. The people who are particularly at high-risk of Aspergillus infection (called Invasive Aspergillosis) are those with acute leukaemia on chemotherapy or post bone marrow transplantation. Currently 15% of those at high-risk get Invasive Aspergillosis and 58-93% of those infected die. The main reason for this high death rate is that our current diagnostic t ....Aspergillus is a fungus found in soil, on farms and on construction sites. In those whose immune system is impaired it causes severe infection. The people who are particularly at high-risk of Aspergillus infection (called Invasive Aspergillosis) are those with acute leukaemia on chemotherapy or post bone marrow transplantation. Currently 15% of those at high-risk get Invasive Aspergillosis and 58-93% of those infected die. The main reason for this high death rate is that our current diagnostic tests are not good at detecting infection or often only detect the infection at advanced stages when treatment is ineffective. Because of the limitations of current diagnostic tests the current practice is to give empiric antifungal therapy (EAFT) early to treat Invasive Aspergillosis. However studies have demonstrated that this therapy has only resulted in a minor reduction in the mortality rates and it causes significant drug toxicity. It is a suboptimal treatment modality. New tests have been developed to diagnose Invasive Aspergillosis. These tests are for the detection of an Aspergillus protein in blood and for the detection of Aspergillus DNA in the blood. Available data suggests that these new tests are sensitive in the detection of Invasive Aspergillosis. Also other studies suggest that these new tests make an early diagnosis and seem to be able to monitor responses to treatment. However no study has been performed to date which demonstrates that the use of these tests can impact on important patient outcomes. This trial is designed to determine whether the use of the new tests to guide therapy will help improve treatment of Invasive Aspergillosis, reduce drug toxicity and reduce the death rate in the high-risk patients as compared with the current standard method of diagnosis and treatment with EAFT. If the trial is successful then this represents a significant advancement in the treatment and survival of leukaemic and bone marrow transplantation patients.Read moreRead less
Magnetic Resonance Methods For Automated, Non-invasive Diagnosis Of Focal Brain Infections
Funder
National Health and Medical Research Council
Funding Amount
$483,564.00
Summary
Brain lesions caused by infections, tumours and some other diseases, often cannot be distinguished from each other clinically or by neuro-radiology examinations. A brain biopsy is usually needed to make a definite diagnosis and may cause sequelae or not be possible if the lesion is in certain areas of the brain. Magnetic resonance imaging (MRI) has increased our ability to detect brain lesions but cannot unequivocally diagnose the disease process. Magnetic resonance spectroscopic (MRS) methods r ....Brain lesions caused by infections, tumours and some other diseases, often cannot be distinguished from each other clinically or by neuro-radiology examinations. A brain biopsy is usually needed to make a definite diagnosis and may cause sequelae or not be possible if the lesion is in certain areas of the brain. Magnetic resonance imaging (MRI) has increased our ability to detect brain lesions but cannot unequivocally diagnose the disease process. Magnetic resonance spectroscopic (MRS) methods report on the chemical composition of lesions and can provide a simultaneous picture of the location of the lesion and the pathology of the disease process. Brain biopsies may therefore be avoided in a significant number of cases where drainage or decompression of lesions are not needed as part of therapy. Identification of specific fingerprints for the different diseases will provide a rapid, robust, automated diagnosis, which will expedite management decisions and improve patient outcomes. It should also be possible to monitor the efficacy of drug treatments using MRS methods. Each of these outcomes would constitute a major medical advance.Read moreRead less
The Safety And Effectiveness Of Hospital E-prescribing Systems: A Controlled Time Series Study
Funder
National Health and Medical Research Council
Funding Amount
$740,460.00
Summary
Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are b ....Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are believed to significantly reduce the number of errors which occur and reduce harm to patients as a result. No studies have demonstrated that these systems result in reducing prescribing errors that cause harm to patients. Alarmingly, anecdotal evidence from overseas suggests that use of electronic prescribing systems introduces new types of errors. This is consistent with a growing body of scientific research which suggests that individuals' decision-making may be significantly influenced by information generated by a computer, resulting in new types of errors. The aim of this project is to undertake a controlled time series study to assess the safety and effectiveness of two electronic prescribing systems to reduce prescribing errors in Australian hospitals. The study will compare error rates before and after the introduction of the systems. In addition, the study will be the first to focus on measuring new types of errors that may result from system use and to investigate how computer use influences clinicians' decision-making. This study will provide critical information about the effectiveness and safety of these systems which are being introduced into Australian hospitals. Unlike other medical interventions, which require stringent safety testing before use with patients, there are no minimum safety requirements for electronic prescribing systems. The data from this study is urgent in developing recommendations to ensure the safety of electronic prescribing systems for Australia.Read moreRead less
Evaluating The Safety Of Computer Decision Support Systems In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$300,389.00
Summary
Use of clinical software has many benefits. However it is also likely that clinical software will introduce new computer-generated errors that may harm patients. This project will evaluate the safety of software for prescribing in general practice. We will firstly examine mechanisms for errors generated by clinical software on its own, and then in the hands of typical users. The outcomes will have broad potential to guide the regulation, use and design of clinical software in general practice.
Reducing CVD Risk In The Metabolic Syndrome And Type 2 Diabetes: Novel Approaches To Studies Of Lipoprotein Metabolism
Funder
National Health and Medical Research Council
Funding Amount
$548,669.00
Summary
The incidence of obesity and diabetes is increasing in Australia. With these two conditions comes an increase in cardiovascular disease risk. Elevated blood lipids are an important component of this increased. Weight loss and cholesterol lowering drugs are first line therapies for obesity and diabetes, respectively. Niacin is effective at lowering lipids and raising HDL cholesterol, but the mechanisms responsible for these changes have not been determined.
Targeting KRAS Mutations In Cancer Using A Novel SiRNA Delivery Technology
Funder
National Health and Medical Research Council
Funding Amount
$498,899.00
Summary
Mutations in a gene called KRAS are found in 20% of human cancers but are impossible to target with existing treatments. RNA interference is a promising new way to target genes previously considered undruggable, but there is no way to deliver the molecules required for RNA interference to tumours. We will evaluate the ability of a new nanotechnology based delivery system (antibody targeted minicells) to deliver RNA interference, thereby selectively targeting of KRAS in tumours while avoiding tox ....Mutations in a gene called KRAS are found in 20% of human cancers but are impossible to target with existing treatments. RNA interference is a promising new way to target genes previously considered undruggable, but there is no way to deliver the molecules required for RNA interference to tumours. We will evaluate the ability of a new nanotechnology based delivery system (antibody targeted minicells) to deliver RNA interference, thereby selectively targeting of KRAS in tumours while avoiding toxicity to normal tissue.Read moreRead less