Evaluating Hand Hygiene Interventions And Their Ability To Reduce Haelthcare Associated Infection
Funder
National Health and Medical Research Council
Funding Amount
$508,848.00
Summary
Healthcare associated infection is a major problem for Australian hospitals. One of the best ways to reduce it is to improve hand hygiene among hospital workers. The National Hand Hygiene Initiative (NHHI) is currently being implemented to improve hygiene among health care workers. This research will evaluate the NHHI and measure how well the program works, what factors are important to its success, and whether implementing the program is good value for money.
Clinical Impact Of Clonal Pseudomonas Aeruginosa In Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$547,238.00
Summary
In patients with cystic fibrosis (CF), the normal defence mechanisms are compromised by an inherent genetic fault which results in an extremely sticky and dehydrated mucus. The respiratory system is unable to eradicate microbes (infection) from the lungs of patients with CF which begin to multiply and cause infection and inflammation. Recurring infections are treated with multiple courses of antibiotics and frequent hospitalisation and eventually result in premature death. This study focuses on ....In patients with cystic fibrosis (CF), the normal defence mechanisms are compromised by an inherent genetic fault which results in an extremely sticky and dehydrated mucus. The respiratory system is unable to eradicate microbes (infection) from the lungs of patients with CF which begin to multiply and cause infection and inflammation. Recurring infections are treated with multiple courses of antibiotics and frequent hospitalisation and eventually result in premature death. This study focuses on the major bacterial problem, Pseudomonas aeruginosa. Several studies from Australia and the UK, including our own have shown that about 30% to 45% of patients share the same strain of Pseudomonas aeruginosa within a centre. We know that two dominant strains of Pseudomonas aeruginosa are found in CF centres on the eastern board of Australia. This is unexpected as this bacterium is usually acquired from the environment. The emergence of these clonal strains is causing increasing anxiety in the CF community. This study is designed to provide vitally needed information on the clinical implications of being infected by an clonal strain of Pseudomonas aeruginosa and the risk factors for the acquisition of an clonal strain. This new information will provide a rationale basis for the need for changes to infection control policies (including patient segregation), better outcome predictors for patients infected with clonal strain of Pseudomonas aeruginosa.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
Amoxycillin For Persistent Nasal Discharge In Rural And Remote Aboriginal Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$226,738.00
Summary
Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical tri ....Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical trial will measure the impact of antibiotic treatment on persistent nasal discharge and rates of transmission of bacterial respiratory pathogens. An innovative study design will test the efficacy of twice daily doses of amoxycillin on newly developed clinical and bacteriological outcome measures. Both the investigators and the Aboriginal community have considerable experience in conducting this type of research and are committed to using a cooperative model of clinical research to reduce disease burden. Ongoing training of Aboriginal health workers in the principles of clinical epidemiology is an essential component of this process. This study will make an important contribution to the medical literature. Despite the deaths of around 10,000 children children from acute respiratory infections each day, very little is known about how antibiotics affect the transmission of some of the principal causative organisms. This project will greatly assist the development of appropriate antibiotic prescribing practices in high-risk populations.Read moreRead less
The world has suddenly been alerted to the threat of pandemic influenza with the recent deaths in Asia of patients and their close contacts from which the avian influenza H5N1 virus has been isolated. Experts believe that it is only a matter of time before this virus mutates and acquires the ability to rapidly spread within the human population. The currently available vaccines have virtually no capacity to prevent infection by a new pandemic virus. Once the virus strikes appropriate vaccines ca ....The world has suddenly been alerted to the threat of pandemic influenza with the recent deaths in Asia of patients and their close contacts from which the avian influenza H5N1 virus has been isolated. Experts believe that it is only a matter of time before this virus mutates and acquires the ability to rapidly spread within the human population. The currently available vaccines have virtually no capacity to prevent infection by a new pandemic virus. Once the virus strikes appropriate vaccines can be made against it but this procedure takes at least 6 months, the time predicted for the virus to have already spread throughout the globe. We are proposing that a vaccine designed to induce killer T cells (called CTLs) that target the conserved regions shared by all influenza viruses, could be used as a preventative measure without prior knowledge of the exact type of virus that will emerge. This sort of vaccine will not prevent against infection but will greatly lessen the severity of the disease. We have already designed a vaccine that that will induce high levels of CTLs that can greatly speed up the clearance of viruses of the type that are currently in the human population, when tested in animal models. However, we predict that a new pandemic virus will be much more vigorous in its growth and so our vaccines will have to be improved to cope with this. This project looks at ways of increasing the number and effectiveness of the CTLs that are induced by our vaccines. This will require an understanding of how we can modulate the function of other specialised cells, dendritic cells and helper T cells, that play a role in starting and maintaining the CTL response, as well as modulating the CTLs themselves.Read moreRead less
Heterosubtypic T Cell-inducing Vaccines For Influenza In Humans
Funder
National Health and Medical Research Council
Funding Amount
$352,307.00
Summary
Bird flu virus poses a large risk to the world if it mutates to become easily spread between people. If this occurs vaccines will be made to the mutated strain but there will be a time lag before these are available. We have been working on a novel vaccine that induces protective T cell immunity to parts of the virus that are common to all influenza strains and will be effective against any new virus. Our information from animal models will be used to create a human vaccine of this type .
Characterisation Of The Biochemical And Cell Biological Mechanisms Of Cross-presentation In Dendritic Cells
Funder
National Health and Medical Research Council
Funding Amount
$303,828.00
Summary
The immune system possesses several mechanisms to fight viruses and cancer. One of these mechanisms consists of recruiting anti-virus or anti-cancer killer cells. These killer cells are recruited by specialized cells known as Dendritic Cells (DC). The DC are distributed all over the body, and can detect the presence of viruses or cancer cells. When they do, they take up chunks of the virus or cancer cells, break them into small pieces called antigens, and display these antigens on their surface, ....The immune system possesses several mechanisms to fight viruses and cancer. One of these mechanisms consists of recruiting anti-virus or anti-cancer killer cells. These killer cells are recruited by specialized cells known as Dendritic Cells (DC). The DC are distributed all over the body, and can detect the presence of viruses or cancer cells. When they do, they take up chunks of the virus or cancer cells, break them into small pieces called antigens, and display these antigens on their surface, where they can be seen by the killer cells. This initiates an immune response whereby the killer cells seek and destroy the viruses and cancer cells. We are trying to harness the ability of DC to initiate immune responses in order to design more efficient vaccines to fight viruses and cancer. Our goal is to deliver vaccines that will directly target the DC and induce the formation of protective killer cells. These strategies require us to overcome two problems. The first is that we possess different types of DC, which play distinct functions, but we do not know which type is the most effective at recruiting killer cells, or why. The second problem is that we need to understand which vaccine design is the most effective at promoting presentation of the antigens that will be used to induce killer cells. The goal of this research project is to learn how we should deliver antigens to which DC type to generate the best possible vaccine.Read moreRead less