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The True Burden Of Nosocomial Staphylococcal Disease: Genomic Markers Of Transmission Of Methicillin-sensitive And –resistant Staphylococcus Aureus
Funder
National Health and Medical Research Council
Funding Amount
$830,092.00
Summary
Staphylococcus aureus is the leading cause of hospital infection, but previous studies have only focused on the 30% caused by resistant strains (MRSA). We will trace the spread of all Staphylococcus strains in hospitals using DNA fingerprinting. This will enable us to determine why patients catch this infection, permitting interventions to reduce hospital infection. We will also examine the genomes of these bacteria to look for markers of transmission and adaptation to the hospital environment.
‘Defying The Odds’: Exploring The Impact Of Perinatal Outcomes, Maternal Social And Health Outcomes And Level Of Culturally Appropriate Service Availability On The Health Of Western Australian Aboriginal Infants And Children
Funder
National Health and Medical Research Council
Funding Amount
$659,356.00
Summary
A healthy start to life is essential for life-long health. Currently, Aboriginal children have greater rates of death and hospitalisation than other Australians. This study will determine individual, community and service-related risk and protective factors for health outcomes among Aboriginal children (0-5yrs) using whole-of-population linked health data from multigenerational Aboriginal families in WA. Findings will support effective service development to help those at-risk ‘defy the odds’.
Does Pneumococcal Vaccination Protect Against Cardiovascular Disease? A Randomised Placebo-controlled Double Blind Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,849,245.00
Summary
Australian researchers have set up a novel multi-centre trial to investigate the effects of the pneumococcal vaccination in reducing heart attacks and stroke. People aged 55 to 61 from 6 sites around Australia will be invited to participate in the study. The selected participants will attend a clinic in their area and will be randomly given the pneumococcal vaccine or a placebo vaccine. Outcomes on the expected 6000 participants will be ascertained by health record linkage with government databa ....Australian researchers have set up a novel multi-centre trial to investigate the effects of the pneumococcal vaccination in reducing heart attacks and stroke. People aged 55 to 61 from 6 sites around Australia will be invited to participate in the study. The selected participants will attend a clinic in their area and will be randomly given the pneumococcal vaccine or a placebo vaccine. Outcomes on the expected 6000 participants will be ascertained by health record linkage with government databases after 4 years.Read moreRead less
The Economics Of Reducing The Risk Of Healthcare-acquired Intravascular Device Related Bloodstream Infections
Funder
National Health and Medical Research Council
Funding Amount
$119,500.00
Summary
Approximately one in ten patients will acquire an infection after admission to hospital. Patients will have their hospital stay prolonged during which time they will employ scarce health care resources that might otherwise have been made available to others in need, they will suffer additional pain and anxiety, they will take longer to recuperate after discharge using primary care and outpatient services more intensively and there is a sevenfold increase in the chance of dying in hospital as a r ....Approximately one in ten patients will acquire an infection after admission to hospital. Patients will have their hospital stay prolonged during which time they will employ scarce health care resources that might otherwise have been made available to others in need, they will suffer additional pain and anxiety, they will take longer to recuperate after discharge using primary care and outpatient services more intensively and there is a sevenfold increase in the chance of dying in hospital as a result of an infection. There will be other social costs as those affected take longer to return to their normal economic activities. The aggregate economic burdens imposed by healthcare-associated infection in the US are valued at $AU 11.3 Billion and $AU 3.1 in the UK. Research in currently underway to estimate the economic costs to Australia. One type of hospital infection are those that affect the blood and many are caused by invasive devices. At least 3,500 patients are affected each year in the Australia. The human and financial costs of these particular infections are significant. These infections can be prevented but the preventive activities are costly. The purpose of this research is to systematically evaluate the cost and effectiveness of all known infection control interventions to identify those which offer the best value for money. Furthermore we propose to identify the efficient investment in infection control activities, a point where the economic benefit is equalised with economic cost. This research will identify how much to invest in infection control and the specific interventions to which these investments should be directed. Efficient infection control will save lives, improve outcomes for patients, reduce the period of recuperation, and reduce the significant economic costs to both the patient and the health care system.Read moreRead less
Randomised Controlled Trial Of Multimedia Patient Education Approaches To Preventing In-hospital Falls
Funder
National Health and Medical Research Council
Funding Amount
$524,137.00
Summary
In hospital falls are one of the most frequently occurring adverse events in Australian hospitals. They are the cause of considerable patient morbidity, stress to family members and care givers, and health care resource use. However, there are many potential causes of in-hospital falls which has made minimising them a difficult task for hospitals around the country. Recent evidence has indicated that a patient intervention strategy is useful for preventing in-hospital falls as a part of a multi- ....In hospital falls are one of the most frequently occurring adverse events in Australian hospitals. They are the cause of considerable patient morbidity, stress to family members and care givers, and health care resource use. However, there are many potential causes of in-hospital falls which has made minimising them a difficult task for hospitals around the country. Recent evidence has indicated that a patient intervention strategy is useful for preventing in-hospital falls as a part of a multi-factorial falls prevention program. This research aims to investigate the effectiveness and economic benefit of two approaches to providing patient education for the prevention of in-hospital falls. Patients at high risk for falls will be recruited from the Princess Alexandra Hospital and be randomly allocated to either a DVD + 4 sessions of face-to-face education with an occupational therapist program, to a DVD alone education program, or to a usual care with no additional education control condition. Patients will be followed up until their discharge from hospital and the number of in-hospital falls they incur will be compared between groups. It is expected that both the DVD + 4 sessions of face-to-face education with an occupational therapist program, to a DVD alone education program will be effective in reducing falls and that the DVD alone education program will demonstrate the greater cost-effectiveness in reducing falls. Stemming from this research, it is anticipated that a cost-effective resource for preventing in-hospital falls will be developed and evaluated such that it can be used in hospitals Australia wide.Read moreRead less
Beta-lactamase Mediated Antibiotic Resistance In Gram-negative Pathogens: How Does Genotype Relate To Phenotype?
Funder
National Health and Medical Research Council
Funding Amount
$397,869.00
Summary
Unfortunately, one of the consequences of antibiotic usage (and in particular over-use and mis-use) is the development of resistance; if a small proportion of bacteria survive treatment, they can grow and replace the previous population of sensitive bacteria. In addition, the genes that confer resistance can be transferred between different bacterial lineages, thus facilitating the dissemination of resistant bacteria. The most important mechanism of penicillin resistance is through the expressio ....Unfortunately, one of the consequences of antibiotic usage (and in particular over-use and mis-use) is the development of resistance; if a small proportion of bacteria survive treatment, they can grow and replace the previous population of sensitive bacteria. In addition, the genes that confer resistance can be transferred between different bacterial lineages, thus facilitating the dissemination of resistant bacteria. The most important mechanism of penicillin resistance is through the expression of an enzyme called a beta-lactamase. This enzyme breaks down the penicillin. Beta-lactamase enzymes come in many different varieties, and new varieties appear quite frequently. Remarkably, when new kinds of penicillin are invented to circumvent resistance, the appearance of new beta-lactamases that can break down these new penicillins follows shortly thereafter. The objectives of our research are twofold. Firstly, it is now clear that the relationship between the beta-lactamase genes in a bacterium and the resulting pattern of resistance can be very complex. It can involve both the broad nature of the genes, the numbers of duplicates of the genes inside the cell, and very minor changes to the gene sequences. We will probe the relationship between the gene and resistance so as to understand it at a deeper level. Secondly, we will use this information to develop very efficient and cost affective methods for keeping track of the spread of the different varieties of beta-lactamase genes. These methods will be designed to be carried out on real-time PCR machines. These high-tech devices are general purpose gene analyzers that can carry out many different kinds of genetic assay. They are rapidly becoming ubiquitous in clinical microbiology laboratories. The use of these methods will provide much hard information that will be used to minimise the dissemination of antibiotic resistance.Read moreRead less
Functional Biology Of Large Serine Recombinases From Mobile Antibiotic Resistance Elements
Funder
National Health and Medical Research Council
Funding Amount
$436,328.00
Summary
In recent years there has been increasing concern about the emergence of multiply antibiotic resistant strains of many common bacterial pathogens. The development of multiple resistance phenotypes has already led to compromises in the ability to successfully treat infected patients and to increased treatment costs. The emergence of these resistant bacteria is the result of excessive or inappropriate use of antibiotics and the ability of antibiotic resistance genes to be transferred from resistan ....In recent years there has been increasing concern about the emergence of multiply antibiotic resistant strains of many common bacterial pathogens. The development of multiple resistance phenotypes has already led to compromises in the ability to successfully treat infected patients and to increased treatment costs. The emergence of these resistant bacteria is the result of excessive or inappropriate use of antibiotics and the ability of antibiotic resistance genes to be transferred from resistant to susceptible bacteria, either within or between bacterial species. The movement of resistance elements that are integrated into the bacterial genome often involves their excision from their existing site and their subsequent integration into another site in the same or a different genome. This project centres on the analysis of this process in resistant bacteria that cause major disease problems in our hospitals. The research project will focus on MRSA (Multiply Resistant Staphylococcus aureus) which has been a serious problem in our hospitals for many years, and Clostridium difficile, an emerging pathogen of increasing importance and which causes a very serious and chronic form of colitis in hospital patients. By studying the biochemical processes by which enzymes called recombinases excise and subsequently integrate antibiotic resistance elements from these bacteria and by determining the three dimensional structure of such enzymes we aim to determine the mechanism of action of members of this important enzyme family. The major outcomes of the project will be an increased understanding of one of the major processes by which antibiotic resistance determinants can spread both within and between bacterial pathogens of importance in the hospital environment. These studies will contribute towards the development of improved methods for controlling the spread of resistant pathogens and resistance genes in the hospital environment, with concomitant benefits to human health.Read moreRead less
The government is committed to reducing the gap in Aboriginal health. This research is part of the Study of Environment on Aboriginal Resilience and Child Health; Australia’s largest prospective, longitudinal study of urban Aboriginal children. It will provide, for the first time, comprehensive information about the causes of health and illness in a large group of urban Aboriginal children. It will identify factors that can be changed in families and early childhood to prevent later disease.