Antibiotic Allergy Testing And Its Impact On Antimicrobial Stewardship In The Immunocompromised Host
Funder
National Health and Medical Research Council
Funding Amount
$124,714.00
Summary
While antibiotic allergy labels are common, the impact on immunosuppressed patients is unknown. This collaboration between Austin Health, Peter MacCallum Cancer Centre and Vanderbilt University Medical Centre (USA) will be the first Australian assessment of the impacts of antibiotic allergy labels on immunosuppressed patients. This project will provide strategies to examine the impact of and revise the antibiotic allergy labels with skin prick allergy testing and advanced immunodiagnostics.
Role Of Novel Mobile Elements In The Infiltration Of Antibiotic Resistance Genes Into Clinical Isolates.
Funder
National Health and Medical Research Council
Funding Amount
$421,650.00
Summary
Bacteria have a remarkable ability to capture and spread antibiotic resistance genes. This phenomenon is a particular problem in our hospitals and in the community as multi-drug resistant pathogenic organisms have been selected over time as a result of the use of antibitoics. Moreover the incidence of resistance appears to be on the increase. Once resistant strains appear they can greatly complicate the treatment of infections and the eradication of such pathogens from a hospital is both difficu ....Bacteria have a remarkable ability to capture and spread antibiotic resistance genes. This phenomenon is a particular problem in our hospitals and in the community as multi-drug resistant pathogenic organisms have been selected over time as a result of the use of antibitoics. Moreover the incidence of resistance appears to be on the increase. Once resistant strains appear they can greatly complicate the treatment of infections and the eradication of such pathogens from a hospital is both difficult and costly. We have been working on the problem of how antibiotic resistance genes are spread for a number of years and have identified a novel genetic element that can capture resistance genes by a process of site-specific recombination. This element, the integron, is common in mutli-drug resistant clinical isolates. To be captured by an integron, an antibiotic resistance gene has to be part of a mobile element known as a gene cassette. Although the application of antibiotics acts to amplify pathogens that are resistant and favours their persistance in hospitals, it is generally recognized that neither the gene cassette nor the drug resistance gene evolve in the hospital. Rather, these genes make their way into human pathogens from bacteria that normally reside in other environments, for example soil or water. In this project, we will investigate one route by which drug resistance genes and integrons might find their way into clinically relevant strains and what the sources of the resistance genes and gene cassettes might be. A greater understanding of these processes will help in developing strategies to limit the spread of drug resistant bacteria into and around hospitals.Read moreRead less
Antibiotic resistance increases mortality and costs in the Intensive Care Unit (ICU), but the impact of antibiotic therapy has not been adequately studied. We propose to characterise the behaviour of key elements of the bacterial microflora (resistant bacteria and major resistance genes) in response to antibiotics. We have developed new rapid diagnostics to harness these data and this proposal has the potential to greatly improve diagnostic speed and accuracy and thus clinical outcomes.
The rapid emergence and spread of antibiotic resistance in bacteria that cause infectious diseases is of major concern to public health authorities throughout the world. Many of the genes that are responsible for this resistance are carried on mobile genetic elements, which are discrete segments of genetic material that can move from one bacterium to another. These genetic elements are important vehicles for the transmission of virulence and antibiotic resistance genes in most bacteria. This pro ....The rapid emergence and spread of antibiotic resistance in bacteria that cause infectious diseases is of major concern to public health authorities throughout the world. Many of the genes that are responsible for this resistance are carried on mobile genetic elements, which are discrete segments of genetic material that can move from one bacterium to another. These genetic elements are important vehicles for the transmission of virulence and antibiotic resistance genes in most bacteria. This project is centred on bacteria that cause intestinal diseases and have the potential to transfer genetic information to other bacteria that are present in the intestine. The focus will be on elucidating the mechanism of action of an enzyme encoded by two of these genetic elements. This enzyme is responsible for the movement of these elements from one site in the bacterial genome to another, by a process that is being increasingly recognised as important in antibiotic-resistant disease-causing bacteria. The project will employ the latest tools of molecular biology to determine the function of this enzyme, and its associated genetic elements, at the detailed molecular level. These studies will contribute to our understanding of how these antibiotic resistance elements are transferred within and between different bacterial cells. In the longer term the project will contribute towards the development of improved methods for the control and treatment of infectious diseases.Read moreRead less
Molecular And Genetic Basis Of Colistin Resistance In Acinetobacter Baumannii
Funder
National Health and Medical Research Council
Funding Amount
$526,878.00
Summary
Acinetobacter baumannii is a bacterium that causes hospital acquired infections which have become difficult to treat due to the bacteria developing resistance to most antibiotics in routine use. Colistin is now widely used as 'salvage' therapy in patients with these infections. Colistin resistance is currently low but is an emerging problem. As a first step in combating this problem this project will identify how this bacterium becomes resistant to colistin.
QacA-mediated Multidrug Resistance And Export In Staphylococcus Aureus
Funder
National Health and Medical Research Council
Funding Amount
$437,545.00
Summary
Strains of the pathogenic bacterium Staphylococcus aureus (Golden Staph) which are resistant to almost all available anti-staphylococcal agents are responsible for serious infections among hospitalised patients; in some hospitals such outbreaks reach epidemic proportions. In these bacteria, resistance has emerged to all classes of antimicrobial agents, including antibiotics and antiseptics-disinfectants commonly used in the hospital environment, largely due to the acquisition of resistance deter ....Strains of the pathogenic bacterium Staphylococcus aureus (Golden Staph) which are resistant to almost all available anti-staphylococcal agents are responsible for serious infections among hospitalised patients; in some hospitals such outbreaks reach epidemic proportions. In these bacteria, resistance has emerged to all classes of antimicrobial agents, including antibiotics and antiseptics-disinfectants commonly used in the hospital environment, largely due to the acquisition of resistance determinants. These determinants encode for proteins which provide the bacterial cell with a range of different biochemical mechanisms to evade antibiotic chemotherapy. Specifically, this project seeks to increase our understanding of proteins which confer resistance by pumping a variety of structurally-dissimilar antimicrobials out of the bacterial cell. Proteins which recognise such a broad spectrum of compounds are called multidrug resistance proteins and present a disturbing clinical threat since the acquisition of one such system by a cell may simultaneously decrease its susceptibility to a number of antimicrobials. Similar multidrug pumps are widespread in nature and are credited for resistance to antibiotics and other chemotherapeutic drugs in many pathogenic organisms, such as the bacteria responsible for tuberculosis, and in human cancer cells. In this project, we aim to characterise the QacA multidrug resistance protein which is involved in pumping many different antimicrobial compounds from staphylococcal cells. We will identify the regions of the QacA multidrug resistance protein which bind the compounds and examine how the protein expels them to give resistance. These studies are a prerequisite for the design of more effective antibacterial compounds able to bypass these drug resistance pumps, and will also provide fundamental knowledge applicable to the problem of multidrug resistance in other infectious diseases and cancer.Read moreRead less
Molecular Genetics And Evolution Of Antibiotic Resistant Staphylococci
Funder
National Health and Medical Research Council
Funding Amount
$437,545.00
Summary
Potentially life-threatening infections caused by Staphylococcus aureus bacteria, commonly known as Golden Staph, often arise as complications in patients within hospitals. These infections compromise the health of the patient and jeopardise their recovery from the condition for which they were initially admitted, which significantly increases healthcare costs. Hospital-acquired infections caused by Golden Staph are a major problem in Australia and globally. The problem is largely due to the pre ....Potentially life-threatening infections caused by Staphylococcus aureus bacteria, commonly known as Golden Staph, often arise as complications in patients within hospitals. These infections compromise the health of the patient and jeopardise their recovery from the condition for which they were initially admitted, which significantly increases healthcare costs. Hospital-acquired infections caused by Golden Staph are a major problem in Australia and globally. The problem is largely due to the presence in hospitals of strains that have become resistant to most clinically-useful antibiotics and are therefore very difficult to eradicate. This research project will reveal detailed information about strains of Golden Staph that are currently prevalent in hospitals in Australia, USA, Europe, and South East Asia. It will also provide important insights into the mechanisms that enable this organism to become resistant so readily, and identify factors that promote the development of resistant strains. The results of this research project will lead to improved methods for the characterisation of clinical strains and the monitoring of antibiotic resistance. The findings will also be of relevance to other types of antibiotic resistant bacteria. Most importantly, the application of knowledge arising from these studies has potential to minimise the emergence of strains that are even more resistant, thereby extending the effectiveness of existing and future antibiotics. The design and implementation of strategies to limit the proliferation of resistant bacteria are essential if we are to avoid a scenario similar to that prior to the introduction of antibiotics, when serious infectious diseases were often untreatable.Read moreRead less
Multidrug Resistance Regulatory Protein QacR From Staphylococcus Aureus
Funder
National Health and Medical Research Council
Funding Amount
$196,527.00
Summary
One of the most significant mechanisms of drug resistance is the export of antibiotics and other chemotherapeutic drugs from the cell. Drug export systems are an important medical problem due to their frequent occurrence in bacteria and parasites which cause human disease and in human cancer cells. Proteins which recognise and export a broad range of drugs from a cell are called multidrug efflux pumps. These multidrug efflux systems present a serious threat to patient care and to successful ther ....One of the most significant mechanisms of drug resistance is the export of antibiotics and other chemotherapeutic drugs from the cell. Drug export systems are an important medical problem due to their frequent occurrence in bacteria and parasites which cause human disease and in human cancer cells. Proteins which recognise and export a broad range of drugs from a cell are called multidrug efflux pumps. These multidrug efflux systems present a serious threat to patient care and to successful therapy, since the ability to produce a single protein simultaneously renders the cell or organism resistant to several different drugs. Strains of the bacterial pathogen Staphylococcus aureus or Golden Staph, which are endemic in hospitals world-wide, contain an example of such a multidrug exporter, the QacA multidrug efflux pump, which exports at least 30 different antimicrobial compounds, including antiseptics and disinfectants. Production of this protein is regulated by a sensor protein, QacR, which detects the presence of a number of these antimicrobial compounds. To understand how the QacR sensor protein can recognise such a wide variety of compounds, we will identify and structurally characterise the regions of the QacR multidrug regulatory protein which bind these compounds. Additionally, we will examine the means by which QacR regulates the production of the QacA pump protein. This project will provide fundamental knowledge that will not only help with understanding the important process of multidrug resistance but will also enable the rational design of more effective antibacterial compounds that either block or evade these multidrug efflux systems.Read moreRead less
Characterisation Of Community Methicillin-resistant Staphylococcus Aureus And Their Control In Remote Communities
Funder
National Health and Medical Research Council
Funding Amount
$300,777.00
Summary
Before the introduction of antibiotics Staphylococcus aureus, the golden staph , was the major cause of infections in hospitals. Although the introduction of antibiotics helped control the organism it has gradually acquired resistance until strains have emerged which can only be treated with vancomycin. Consequently staphs have again emerged as a major hospital pathogen. The emergence of these multiply resistant strains corresponded to them acquiring methicillin resistance and consequently they ....Before the introduction of antibiotics Staphylococcus aureus, the golden staph , was the major cause of infections in hospitals. Although the introduction of antibiotics helped control the organism it has gradually acquired resistance until strains have emerged which can only be treated with vancomycin. Consequently staphs have again emerged as a major hospital pathogen. The emergence of these multiply resistant strains corresponded to them acquiring methicillin resistance and consequently they have come to be known as methicillin-resistant Staphylococcus aureus or MRSA. Soon after the emergence of MRSA the hospitals of Western Australia (WA) developed a policy to prevent introduced MRSA from becoming established in its hospitals. Although this has been successful the policy is now under threat with the emergence of MRSA in remote WA Aboriginal communities. Aboriginals in these communities have a large number of infections which are usually treated empirically. This can result in the selection of antibiotic resistant bacteria if they are present. Consequently, it is planned to regularly screen Aboriginal communities which are known to have a high prevalence of MRSA and recommend antibiotic prescribing which will not select for any resistant staphylococci carried by a person. This is possible because the community MRSA are still susceptible to some anti-staphylococcal drugs. If this program is shown to reduce the prevalence of MRSA in the communities then the program will be extended to other communities. Community MRSA are now being reported from other Australian states and it is planned to study these to see if they are related to the WA strains. The community isolates will be studied to assess their potential to acquire additional antibiotic resistances. As some strains are known to be more of a threat to hospitals than others methods will be investigated to develop rapid methods for detecting them.Read moreRead less