ORCID Profile
0000-0003-3948-9272
Current Organisations
Australian Society for Microbiology
,
Royal Brisbane and Women's Hospital
,
University of Queensland
,
Townsville Hospital
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Publications
Clinical Features That Affect Indirect-Hemagglutination-Assay Responses to Burkholderia pseudomallei
Publisher: American Society for Microbiology
Date: 06-2009
DOI: 10.1128/CVI.00026-09
Abstract: Melioidosis, a disease endemic to northern Australia and Southeast Asia, is caused by the soil saprophyte Burkholderia pseudomallei . The indirect hemagglutination assay (IHA) is the most frequently used serological test to help confirm exposure to the causative organism. However, despite culture-confirmed disease, patients often have a negative IHA result at presentation and occasionally fail to seroconvert in serial testing. We retrospectively examined results for all patients with culture-confirmed melioidosis from our laboratory between January 1996 and August 2008. One hundred forty patients had a recorded IHA titer at presentation, 71 of which were positive at a titer of 1:40 or greater. Fifty-three patients went on to have subsequent IHAs 1 month or more after presentation. The relationships between IHA responses and clinical features were examined. The presence of bacteremia was significantly associated with a negative IHA at presentation. The coexistence of diabetes was associated with the presence of a positive IHA at presentation. In total, 14 patients (26%) demonstrated persistently negative IHA titers upon serial testing. No clinical factors were found to be significantly associated with this phenomenon. Supplementary testing using melioidosis-specific immunoglobulin G by EIA demonstrated different effects, with only Aboriginal or Torres Straits Islander ethnicity being significantly associated with a positive EIA at presentation. Reasons for these findings are examined, and directions for future research are discussed.
Paediatric melioidosis in North Queensland, Australia
Publisher: Wiley
Date: 12-2008
DOI: 10.1111/J.1440-1754.2008.01410.X
Abstract: to review admissions to the hospital due to Paediatric Melioidosis over a 10 year period. This was a retrospective chart review of all paediatric patients admitted to Townsville Hospital between 1996 and 2006 that were proven to have positive cultures for B. pseudomallei. Details were obtained from the Microbiology Department of Townsville Hospital. Between 1996 and 2006, there were 150 cases of culture-confirmed melioidosis in North Queensland. Of these, eight (5.3%) were in children aged under 16 years. There were three deaths in this group. Three patients developed neurological melioidosis and there were no cases of parotid involvement. In our series, neurological melioidosis appeared to be statistically more significant in children compared with adults. Melioidosis is an uncommon paediatric infection in Australia. In our series, neurological melioidosis appeared to be common in children compared with adults with devastating sequelae. The reasons for this remain unclear.
Toll-Like Receptor 2 Ligand Pretreatment Attenuates Retinal Microglial Inflammatory Response but Enhances Phagocytic Activity toward Staphylococcus aureus
Publisher: American Society for Microbiology
Date: 06-2012
DOI: 10.1128/IAI.00149-12
Abstract: Staphylococcus aureus is a leading cause of severe endophthalmitis, which often results in vision loss in some patients. Previously, we showed that Toll-like receptor 2 (TLR2) ligand pretreatment prevented the development of staphylococcal endophthalmitis in mice and suggested that microglia might be involved in this protective effect (Kumar A, Singh CN, Glybina IV, Mahmoud TH, Yu FS. J. Infect. Dis. 201:255–263, 2010). The aim of the present study was to understand how microglial innate response is modulated by TLR2 ligand pretreatment. Here, we demonstrate that S. aureus infection increased the CD11b + CD45 + microglial/macrophage population in the C57BL/6 mouse retina. Using cultured primary retinal microglia and a murine microglial cell line (BV-2), we found that these cells express TLR2 and that its expression is increased upon stimulation with bacteria or an exclusive TLR2 ligand, Pam3Cys. Furthermore, challenge of primary retinal microglia with S. aureus and its cell wall components peptidoglycan (PGN) and lipoteichoic acid (LTA) induced the secretion of proinflammatory mediators (tumor necrosis factor alpha [TNF-α] and MIP-2). This innate response was attenuated by a function-blocking anti-TLR2 antibody or by small interfering RNA (siRNA) knockdown of TLR2. In order to assess the modulation of the innate response, microglia were pretreated with a low dose (0.1 or 1 μg/ml) of Pam3Cys and then challenged with live S. aureus . Our data showed that S. aureus -induced production of proinflammatory mediators is dramatically reduced in pretreated microglia. Importantly, microglia pretreated with the TLR2 agonist phagocytosed significantly more bacteria than unstimulated cells. Together, our data suggest that TLR2 plays an important role in retinal microglial innate response to S. aureus , and its sensitization inhibits inflammatory response while enhancing phagocytic activity.
Evaluation of a commercially available synthetic RNA lipid enveloped control molecule
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.JVIROMET.2014.10.001
Abstract: Detection of viral ribonucleic acid with RT PCR is a useful tool for viral detection. One of the drawbacks of this technique is the difficulty in including an internal control molecule to ensure the validity of the extraction and lification process. In this study the potential usefulness of a novel lipid enveloped commercially available RNA control molecule is investigated. Initial optimisation of the detection assay was performed by lification of IC (internal control) spiked into PCR water. Thirty-two clinical respiratory s les were spiked with the IC before and after extraction and RT PCR was then performed. Inefficient extraction was simulated. Inhibition of the RT PCR was achieved by serial dilution of heparin sulfate into s les post extraction. No Targets that matched the IC (Internal Control) primers were identified in 32 extracted sputum s les as determined by the absence of non specific lification curves. The unextracted IC had an increased CT (cycle threshold) value compared to IC that had been extracted. Inefficient extraction was detected by an increased CT. Increasing concentrations of heparin inhibited the PCR in a predictable fashion. The Bioline IC molecule provides a stable RNA IC that has acceptable performance characteristics.
Clinical Burkholderia pseudomallei isolates from north Queensland carry diverse bimABm genes that are associated with central nervous system disease and are phylogenomically distinct from other Australian strains
Publisher: Public Library of Science (PLoS)
Date: 14-06-2022
DOI: 10.1371/JOURNAL.PNTD.0009482
Abstract: Burkholderia pseudomallei is an environmental gram-negative bacterium that causes the disease melioidosis and is endemic in many countries of the Asia-Pacific region. In Australia, the mortality rate remains high at approximately 10%, despite curative antibiotic treatment being available. The bacterium is almost exclusively found in the endemic region, which spans the tropical Northern Territory and North Queensland, with clusters occasionally present in more temperate climates. Despite being endemic to North Queensland, these infections remain understudied compared to those of the Northern Territory. This study aimed to assess the prevalence of central nervous system (CNS) disease associated variant bimA Bm , identify circulating antimicrobial resistance mutations and genetically distinct strains from Queensland, via comparative genomics. From 76 clinical isolates, we identified the bimA Bm variant in 20 (26.3%) isolates and in 9 (45%) of the isolates with documented CNS infection (n = 18). Explorative analysis suggests a significant association between isolates carrying the bimA Bm variant and CNS disease (OR 2.8, 95% CI 1.3–6.0, P = 0.009) compared with isolates carrying the wildtype bimA Bp . Furthermore, 50% of isolates were identified as novel multi-locus sequence types, while the bimA Bm variant was more commonly identified in isolates with novel sequence types, compared to those with previously described. Additionally, mutations associated with acquired antimicrobial resistance were only identified in 14.5% of all genomes. The findings of this research have provided clinically relevant genomic data of B . pseudomallei in Queensland and suggest that the bimA Bm variant may enable risk stratification for the development CNS complications and be a potential therapeutic target.
Acute Q fever in northern Queensland: variation in incidence related to rainfall and geographical location
Publisher: Cambridge University Press (CUP)
Date: 13-08-2012
DOI: 10.1017/S0950268812001495
Abstract: The aims of this study were to define the basic epidemiology of serologically confirmed acute Q fever in patients tested via the Townsville Hospital laboratory from 2000 to 2010 and to determine the impact of geographical location and seasonality on the incidence of acute cases in the Townsville region. Seven Statistical Local Areas (SLA) were identified as having an incidence higher than the average Queensland incidence over the study period. The SLA with the highest incidence was Woodstock-Ross with 24·9 cases/100 000. A clear seasonal peak was found, with the greatest number of cases observed in May, 3 months following the peak in rainfall in February. We hypothesize that an increase in wildlife numbers and drier conditions seen immediately following the wet season is the reason for the seasonal peak of human acute Q fever cases in Townsville.
Diabetes: A Contributor to Tuberculosis in Tropical Australia
Publisher: American Society of Tropical Medicine and Hygiene
Date: 02-09-2015
Disseminated Infection due to Nocardia transvalensis Coincident with Cryptococcus neoformans variety gattii Meningitis
Publisher: Springer Science and Business Media LLC
Date: 02-09-1999
Abstract: A case of meningitis due to Cryptococcus neoformans var. gattii coincident with disseminated Nocardia transvalensis infection is reported. Nocardia infection initially progressed despite high-dose antimicrobial therapy. Although a specific immunologic defect could not be defined, in vitro lymphocyte proliferation in response to stimulation with the Nocardia isolate was reduced. It is proposed that coinfection with Cryptococcus neoformans may have contributed to the observed impairment of lymphocyte function, leading to disseminated Nocardia disease and a suboptimal treatment response.
Thoracic and lumbar posture behaviour in sitting tasks and standing: Progressing the biomechanics from observations to measurements
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.APERGO.2015.09.006
Abstract: Few studies quantify spinal posture behaviour at both the thoracolumbar and lumbar spinal regions. This study compared spontaneous spinal posture in 50 asymptomatic participants (21 males) during three conditions: 10-min computer task in sitting (participants naïve to the measure), during their perceived 'correct' sitting posture, and standing. Three-dimensional optical tracking quantified surface spinal angles at the thoracolumbar and lumbar regions, and spinal orientation with respect to the vertical. Despite popular belief that lordotic lumbar angles are 'correct' for sitting, this was rarely adopted for 10-min sitting. In 10-min sitting, spinal angles flexed 24(7-9)deg at lumbar and 12(6-8)deg at thoracolumbar regions relative to standing (P < 0.001). When participants 'corrected' their sitting posture, their thoracolumbar angle -2(7)deg was similar to the angle in standing -1(6)deg (P = 1.00). Males were flexed at the lumbar angle relative to females for 10-min sitting, 'correct' sitting and standing, but showed no difference at the thoracolumbar region.
Coxiella burnetii causing haemophagocytic syndrome: a rare complication of an unusual pathogen
Publisher: Springer Science and Business Media LLC
Date: 29-06-2011
DOI: 10.1007/S15010-011-0142-4
Abstract: We describe an unusual presentation of Q fever with associated haemophagocytic syndrome, confirmed by bone marrow aspirate, Q fever polymerase chain reaction (PCR) and serological testing. Clinical recovery was observed after the commencement of doxycycline with normalisation of the patient's full blood count and serum biochemistry. Serial monitoring of the Q fever serology revealed the subsequent development of sustained high phase 1 IgG antibodies, suggestive of chronic Q fever. Although many infectious aetiologies have been associated with haemophagocytosis, Q fever has only rarely been described in this context. The diagnosis of Q fever is often overlooked, especially when the presentation is atypical. We describe how the use of PCR testing significantly shortened the interval to definitive diagnosis and helped elucidate the underlying cause of the patient's haematological disorder.
Burkholderia pseudomallei virulence: definition, stability and association with clonality.
Publisher: Elsevier BV
Date: 07-2001
DOI: 10.1016/S1286-4579(01)01417-4
Abstract: Clinical presentations of melioidosis, caused by Burkholderia pseudomallei are protean, but the mechanisms underlying development of the different forms of disease remain poorly understood. In murine melioidosis, the level of virulence of B. pseudomallei is important in disease pathogenesis and progression. In this study, we used B. pseudomallei-susceptible BALB/c mice to determine the virulence of a library of clinical and environmental B. pseudomallei isolates from Australia and Papua New Guinea. Among 42 non-arabinose-assimilating (ara(-)) isolates, LD(50) ranged from 10 to > 10(6) CFU. There were numerous correlations between virulence and disease presentation in patients however, this was not a consistent observation. Virulence did not correlate with isolate origin (i.e. clinical vs environmental), since numerous ara(-) environmental isolates were highly virulent. The least virulent isolate was a soil isolate from Papua New Guinea, which was arabinose assimilating (ara(+)). Stability of B. pseudomallei virulence was investigated by in vivo passage of isolates through mice and repetitive in vitro subculture. Virulence increased following in vivo exposure in only one of eight isolates tested. In vitro subculture on ferric citrate-containing medium caused attenuation of virulence, and this correlated with changes in colony morphology. Pulsed-field gel electrophoresis and randomly lified polymorphic DNA typing demonstrated that selected epidemiologically related isolates that had variable clinical outcomes and different in vivo virulence were clonal strains. No molecular changes were observed in isolates after in vivo or in vitro exposure despite changes in virulence. These results indicate that virulence of selected B. pseudomallei isolates is variable, being dependent on factors such as iron bioavailability. They also support the importance of other variables such as inoculum size and host risk factors in determining the clinical severity of melioidosis.
Does foot mobility affect the outcome in the management of patellofemoral pain with foot orthoses versus hip exercises? A randomised clinical trial
Publisher: BMJ
Date: 26-03-2020
DOI: 10.1136/BJSPORTS-2019-100935
Abstract: To test (i) if greater foot pronation (measured as midfoot width mobility) is associated with better outcomes with foot orthoses treatment, compared with hip exercises and (ii) if hip exercises are superior to foot orthoses, irrespective of midfoot width mobility. A two-arm parallel, randomised superiority clinical trial was conducted in Australia and Denmark. Participants (18–40 years) were included who reported an insidious onset of knee pain (≥6 weeks duration) ≥3/10 numerical pain rating, that was aggravated by activities (eg, stairs, squatting, running). Participants were stratified by midfoot width mobility ( high ≥11 mm change in midfoot width) and site, randomised to foot orthoses or hip exercises and blinded to objectives and stratification. Success was defined a priori as much better or better on a patient-perceived 7-point scale at 12 weeks. Of 218 stratified and randomised participants, 192 completed 12-week follow-up. This study found no difference in success rates between foot orthoses versus hip exercises in those with high (6/21 vs 9/20 29% vs 45%, respectively) or low (42/79 vs 37/72 53% vs 51%) midfoot width mobility. There was no association between midfoot width mobility and treatment outcome (Interaction effect p=0.19). This study found no difference in success rate between foot orthoses versus hip exercises (48/100 vs 46/92 48% vs 50%). Midfoot width mobility should not be used to help clinicians decide which patient with patellofemoral pain might benefit most from foot orthoses. Clinicians and patients may consider either foot orthoses or hip exercises in managing patellofemoral pain. ACTRN12614000260628.
Pathogens penetrating the central nervous system: infection pathways and the cellular and molecular mechanisms of invasion.
Publisher: American Society for Microbiology
Date: 10-2014
DOI: 10.1128/CMR.00118-13
Abstract: The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality. Bacteria, amoebae, fungi, and viruses are capable of CNS invasion, with the latter using axonal transport as a common route of infection. In this review, we compare the mechanisms by which bacterial pathogens reach the CNS and infect the brain. In particular, we focus on recent data regarding mechanisms of bacterial translocation from the nasal mucosa to the brain, which represents a little explored pathway of bacterial invasion but has been proposed as being particularly important in explaining how infection with Burkholderia pseudomallei can result in melioidosis encephalomyelitis.
Advancing use of DEXA scans to quantitatively and qualitatively evaluate lateral spinal curves, for preliminary identification of adolescent idiopathic scoliosis.
Publisher: Springer Science and Business Media LLC
Date: 13-03-2023
DOI: 10.1007/S00223-023-01075-2
Abstract: Dual-energy X-ray absorptiometry (DEXA) scan is an emerging screening method for identifying likely adolescent idiopathic scoliosis (AIS). Using DEXA in an unbiased population s le (the Raine Study), we aimed to report the inter-rater reliability and minimal detectable change (MDC 95 ) for scoliosis curve angle measurement, identify likely AIS prevalence, and the concordance between reported AIS diagnosis and DEXA-identified likely AIS. Scoliosis curve angles were measured using the modified Ferguson method on DEXA scans ( n = 1238) at age 20 years. For curve angle inter-rater reliability, two examiners measured angles (6–40°) on 41 scans. Likely, AIS was determined with quantitative and qualitative criteria (modified Ferguson angles ≥ 10° and expert review of spinal curves).The inter-rater reliability for scoliosis curve angle measurement was good–excellent (ICC: 0.82 95% CI: 0.71–0.89 p 0.001), and MDC 95 was 6.2°. The prevalence of likely AIS was 2.1% (26/1238). Diagnosis of AIS was reported despite little or no scoliosis curve ( 3.8°) for 20 participants (1.6%), and diagnosis of AIS was not reported despite scoliosis curve ≥ 10° for 11 participants (0.9%). Results support the use of modified Ferguson method to measure scoliosis curve angles on DEXA. There is potential utility for using a combination of quantitative measurement and qualitative criteria to evaluate DEXA images, to identify likely AIS for reporting prevalence. Without formal school screening, the analysis of DEXA in this population s le suggested that relying on current health professional diagnosis alone could result in 2.5% of this cohort being at risk of false positive diagnosis or delay in necessary management due to non-diagnosis of AIS.
Burkholderia pseudomallei - Antimicrobial Susceptibility Testing and Alternative Models of Predicting Clinical Efficacy.
Publisher: Bentham Science Publishers Ltd.
Date: 04-2007
Neck muscle function in violinists/violists with and without neck pain
Publisher: Springer Science and Business Media LLC
Date: 15-07-2016
DOI: 10.1007/S10067-015-3000-4
Abstract: Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG litudes during CCFT than the pain-free musicians and non-musicians (P < 0.05). Playing-related neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.
The Sander parallelogram illusion dissociates action and perception despite control for the litany of past confounds
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.CORTEX.2017.09.013
Abstract: The two visual systems hypothesis proposes that human vision is supported by an occipito-temporal network for the conscious visual perception of the world and a fronto-parietal network for visually-guided, object-directed actions. Two specific claims about the fronto-parietal network's role in sensorimotor control have generated much data and controversy: (1) the network relies primarily on the absolute metrics of target objects, which it rapidly transforms into effector-specific frames of reference to guide the fingers, hands, and limbs, and (2) the network is largely unaffected by scene-based information extracted by the occipito-temporal network for those same targets. These two claims lead to the counter-intuitive prediction that in-flight anticipatory configuration of the fingers during object-directed grasping will resist the influence of pictorial illusions. The research confirming this prediction has been criticized for confounding the difference between grasping and explicit estimates of object size with differences in attention, sensory feedback, obstacle avoidance, metric sensitivity, and priming. Here, we address and eliminate each of these confounds. We asked participants to reach out and pick up 3D target bars resting on a picture of the Sander Parallelogram illusion and to make explicit estimates of the length of those bars. Participants performed their grasps without visual feedback, and were permitted to grasp the targets after making their size-estimates to afford them an opportunity to reduce illusory error with haptic feedback. The results show unequivocally that the effect of the illusion is stronger on perceptual judgments than on grasping. Our findings from the normally-sighted population provide strong support for the proposal that human vision is comprised of functionally and anatomically dissociable systems.
Presence of fibronectin-binding protein gene prtF2 in invasive group A streptococci in tropical Australia is associated with increased internalisation efficiency
Publisher: Elsevier BV
Date: 03-2005
DOI: 10.1016/J.MICINF.2004.11.015
Abstract: The fibronectin-binding proteins (FnBPs) PrtF1 and PrtF2 are considered to be major group A streptococcal virulence factors, mediating adherence to and internalisation of host cells. The present study investigated an association between the presence of prtF1 and prtF2 genes and internalisation efficiency in group A streptococci (GAS) isolated from patients with invasive disease. Of the 80 isolates tested, 58 (73%) had prtF1 and 71 (89%) possessed prtF2. Three isolates (4%) had neither gene, seven (9%) had prtF1 only, 19 (24%) had prtF2 only and 51 isolates (64%) had both prtF1 and prtF2. prtF2-positive isolates internalised up to three times more efficiently than isolates that had prtF1 alone (P<0.001), and 1.5-fold better than isolates that had neither gene. No significant association was found between internalisation efficiency and presence of the prtF1 gene. Analysis of the fibronectin-binding repeat domain (FBRD) of prtF2 revealed that this gene can contain 2, 3, 4 or 5 repeat regions and that five repeat regions conferred very high internalisation efficiency in invasive GAS isolates.
Chlamydia pneumoniae pneumonia with endocarditis
Publisher: Elsevier BV
Date: 05-1995
DOI: 10.1016/S0140-6736(95)92579-1
Abstract: Eucalyptus camaldulensis EcDQD/SDH2 and 3 combine gallate formation, dehydroquinate dehydratase, and shikimate dehydrogenase activities. They are candidates for providing the essential gallate for the biosynthesis of the aluminum-detoxifying metabolite oenothein B. The tree species Eucalyptus camaldulensis shows exceptionally high tolerance against aluminum, a widespread toxic metal in acidic soils. In the roots of E. camaldulensis, aluminum is detoxified via the complexation with oenothein B, a hydrolyzable tannin. In our approach to elucidate the biosynthesis of oenothein B, we here report on the identification of E. camaldulensis enzymes that catalyze the formation of gallate, which is the phenolic constituent of hydrolyzable tannins. By systematical screening of E. camaldulensis dehydroquinate dehydratase/shikimate dehydrogenases (EcDQD/SDHs), we found two enzymes, EcDQD/SDH2 and 3, catalyzing the NADP
Q fever cases at a North Queensland centre during 1994–2006
Publisher: Wiley
Date: 14-08-2007
DOI: 10.1111/J.1445-5994.2007.01441.X
Abstract: This study reviewed the epidemiological features, management and outcomes of patients with Q fever treated at a tertiary facility in North Queensland during the period from July 1994 to January 2006. Twenty-seven patients were identified. Our findings were consistent with the observations about Q fever that have been made in other regions of Australia. A diagnosis of Q fever should be considered in patients with a non-specific febrile illness.
Late-onset Neonatal Sepsis—A 10-year Review From North Queensland, Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2017
Different ways to balance the spine in sitting: Muscle activity in specific postures differs between individuals with and without a history of back pain in sitting
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.CLINBIOMECH.2018.01.003
Abstract: Previous research explored muscle activity in four distinct sitting postures with fine-wire electromyography, and found that lumbar multifidus muscle activity increased incrementally between sitting with flat thoracolumbar and lumbar regions, long thoracolumbar lordosis, or short lordosis confined to the lumbar region. This study used similar methods to explore whether people with a history of low back pain provoked by prolonged sitting used different patterns of trunk muscle activity in specific postures. Fine-wire electromyography electrodes were inserted into the right lumbar multifidus (deep and superficial), iliocostalis (lateral and medial), longissimus thoracis and transversus abdominis muscles. Superficial abdominal muscle activity was recorded with surface or fine-wire electrodes. Electromyography litude was compared between postures for the back pain group and observations were contrasted with the changes previously reported for pain-free controls. For comparison between groups normalised and non-normalised electromyography litudes were compared. In iduals with a history of back pain demonstrated greater activity of the longissimus thoracis muscle in the long lordosis compared with the flat posture [mean difference (95% CI): 46.6 (17.5-75.7)%, normalised to sitting posture peak activity], but pain-free participants did not [mean difference: 7.7 (minus 12-27.6)%]. Pain-free participants modulated lumbar multifidus activity with changes in lumbar curve, but people with a history of pain in prolonged sitting did not change multifidus activity between the long and short lordotic postures. In clinical ergonomic interventions that modify spinal curves and sagittal balance in sitting, the muscle activity used in those postures may differ between people with and without a history of back pain.
Rapid diagnostics for melioidosis: A comparative study of a novel lateral flow antigen detection assay
Publisher: Microbiology Society
Date: 08-2015
DOI: 10.1099/JMM.0.000098
Impact of polymerase chain reaction results on patient management during a viral meningitis outbreak in Tropical North Queensland
Publisher: Wiley
Date: 13-09-2012
DOI: 10.1111/J.1742-6723.2011.01483.X
Abstract: Enterovirus is the most commonly isolated pathogen in viral meningitis. We report on the first outbreak of viral meningitis in Tropical Queensland and the effect of polymerase chain reaction (PCR) results on antibiotic use and hospital length of stay. Retrospective case series of consecutive patients presenting to the Townsville ED with viral meningitis were evaluated by examining hospital medical records. The study period was November 2008 to February 2009. Forty-three patients were available for full analysis of which 17 (40%) were female and 17 (40%) had a positive enteroviral PCR. Antibiotics were commenced on 37 (86%) of patients. There was no difference in hospital length of stay in patients with a negative versus positive PCR (2.52 vs 2.72 days, P = 0.68) or duration of antibiotic therapy (2.20 vs 1.94 days, P = 0.61). In our study a positive result on PCR was not associated with a shorter hospital length of stay or a shorter duration of antibiotic therapy. This contrasts with previous reports on this topic and requires further evaluation.
Activity of Ceftolozane–Tazobactam against Burkholderia pseudomallei
Publisher: American Society of Tropical Medicine and Hygiene
Date: 02-08-2018
Q fever in an endemic region of North Queensland, Australia: A 10 year review
Publisher: Elsevier BV
Date: 06-2017
A survey of the antibiotic prescribing practices of doctors in an Australian Emergency Department
Publisher: Elsevier BV
Date: 06-2018
Review of invasive group A streptococci in Queensland, Australia 1996–2004
Publisher: Elsevier BV
Date: 04-2006
The Burkholderia pseudomallei intracellular ‘TRANSITome’
Publisher: Springer Science and Business Media LLC
Date: 26-03-2021
DOI: 10.1038/S41467-021-22169-1
Abstract: Prokaryotic cell transcriptomics has been limited to mixed or sub-population dynamics and in idual cells within heterogeneous populations, which has h ered further understanding of spatiotemporal and stage-specific processes of prokaryotic cells within complex environments. Here we develop a ‘TRANSITomic’ approach to profile transcriptomes of single Burkholderia pseudomallei cells as they transit through host cell infection at defined stages, yielding pathophysiological insights. We find that B. pseudomallei transits through host cells during infection in three observable stages: vacuole entry cytoplasmic escape and replication and membrane protrusion, promoting cell-to-cell spread. The B. pseudomallei ‘TRANSITome’ reveals dynamic gene-expression flux during transit in host cells and identifies genes that are required for pathogenesis. We find several hypothetical proteins and assign them to virulence mechanisms, including attachment, cytoskeletal modulation, and autophagy evasion. The B. pseudomallei ‘TRANSITome’ provides prokaryotic single-cell transcriptomics information enabling high-resolution understanding of host-pathogen interactions.
More parasitic myositis cases in humans in Australia, and the definition of genetic markers for the causative agents as a basis for molecular diagnosis.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.MEEGID.2016.06.026
Abstract: Since 1998, there have been six reported human cases of myositis in Australia, attributable to infection with the nematode Haycocknema perplexum. However, an unequivocal diagnosis of H. perplexum infection and associated disease has been seriously compromised by a lack of molecular markers for this nematode. Here, we report new cases of disseminated myositis in two male patients from the states of Queensland and Tasmania in Australia, respectively genetically characterize the causative agent from each case and, also establish a PCR-based sequencing approach as a tool to support the diagnosis of future cases and to underpin epidemiological studies.
Evaluation of recombinant antigens for diagnosis of melioidosis
Publisher: Oxford University Press (OUP)
Date: 10-2008
Genetic Diversity of Burkholderia pseudomallei Isolates in Australia
Publisher: American Society for Microbiology
Date: 2008
DOI: 10.1128/JCM.01725-07
Abstract: Melioidosis is caused by the gram-negative saprophytic bacterium Burkholderia pseudomallei , which is endemic to southeast Asia and northern Australia. We have previously found evidence of geographic localization of strains based on multilocus sequence typing (MLST). In this study, we examined the ersity of 277 isolates from northern Australia, which were resolved into 159 different sequence types. No sequence types were common to both Queensland and the Northern Territory, and there was significant differentiation between the alleles present in the two regions. The considerable ersity in sequence types contrasts with the limited ersity of alleles at MLST loci, supporting previous work suggesting a high rate of recombination relative to mutation in B. pseudomallei , where new sequence types are primarily generated by reassortment of existing alleles.
Missing malaria? Potential obstacles to diagnosis and hypnozoite eradication
Publisher: Wiley
Date: 12-2014
DOI: 10.5694/MJA14.00313
Communication and access to healthcare
Publisher: Frontiers Media SA
Date: 06-12-2022
DOI: 10.3389/FPAIN.2022.1041968
Abstract: Pain management requires a multidisciplinary approach and a collaborative relationship between patient-provider in which communication is crucial. This study examines the communication experiences of Aboriginal and Torres Strait Islander patients and Aboriginal and Torres Strait Islander Hospital Liaison Officers (ATSIHLOs), to improve understanding of how pain is managed in and through patient-health professional communication. This qualitative study involved a purposive s le of patients attending three persistent pain clinics and ATSIHLOs working in two hospitals in Queensland, Australia. Focus groups and in-depth interviews explored the communication experiences of patients managing pain and ATSIHLOs supporting patients with pain. This study adopted a descriptive phenomenological methodology, as described by Colaizzi (1978). Relevant statements (patient and ATSIHLOs quotes) about the phenomenon were extracted from the transcripts to formulate meanings. The formulated meanings were subsequently sorted into thematic clusters and then integrated into themes. The themes were then incorporated into a concise description of the phenomenon of communication within pain management. Findings were validated by participants. A total of 21 Aboriginal and Torres Strait Islander participants were involved in this study. Exploration of the communication experiences of patients and ATSIHLOs revealed overlapping themes of important barriers to and enablers of communication that affected access to care while managing pain. Acknowledging historical and cultural factors were particularly important to build trust between patients and health professionals. Some patients reported feeling stigmatized for identifying as Aboriginal and Torres Strait Islander, while others were reluctant to disclose their background for fear of not having the same opportunity for treatment. Differences in the expression of pain and the difficulty to use standard pain measurement scales were identified. Communication was described as more than the content delivered, it is visual and emotional expressed through body language, voice intonation, language and the speed of the conversation. Communication can significantly affect access to pain management services. Aboriginal and Torres Strait Islander patients highlighted the burden of emotional pain caused by historical factors, negative stereotypes and the fear of discrimination. Pain management services and their health professionals need to acknowledge how these factors impact patients trust and care.
Human Melioidosis
Publisher: American Society for Microbiology
Date: 18-03-2020
DOI: 10.1128/CMR.00006-19
Abstract: The causative agent of melioidosis, Burkholderia pseudomallei , a tier 1 select agent, is endemic in Southeast Asia and northern Australia, with increased incidence associated with high levels of rainfall. Increasing reports of this condition have occurred worldwide, with estimates of up to 165,000 cases and 89,000 deaths per year. The ecological niche of the organism has yet to be clearly defined, although the organism is associated with soil and water. The culture of appropriate clinical material remains the mainstay of laboratory diagnosis.
Clinical presentation of melioidosis in Queensland, Australia
Publisher: Oxford University Press (OUP)
Date: 11-2005
DOI: 10.1016/J.TRSTMH.2005.06.015
Abstract: A retrospective study was performed on culture-positive patients (n = 57) with melioidosis presenting to the Townsville Hospital to define the epidemiology of the disease in Queensland, Australia. Mortality was 25% (n = 14) with a 9% (n = 5) relapse rate. At presentation, primary organs involved included the lungs (58% n = 33), genitourinary system (11% n = 6), skin and soft tissue (9% n = 5), bone and joints (4% n = 2), central nervous system (4% n = 2), mycotic aneurysm (2% n = 1) and peritonitis (2% n = 1). No focus of infection could be identified in 12% of cases (n = 7). There was no significant difference in the clinical presentation of melioidosis in Queensland compared with the Northern Territory. Regional trends in the clinical presentation of melioidosis in Australia compared with Southeast Asia were confirmed. Risk factors for disease included diabetes (42%), excess alcohol consumption (42%), chronic lung disease (26%), immunosuppressive drug use (12%), renal disease (11%), malignancy (7%) and autoimmune disease (5%). No risk factors were identifiable in 18% of cases. The presence of multiple risk factors for melioidosis was not significantly associated with increased mortality (P > 0.05).
G-CSF immunotherapy for treatment of acute disseminated murine melioidosis
Publisher: Oxford University Press (OUP)
Date: 07-2003
Genetic analysis of Giardia and Cryptosporidium from people in Northern Australia using PCR-based tools
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.MEEGID.2015.08.034
Abstract: To date, there has been limited genetic study of the gastrointestinal pathogens Giardia and Cryptosporidium in northern parts of Australia. Here, PCR-based methods were used for the genetic characterization of Giardia and Cryptosporidium from 695 people with histories of gastrointestinal disorders from the tropical North of Australia. Genomic DNAs from fecal s les were subjected to PCR-based analyses of regions from the triose phosphate isomerase (tpi), small subunit (SSU) of the nuclear ribosomal RNA and/or the glycoprotein (gp60) genes. Giardia and Cryptosporidium were detected in 13 and four of the 695 s les, respectively. Giardia duodenalis assemblages A and B were found in 4 (31%) and 9 (69%) of the 13 s les in persons of <9 years of age. Cryptosporidium hominis (subgenotype IdA18), Cryptosporidium mink genotype (subgenotype IIA16R1) and C. felis were also identified in single patients of 11-21 years of age. Future studies might focus on a comparative study of these and other protists in rural communities in Northern Australia.
Two examples of ‘cuboid syndrome’ with active bone pathology: Why did manual therapy help?
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.MATH.2013.11.007
Abstract: Cuboid syndrome describes lateral midfoot pain localised to the cuboid bone. Previously reported case studies promoted joint mobilisation or manipulation interventions. The assumed mechanism was correction of a subtle disruption to the calcaneocuboid joint position. There is an absence of evidence for correction of joint position, but there is evidence of neurophysiological mechanisms for pain modulation. This case study reports on a patient who suffered two occurrences of cuboid syndrome on opposite feet, three years apart. With both occurrences, joint mobilisation achieved rapid and lasting resolution of severe pain and functional limitations. This occurred despite the presence of an active bone pathology at the symptomatic cuboid (demonstrated with nuclear imaging), which could represent a stress reaction, transient osteoporosis, ischaemic necrosis, infection or neoplasm. This case contributes three considerations for clinical reasoning and manual therapy research. 1. Active local bone pathology could exist in other patients with pain at the cuboid, and other conditions where symptoms resolve with joint mobilisation. 2. Rapid and lasting symptom resolution fits with a hypothesis that joint mobilisation acted to reverse neurological sensitisation. 3. Lasting symptom resolution may be clinically associated with manual therapy, but mechanisms extending beyond temporary analgesia are yet to be identified.
Manual handling: differences in perceived effort, success rate and kinematics between three different pushing techniques
Publisher: Informa UK Limited
Date: 24-10-2015
DOI: 10.1080/00140139.2014.970586
Abstract: This study examined the perceived effort, success rates and kinematics for three push strategies in a simulated lateral patient transfer (horizontal slide). Thirteen healthy subjects (four males) completed three repetition pushing loads of 6, 10 and 14 kg in random order with a spontaneous push strategy, then with a straight-back bent-knees (squat) strategy and the preparatory pelvic movement ('rockback') strategy in random order. Perceived effort and kinematic parameters measured at the onset of movement and at maximum push excursion were compared between strategies and between loads with repeated measures ANOVA. The spontaneous and 'rockback' strategies achieved the pushing task with less perceived effort across all loads than the squat push (P < 0.001). Only 3/13 participants were successful on all attempts at pushing the 14 kg load using a squat strategy, which contrasted with 12/13 participants when the spontaneous strategy or the 'rockback' strategy was used. Forward movement of the pelvis and forward trunk inclination may be positively associated with lower perceived effort in the push task. Practitioner Summary: In a manual-handling task that simulated a lateral patient transfer (horizontal slide), perceived effort and success rates of three push strategies were compared. A straight-back bent-knees push (squat) strategy demonstrated greater perceived effort and lower success rates than a spontaneous push strategy, or a push strategy with preparatory 'rockback' pelvic movement.
Evaluating validity of the Kids-Balance Evaluation Systems Test (Kids-BESTest) Clinical Test of Sensory Integration of Balance (CTSIB) criteria to categorise stance postural control of ambulant children with CP
Publisher: Informa UK Limited
Date: 28-02-2022
DOI: 10.1080/09638288.2021.1887374
Abstract: Evaluate the validity of the Clinical Test of Sensory Integration of Balance (CTSIB) scored using Kids-Balance Evaluation Systems Test (Kids-BESTest) criteria compared to laboratory measures of postural control. Participants were 58 children, 7-18 years, 17 with ambulant cerebral palsy (CP) (GMFCS I-II), and 41 typically developing (TD). Postural control in standing was assessed using CTSIB items firm and foam surfaces, eyes open (EO) then closed (EC). Face validity was evaluated comparing clinical Kids-BESTest scores between groups. Correlating force plate centre-of-pressure (CoP) data and clinical scores allowed evaluation of concurrent and content validity. Face validity: TD children scored higher for all CTSIB conditions when compared to children with CP. Concurrent validity: the agreement between clinical and CoP derived scores was poor to excellent (Firm-EO = 76%, Firm-EC = 76%, Foam-EO = 59%, Foam-EC = 94%). Clinical scores of "2- Face validity of Kids-BESTest CTSIB criteria was supported. Content and concurrent validity were partially supported. Improved Kids-BESTest scoring terms were recommended to describe postural characteristics of "2
Recruitment of Discrete Regions of the Psoas Major and Quadratus Lumborum Muscles Is Changed in Specific Sitting Postures in Individuals With Recurrent Low Back Pain
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 11-2013
Abstract: Cross-sectional controlled laboratory study. To investigate potential changes in the function of discrete regions of the psoas major (PM) and quadratus lumborum (QL) with changes in spinal curvatures and hip positions in sitting, in people with recurrent low back pain (LBP). Although the PM and QL contribute to control of spinal curvature in sitting, whether activity of these muscles is changed in in iduals with LBP is unknown. Ten volunteers with recurrent LBP (pain free at the time of testing) and 9 pain-free in iduals in a comparison group participated. Participants with LBP were grouped into those with high and low erector spinae (ES) electromyographic (EMG) signal litude, recorded when sitting with a lumbar lordosis. Data were recorded as participants assumed 3 sitting postures. Fine-wire electrodes were inserted with ultrasound guidance into fascicles of the PM arising from the transverse process and vertebral body, and the anterior and posterior layers of the QL. When data from those with recurrent LBP were analyzed as 1 group, PM and QL EMG signal litudes did not differ between groups in any of the sitting postures. However, when subgrouped, those with low ES EMG had greater EMG signal litude of the PM vertebral body and QL posterior layer in flat posture and greater EMG signal litude of the QL posterior layer in short lordotic posture, compared to those in the pain-free group. For the group with high ES EMG, the PM transverse process and PM vertebral body EMG was less than that of the other LBP group in short lordotic posture. The findings suggest a redistribution of activity between muscles that have a potential extensor moment in in iduals with LBP. The modification of EMG of discrete fascicles of the PM and QL was related to changes in ES EMG signal litude recorded in sitting.
Paediatric bacteraemias in tropical A ustralia
Publisher: Wiley
Date: 15-10-2014
DOI: 10.1111/JPC.12750
Abstract: Bacteraemias in children are an important cause of morbidity and mortality. Knowledge of local epidemiology and trends is important to inform practitioners of likely pathogens in the sick child. This study aimed to determine trends over time in pathogenic organisms causing paediatric bacteraemia in North Queensland and to audit a hospital's blood culture results with respect to contamination rate. This was a retrospective review of 8385 blood cultures collected from children attending a tertiary centre in North Queensland over a 10-year period (2001-2010). There were 696 positive blood cultures (8.3%) with 70 different bacterial species detected. Gram-positive and Gram-negative bacteria accounted for 48.6% and 51.4% of isolates, respectively. Overall, bacteraemia accounted for 4.7 per 1000 admissions. The rate of contamination was 60.6% among positive blood cultures and 5.0% for all blood cultures s led. These results were compared with previous published reports. Notable differences were seen in the frequencies of Salmonella and group A Streptococcus bacteraemias in North Queensland when compared with other reports. There was also a decline in vaccine-preventable infections such as S. pneumoniae and an increasing trend of community-acquired MRSA bacteraemia. This study has demonstrated the unique profile of causative pathogens of paediatric bacteraemias in tropical Australia. In light of the increasing prevalence of MRSA, empiric treatment for sepsis for children in this region needs to be reconsidered.
Comparative in vitro susceptibility of Burkholderia pseudomallei to doripenem, ertapenem, tigecycline and moxifloxacin
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.IJANTIMICAG.2011.02.001
Abstract: Burkholderia pseudomallei, the causative agent of melioidosis, continues to present therapeutic challenges in endemic areas. A number of clinical issues have prompted consideration of alternative antimicrobial therapies. These include stability in 24-h infusion pumps, broad-spectrum coverage in the empirical treatment of community-acquired pneumonia, cost, the need for effective oral agents and rare reports of emerging resistance. This study aimed to examine the in vitro susceptibility of B. pseudomallei to four new antimicrobial agents, namely moxifloxacin, tigecycline, ertapenem and doripenem. A total of 100 clinical isolates were tested by Etest and disk diffusion. As there are no interpretative standards for these antimicrobials, MIC(90) values (minimum inhibitory concentrations for 90% of the isolates) were compared with those for meropenem. MIC values for each agent were correlated with zone of inhibition diameters. MICs for doripenem were broadly similar to those for meropenem, with a MIC(90) of 1.5 μg/mL (range 0.38-4 μg/mL). There was good correlation (r=-0.71 P<0.001) between the MIC and disk diffusion for doripenem. Ertapenem, tigecycline and moxifloxacin had limited in vitro activity in this study, although no interpretative criteria exist for these agents. Further in vitro, animal and clinical studies are suggested to validate the efficacy of doripenem in the management of melioidosis.
In a Pandemic That Limits Contact, Can Videoconferencing Enable Interdisciplinary Persistent Pain Services and What Are the Patient's Perspectives?
Publisher: Elsevier BV
Date: 03-2022
EvaluatingBurkholderia pseudomalleiBip proteins as vaccines and Bip antibodies as detection agents
Publisher: Oxford University Press (OUP)
Date: 2008
Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection
Publisher: BMJ
Date: 09-2005
Retrospective Review of Treponema pallidum PCR and Serology Results: Are Both Tests Necessary?
Publisher: American Society for Microbiology
Date: 05-2018
DOI: 10.1128/JCM.01782-17
Abstract: There has been a resurgence of syphilis diagnoses in Australia. We investigated whether our Treponema pallidum PCR test provides any additional diagnostic information over syphilis serology (chemiluminescence immunoassay [CMIA], Treponema pallidum particle agglutination [TPPA] assay, and the rapid plasma reagin [RPR] flocculation test). A retrospective audit of all T. pallidum PCR requests that came through our laboratory from January 2010 to June 2017 was conducted data collected included age, gender, site of swab, and results from T. pallidum PCR, syphilis serology, and herpes simplex virus 1 (HSV-1) and HSV-2 PCRs. A total of 441 T. pallidum PCR tests were performed on average, 3 T. pallidum PCRs per month were requested in 2011, and this rate increased to 17.2 requests per month in 2017. A total of 323 patients had both T. pallidum PCR and syphilis serology performed, with 67% of swabs taken from the genitals. T. pallidum PCR gave positive results for 61/323 (19%) patients of these 61 patients, 59 (97%) also had positive syphilis serology results ( T. pallidum PCR sensitivity, 68% specificity, 99% positive predictive value, 97% negative predictive value, 89%). Syphilis serology was positive for 91/323 patients (28%) of these 91 patients, 61 (66%) were also T. pallidum PCR positive (syphilis serology sensitivity, 97% specificity, 88% positive predictive value, 60% negative predictive value, 99%). The Cohen's kappa value was 0.74, indicating substantial agreement between the two tests. Our results show that most patients with positive T. pallidum PCR results also had positive syphilis serology. Therefore, T. pallidum PCR adds little clinical value over serology for the diagnosis of syphilis in certain clinical settings.
Acceptability of a Pain History Assessment and Education Chatbot (Dolores) Across Age Groups in Populations With Chronic Pain: Development and Pilot Testing (Preprint)
Publisher: JMIR Publications Inc.
Date: 14-03-2023
Abstract: he delivery of education about pain neuroscience and the evidence for different treatment approaches has become a key component of contemporary persistent pain management. Chatbots, or more formally conversation agents, are increasingly being used in health care settings due to their versatility to provide interactive and in idualized approaches to both capture and deliver information. Research focused on the acceptability of erse chatbot formats can assist in developing a better understanding of the education needs of target populations and maximize the impact of these software applications within the health field. his study aimed to 1) detail the development and initial pilot testing of a multi-modality pain education chatbot (Dolores) that can be utilized across different age groups, and 2) investigate if acceptability and feedback was comparable across age groups following pilot testing. ollowing an initial design phase involving software engineers (n=2) and expert clinicians (n=6), 60 in iduals with chronic pain who attended an outpatient clinic at one of two pain centers in Australia were recruited for pilot testing. Twenty adolescents (10-18 years), 20 young adults (19-35 years), and 20 adults (over 35 years of age) with persistent pain were recruited. Participations were given an iPad with the Dolores app installed and spent 20-30 minutes completing interactive chatbot activities to: i) gather a pain history and ii) provide education about pain and pain treatments. After the chatbot activities, participants completed a custom-made feedback questionnaire measuring acceptability constructs pertaining to health education chatbots. To determine the effect of age group on acceptability ratings and feedback provided, a series of binomial logistic regression models and cumulative odds ordinal logistic regression models with proportional odds were then generated. verall, acceptability was high for the following constructs: engagement, perceived value, usability, accuracy, responsiveness, adoption intention, aesthetics and overall quality. The effect of age group on all acceptability ratings was small and not statistically significant. Analysis of open-ended question responses revealed that major frustrations with the app were related to Dolores’ speech which was explored further through a comparative analysis. For providing negative feedback about Dolores’ speech, a logistic regression model showed that the effect of age group was statistically significant (χ2(2) = 11.68, P = .003) and explained 27.1% of the variance (Nagelkerke R2). Adults and young adults were less likely to comment on Dolores’ speech compared to adolescent participants (OR=0.20, 95% CI [0.05, 0.84] OR=0.05, 95% CI [0.01, 0.43] respectively). Comments related to both speech rate (too slow) and quality (unpleasant and robotic). his study provided support for the acceptability of pain history and education chatbots across different age groups. Chatbot acceptability for adolescent cohorts may be improved by enabling self-selection of speech characteristics such as rate and personable tone.
Predicting respiratory syncytial virus hospitalisation in Australian children
Publisher: Wiley
Date: 05-2006
DOI: 10.1111/J.1440-1754.2006.00849.X
Abstract: There is limited information on respiratory syncytial virus infections among Australians, particularly those of Indigenous descent. This study identifies groups of infants at risk of hospitalisation with respiratory syncytial virus-positive lower respiratory tract infection who may be targeted for prevention with palivizumab. Case control study: the case notes of 271 children with cases of respiratory syncytial virus-positive lower respiratory tract infection admitted to The Townsville Hospital were studied for risk factors. Controls were chosen randomly from babies born in The Townsville Hospital during that period. Multiple logistic regression analysis and classification and regression tree analysis were used to identify risk factors. Multiple logistic regression analysis identified birthweight <2500 g, maternal parity and marital status to be independent predictors of hospitalisation with respiratory syncytial virus-positive lower respiratory tract infection. Classification and regression tree analysis identified babies born weighing <2500 g who possessed older siblings to be at highest risk. Single mothers and smoking were additional risk factors. Indigenous babies were significantly more likely to be exposed to all of the identified risk factors. Babies born weighing <2500 g (especially with siblings) could be targeted for prevention. All Indigenous babies should be considered at high risk because of their exposure to multiple risk factors.
A comparison of antibiotic susceptibility testing methods for cotrimoxazole with Burkholderia pseudomallei
Publisher: Elsevier BV
Date: 05-2002
DOI: 10.1016/S0924-8579(02)00016-X
Abstract: Melioidosis is caused by the Gram-negative soil saprophyte, Burkholderia pseudomallei and is endemic in tropical and subtropical regions of southeast Asia and northern Australia. Cotrimoxazole has been traditionally used for the therapy of melioidosis despite results indicating resistance often produced in the disc diffusion test against B. pseudomallei. This inconsistency was addressed by comparing this method with the agar dilution, MicroScan and E-test methods. The results demonstrated that by disc diffusion, 41.3% of 80 B. pseudomallei clinical isolates tested were susceptible to cotrimoxazole, whereas the MicroScan, agar dilution and the E-test demonstrated 92.5, 90 and 97.5% of the isolates to be susceptible, respectively. These results indicate that an MIC based method is required to test the susceptibility of B. pseudomallei against cotrimoxazole.
Evidence of Burkholderia pseudomallei-Specific Immunity in Patient Sera Persistently Nonreactive by the Indirect Hemagglutination Assay
Publisher: American Society for Microbiology
Date: 15-06-2011
DOI: 10.1128/CVI.00077-11
Abstract: The indirect hemagglutination assay (IHA) is the most frequently used serological test to confirm exposure to Burkholderia pseudomallei . Patients with culture-confirmed disease often have a nonreactive IHA at presentation and occasionally fail to seroconvert on serial testing. We investigated whether using antigens derived from the cultured isolates of persistently IHA-nonreactive patient sera improved the sensitivity of the IHA. In addition, we assessed the antigen-specific lymphocyte response in this group of patients to a panel of B. pseudomallei antigens, including those derived from their own cultured isolates. Eleven patients with culture-proven melioidosis were identified as having persistently IHA-nonreactive sera. A modified IHA using erythrocytes sensitized with patient isolate-derived antigen tested against convalescent-phase serum was performed. The majority (82%) of sera showed a negative (≤1:5) result, one was borderline (1:20), and one was positive at the cutoff value (1:40). IHA-nonreactive sera were also tested by enzyme immunoassay (EIA), with 73% (8/11) demonstrating IgG positivity. In addition, lymphocytes isolated from persistently IHA-nonreactive patient sera demonstrated significantly increased proliferation in response to B. pseudomallei antigens compared to controls. These studies demonstrate the presence of B. pseudomallei -specific antibody by EIA and B. pseudomallei -specific lymphocytes in patient sera categorized as persistently nonreactive according to the IHA. New immunoassays are required and should incorporate B. pseudomallei antigens that are immunoreactive for this subset of IHA-nonreactive patient sera.
Pseudomonas fluorescens pseudobacteraemia: A cautionary lesson
Publisher: Wiley
Date: 02-2002
DOI: 10.1046/J.1440-1754.2002.00727.X
Abstract: To describe an outbreak of pseudobacteraemia caused by Pseudomonas fluorescens in a paediatric population. To document and highlight the effect this outbreak had on clinical management and the steps taken to determine the source. A clinical and microbiological investigation was carried out into a cluster of 38 pseudobacteraemias caused by Pseudomonas fluorescens in paediatric patients over a 10 month period. The source of the outbreak of pseudobacteraemia was found to be contaminated lithium heparin tubes, which were being filled prior to the filling of the blood culture bottle. Cultures of the same tubes yielded Pseudomonas fluorescens. As a result of the initial positive blood cultures, clinical management was altered in 18 cases. A staff education programme was instituted and eventually resulted in a cessation of the pseudobacteraemia. Pseudobacteraemias are a major cause of potentially inappropriate therapy in febrile children. Attention to detail in the collection of blood cultures can help reduce this outcome. Staff involved in the collection of blood cultures need to be aware of this potential source of contamination.
Bartonella henselae infective endocarditis in north Queensland
Publisher: Wiley
Date: 2003
The Laboratory Diagnosis of Syphilis
Publisher: American Society for Microbiology
Date: 20-09-2021
DOI: 10.1128/JCM.00100-21
Abstract: Syphilis is a multisystem infection caused by the spirochete Treponema pallidum . Currently, cases of possible syphilis are commonly investigated using the treponemal serological tests T. pallidum IgG chemiluminescence immunoassay (CLIA) and the T. pallidum particle agglutination (TPPA).
Automated erythrocytapheresis for severe falciparum malaria
Publisher: Wiley
Date: 2011
DOI: 10.1111/J.1445-5994.2010.02362.X
Abstract: We describe a case of severe falciparum malaria with hyperparasitaemia. Treatment with automated erythrocytapheresis, in conjunction with parenteral artesunate, produced a rapid and sustained fall in parasite burden. Several poor prognostic features were present at admission. Despite the development of a severe headache with abnormal cerebrospinal fluid parameters and transient pulmonary oedema, a complete recovery was observed. Erythrocytapheresis can be considered in selected cases where facilities exist and has theoretical and practical advantages over traditional methods of red cell exchange transfusion. The paucity of systematic or trial evidence convincingly demonstrating a benefit in terms of morbidity or mortality has limited its application. However, the lack of robust trial data should not in itself invalidate considering this therapeutic option in the appropriate context.
People at a persistent pain service can walk it, but some struggle to talk about it: Reliability, detectable difference and clinically important difference of the six‐minute walk test
Publisher: Wiley
Date: 05-09-2022
DOI: 10.1002/MSC.1687
Abstract: The six‐minute walk test (6MWT) is a commonly used measure of functional capacity. This study is the first to investigate the test‐retest reliability, minimal detectable difference (MDD) and the minimal clinically important difference (MCID) for people attending a persistent pain service. Relationships between change in 6MWT performance and change in self‐reported physical, functional and psychological outcome measures were also explored. A cross‐sectional repeated measures design was used with people having months of pain attending an 8‐week outpatient persistent pain programme. For reliability and MDD, 27 people were recruited, for MCID calculations, 32 people were recruited. The MCID was examined by dichotomising people into “improvers”, or “non‐improvers” based upon the Global Rating of Change (GRC) in physical abilities score. The mean (SD) 6MWT distance was 389.4 (93.6) m at programme start, and 427.8 (83.0) m at week eight completion. The test‐retest reliability was good (intraclass correlation coefficient = 0.89) and the MDD = 86.1 m. As there was no relationship between change in 6MWT distance and GRC physical abilities at week eight ( r = 0.132, p = 0.472) the MCID could not be calculated. Furthermore, no relationships were found between change in 6MWT distance and other self‐reported measures. Changes in GRC physical abilities and 6MWT were frequently discordant, with increased 6MWT for 7/11 “GRC non‐improvers” and decreased 6MWT for 7/21 “GRC improvers”. Amongst this cohort, change in physical ability may or may not be reflected by self‐reported change. Objective tests of physical ability are recommended for people attending pain services, and validated tests should align with intervention aims.
Herpes Zoster Meningoencephalitis: Not Only a Disease of the Immunocompromised?
Publisher: Springer Science and Business Media LLC
Date: 10-11-2009
Mycoplasma hominis pneumonia in aboriginal adults
Publisher: Elsevier BV
Date: 1995
DOI: 10.1080/00313029500169472
Abstract: Mycoplasma hominis (M. hominis) is a well recognized extragenital pathogen. Its role as a pathogen of the respiratory tract, however, remains difficult to determine. Four cases of pneumonia are presented in which M. hominis was isolated from blood, tracheal aspirates or post-mortem lung tissue. All 4 of these isolates were in young Aboriginal adult males. M. hominis is the least fastidious of the human mycoplasmas and grows well on most blood-containing bacteriological media. The recognition and identification of M. hominis is important as it is commonly resistant to erythromycin which would be the drug of choice in most atypical pneumonias. Early recognition and treatment with tetracycline instead may influence outcome.
Reply to Dale and Shulman.
Publisher: Oxford University Press (OUP)
Date: 24-09-2019
Comparative evaluation of Panther Fusion and real-time PCR for detection of Burkholderia pseudomallei in spiked human blood
Publisher: Microbiology Society
Date: 21-03-2022
Abstract: Introduction. Melioidosis is an infection that most commonly presents with bacteraemia. Culture-based laboratory methods can result in a significant delay to organism identification. Molecular diagnostic techniques have a high sensitivity and rapid time to diagnosis. A decreased time to diagnosis is likely to improve patient outcomes. Aim. To compare the Panther Fusion automated molecular instrument to an in-house method for the detection of Burkholderia pseudomallei directly from spiked human whole-blood s les. Results. The in-house method detected 11/12 (92 %) s les with a B. pseudomallei concentration of 2.5–4.5×10 2 c.f.u. ml −1 . The Panther was less reliable, detecting only 8/14 (75 %) s les with a similar bacterial concentration. The Panther was able to detect 12/12 (100 %) spiked blood culture-positive s les. Conclusion. The direct detection of B. pseudomallei from patient blood on presentation to a healthcare facility will significantly decrease time to diagnosis. We describe an in-house real-time PCR method with the lowest reported limit of detection to date. Due to lower sensitivity, the Panther Fusion would be best used as a diagnostic method directly from a positive blood culture.
Correlation between serum cryptococcal antigen titre and meningitis in immunocompetent patients
Publisher: Microbiology Society
Date: 10-2018
DOI: 10.1099/JMM.0.000830
Abstract: The aim of this paper was to determine the correlation between serum cryptococcal antigen and a diagnosis of cryptococcal meningitis in the immunocompetent cohort. A retrospective multicentre analysis of immunocompetent patients diagnosed and treated for cryptococcal meningitis between January 2000 and December 2017 was performed. Sixty-seven of the 143 cases of cryptococcosis occurred in immunocompetent patients. The serum cryptococcal antigen titre was significantly higher in the meningitis group [1 : 256 (IQR: 64-1024)] compared with that for non-meningitis patients [1 : 64 (IQR: 8-256)], P=0.012. The relative risk of meningitis with a serum cryptococcal antigen (CRAG) >1 : 64 was 1.8 (95 % CI: 1.15-2.82). This study demonstrates a clear correlation between serum cryptococcal antigen titre and meningitis. While the serum titre is not definitive for meningitis, in resource-limited settings or cases where lumbar puncture may be contraindicated, this evidence may aid diagnosis and subsequent therapeutic decisions.
Paediatric thoracic empyema in the tropical North Queensland region of Australia: Epidemiological trends over a decade
Publisher: Wiley
Date: 14-02-2018
DOI: 10.1111/JPC.13853
Abstract: The Townsville Hospital and Health Service is the regional referral centre for children in the north of Queensland. Aboriginal and Torres Strait Islander (ATSI) people make up 7-10% of the population. Increasing numbers of children with paediatric thoracic empyema (pTE) are being referred to Townsville Hospital and Health Service for management. This study aims to describe the incidence rates, epidemiology, microbiology and trends of this disease in North Queensland over a 10-year period. A retrospective chart review of all children (1 month to 16 years), admitted in the years 2007-2016, with community-acquired pTE was conducted. International Classification of Diseases codes were used to identify the patients. Epidemiological and microbiological data were extracted from records. Of the 123 cases identified, incidence rates per 100 000 were 8.5 (95% confidence interval (CI) 8.4-8.6) in all children and much higher at 19.8 (95% CI: 19.5-21.9) in ATSI children. The under 5 years age group had the highest rate (24.5 95% CI: 24.4-24.6). There was a progressive rise in incidence during the 10-year period, with the highest incidence of 15.2 (95% CI: 15.1-15.2) occurring in 2016. A pathogen was isolated in 76% of cases. Non-multi-resistant methicillin-resistant Staphylococcus aureus was the most common pathogen isolated in 22 of 64 ATSI children (34%), while Streptococcus pneumoniae was the most common pathogen isolated in 27 of 59 non-ATSI children (46%). A high and increasing incidence of pTE in North Queensland is being observed. ATSI children have higher incidence rates and are more likely to have non-multi-resistant methicillin-resistant Staphylococcus aureus as a causative agent.
Rapid diagnosis of chlamydial respiratory infection in children
Publisher: Informa UK Limited
Date: 1995
DOI: 10.3109/00365549509047055
Abstract: A study was undertaken to determine the incidence of chlamydial respiratory infection in paediatric patients during a 12-month period by antigen detection. Nasopharyngeal aspirates (NPA) from 514 patients were screened for genus-specific chlamydia antigen using the Pharmacia Chlamydia enzyme immunoassay (EIA) and Kallestad immunofluorescence (IF) assays. EIA screen-positive s les were confirmed by specific blocking antibody. Specimens which were EIA positive or IF positive were cultured for chlamydia. The NPAs from 7 patients were positive in the EIA and IF assays. Four of these patients were culture positive for chlamydia. Our results showed that the incidence of chlamydia respiratory infection by antigen detection was 1.4% or 0.8% if confirmed by culture.
The utility of syphilis point of care testing in remote Queensland communities
Publisher: Elsevier BV
Date: 06-2014
ELISA and immuno-polymerase chain reaction assays for the sensitive detection of melioidosis
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1016/J.DIAGMICROBIO.2012.10.011
Abstract: Melioidosis is caused by the Gram-negative bacterium Burkholderia pseudomallei. The gold standard for diagnosis is culture, which requires at least 3-4 days to obtain a result, hindering successful treatment of acute disease. An indirect haemagglutination assay (IHA) is often used but lacks sensitivity. Approximately half of patients later confirmed culture positive are not detected by IHA at presentation and a subset of patients persistently continue to be IHA negative. More rapid and reliable serologic testing for melioidosis is essential and will improve diagnosis and patient outcome. We have developed an ELISA and a quantitative immuno-polymerase chain reaction assay capable of detecting melioidosis-specific antibodies and demonstrate their validity with IHA-negative sera from patients with melioidosis. These new sensitive assays are based upon a secreted antigenic fraction from B. pseudomallei and will be ideal for the diagnosis of melioidosis in patients in nonendemic regions returning from endemic tropical areas and for seroepidemiologic surveys.
Infographic. Does foot mobility affect the outcome in the management of patellofemoral pain with foot orthoses versus hip exercises? A randomised clinical trial
Publisher: BMJ
Date: 07-10-2021
Speed and safety of mass spectrometry for identification of Burkholderia pseudomallei directly from spiked blood cultures
Publisher: Microbiology Society
Date: 22-04-2022
DOI: 10.1099/JMM.0.001521
Abstract: Burkholderia pseudomallei is a bipolar Gram-negative bacillus and the causative agent of melioidosis an infectious disease which commonly presents with bacteraemia. Data regarding direct from blood culture identification of B. pseudomallei using the Vitek mass spectrometer (MS) are limited. The authors aim to assess the safety and sensitivity of the Vitek MS for identification of B. pseudomallei from spiked positive blood culture s les. Safety was assessed by determining the ability of the standard MS α-cyano-4-hydroxycinnamic acid (CHCA) matrix solution to inactivate B. pseudomallei . Organism identification using the manufacturer’s blood culture extraction method was compared to an in-house technique. Additionally, identification following abbreviated agar incubation of blood culture broth was performed. All 70 MS target spots were inactivated by the matrix solution. The manufacturer’s blood culture extraction method identified 0/26 (0%) B. pseudomallei s les. An in-house method using the spun deposit from blood culture broth s les identified 38/38 (100%) B. pseudomallei s les. MS analysis of a blood culture broth drop on Chocolate agar following a 6 h incubation identified 30/32 (94%) s les. Decreased time to diagnosis of melioidosis bacteraemia is likely to improve patient outcomes. This study adds to the literature with regards to the utility of MALDI-TOF MS identification of B. pseudomallei both directly from positive blood culture broth and a subsequent 6 h plate incubation. The use of a standard matrix solution inactivates the organism, and use of the spun deposit from a positive blood culture broth is most effective for early identification of B. pseudomallei .
Changes in Regional Activity of the Psoas Major and Quadratus Lumborum With Voluntary Trunk and Hip Tasks and Different Spinal Curvatures in Sitting
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 02-2013
Abstract: Cross-sectional controlled laboratory study. To investigate the function of discrete regions of psoas major (PM) and quadratus lumborum (QL) with changes in spinal curvature and hip position. Anatomically discrete regions of PM and QL may have differential function on the lumbar spine, based on anatomical and biomechanical differences in their moment arms between fascicles within each muscle. Fine-wire electrodes were inserted with ultrasound guidance into PM fascicles arising from the transverse process (PM-t) and vertebral body (PM-v) and anterior (QL-a) and posterior (QL-p) layers of QL. Recordings were made on 9 healthy participants, who performed 7 tasks with maximal voluntary efforts and adopted 3 sitting postures that involved different spinal curvatures and hip angles. Activity of PM-t was greater during trunk extension than flexion, whereas activity of PM-v was greater during hip flexion than trunk efforts. Activity of QL-p was greater during trunk extension and lateral flexion, whereas QL-a showed greater activity during lateral flexion. During sitting tasks, PM-t was more active when sitting with a short lordosis than a flat (less extended) lumbar spine posture, whereas PM-v was similarly active in both sitting postures. Activity of PM-t was more affected by changes in position of the lumbar spine than the hip, whereas PM-v was more actively involved in the movement of the hip rather than that of the lumbar spine. Moreover, from its anatomy, PM-t has a combined potential to extend/lordose the lumbar spine and flex the hip, at least in a flexed-hip position.
Group G Streptococcus Induces an Autoimmune Carditis Mediated by Interleukin 17A and Interferon γ in the Lewis Rat Model of Rheumatic Heart Disease
Publisher: Oxford University Press (OUP)
Date: 09-12-2017
Abstract: Acute rheumatic fever and rheumatic heart disease (ARF/RHD) have long been described as autoimmune sequelae of Streptococcus pyogenes or group A streptococcal (GAS) infection. Both antibody and T-cell responses against immunodominant GAS virulence factors, including M protein, cross-react with host tissue proteins, triggering an inflammatory response leading to permanent heart damage. However, in some ARF/RHD-endemic regions, throat carriage of GAS is low. Because Streptococcus dysgalactiae subspecies equisimilis organisms, also known as β-hemolytic group C streptococci and group G streptococci (GGS), also express M protein, we postulated that streptococci other than GAS may have the potential to initiate or exacerbate ARF/RHD. Using a model initially developed to investigate the uniquely human disease of ARF/RHD, we have discovered that GGS causes interleukin 17A/interferon γ-induced myocarditis and valvulitis, hallmarks of ARF/RHD. Remarkably the histological, immunological, and functional changes in the hearts of rats exposed to GGS are identical to those exposed to GAS. Furthermore, antibody cross-reactivity to cardiac myosin was comparable in both GGS- and GAS-exposed animals, providing additional evidence that GGS can induce and/or exacerbate ARF/RHD.
The utility of serial blood film testing for the diagnosis of malaria
Publisher: Elsevier BV
Date: 2015
Pathology stewardship in emergency departments: a single-site, retrospective, cohort study of the value of C-reactive protein in patients with suspected sepsis
Publisher: Elsevier BV
Date: 08-2023
Rapid serological diagnosis of melioidosis: an evaluation of a prototype immunochromatographic test
Publisher: Elsevier BV
Date: 04-2005
DOI: 10.1080/00313020500058516
Abstract: To evaluate the Panbio melioidosis prototype (ICT) IgG and IgM test kits in detecting antibodies to Burkholderia pseudomallei from an endemic region of Australia. This would be of particular importance in high prevalence, low resource regions. Seventy-five culture-confirmed sera for melioidosis and 158 negative control sera from subjects in North Queensland were tested. All sera s les were also tested with an in-house indirect haemagglutination assay (IHA). Seventy-three of the positive sera were further tested using an in-house EIA IgG and IgM assay. The Panbio IgG kits had a sensitivity of 50.6% (95%CL 38.9-62.4) and a specificity of 97.4% (95%CL 93.7-99.3). The Panbio IgM kits had a sensitivity and specificity, respectively, of 72.0% (95%CL 60.4-81.8) and 71.5% (95%CL 63.8-78.4). The ICT kits were found to be rapid and easier to use than current serological methods. In particular, the IgG ICT kit would have a potential role in determining existing disease in low resource regions.
Recurrent Methylobacterium mesophilicum sepsis associated with haemodialysis
Publisher: Elsevier BV
Date: 2001
DOI: 10.1080/00313020120083331
Abstract: Methylobacterium mesophilicum is an environmental organism that has infrequently been implicated as a human pathogen. Most reported cases are in immunocompromised hosts. The natural ecology of this organism is related to vegetation or soil. We report the case of a 51-year-old man who developed a recurrent bacteraemia with this organism while receiving haemodialysis through an indwelling intravascular catheter. The literature on the clinical significance of this organism is reviewed together with specific microbiological identifying features which could be of use in the routine diagnostic laboratory.
Workshop on Treatment of and Postexposure Prophylaxis forBurkholderia pseudomalleiandB. malleiInfection, 2010
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 12-2012
Corynebacterium aquaticum septicaemia in a neutropenic patient.
Publisher: BMJ
Date: 10-1995
Abstract: Corynebacteria are a well recognised cause of sepsis in the immunocompromised patient. Corynebacterium aquaticum, however, is rarely seen in the clinical setting, being an environmental organism associated with fresh water. A septicaemic episode caused by this organism in a 74 year old neutropenic woman with an indwelling central venous catheter is reported. It is postulated that the source of the organism was untreated stored rainwater which she used for showering.
Low back pain websites do not meet the needs of consumers: A study of online resources at three time points
Publisher: SAGE Publications
Date: 02-07-2020
Abstract: The popularity of the Internet as a source of health-related information for low back pain (LBP) is growing. Although research has evaluated information quality in health-related websites, few studies have considered whether content and presentation match consumer preferences. The aim of this study was to evaluate whether LBP website content and presentation matched preferences of consumers with LBP, whether matching preference of consumers changed over 8 years as recognition of people-centred healthcare has developed and whether this differs between countries of Internet searching. The most prominent and top 20 LBP websites were identified using common search engines in 2010, 2015 and 2018. Websites identified in the top 20 in 2010 were followed up if not identified in 2015 and 2018. Two reviewers independently evaluated websites with a 16-item checklist developed from research of consumer preferences. In 2015, websites were identified using searches conducted using IP addresses from Australia, the United States of America (USA), the United Kingdom and Canada. After removal of duplicates, 55 websites were evaluated in 2010. In 2015 and 2018, 33 and 28 new sites, respectively, were identified, and 37 previous websites were re-evaluated. In 2010 and 2015, websites predominantly originated from USA and were sponsored by “for-profit” organisations. In 2018, most websites originated from Australian “not-for-profit” organisations. None of the websites provided information on all content areas. At least 55% of websites were rated as poor or fair. No site rated as excellent overall. There was some worsening over time. Country of search did not affect results. Websites retrieved using typical searches did not meet information and presentation preferences of people with LBP.
Peripheral Blood Lymphocyte Subsets in Acute Human Melioidosis
Publisher: Springer Science and Business Media LLC
Date: 07-2002
Sitting versus standing: Does the intradiscal pressure cause disc degeneration or low back pain?
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.JELEKIN.2006.10.011
Abstract: Studies of lumbar intradiscal pressure (IDP) in standing and upright sitting have mostly reported higher pressures in sitting. It was assumed clinically that flexion of the lumbar spine in sitting relative to standing, caused higher IDP, disc degeneration or rupture, and low back pain. IDP indicates axial compressive load upon a non-degenerate disc, but provides little or no indication of shear, axial rotation or bending. This review is presented in two main parts. First, in vivo IDP data in standing and upright sitting for non-degenerate discs are comprehensively reviewed. As methodology, results and interpretations varied between IDP studies, in vivo studies measuring spinal shrinkage and spinal internal-fixator loads to infer axial compressive load to the discs are also reviewed. When data are considered together, it is clear that IDP is often similar in standing and sitting. Secondly, clinical assumptions related to IDP in sitting are considered in light of basic and epidemiologic studies. Current studies indicate that IDP in sitting is unlikely to pose a threat to non-degenerate discs, and sitting is no worse than standing for disc degeneration or low back pain incidence. If sitting is a greater threat for development of low back pain than standing, the mechanism is unlikely to be raised IDP.
A comparison of antibiotic regimens in the treatment of acute melioidosis in a mouse model
Publisher: Oxford University Press (OUP)
Date: 28-11-2002
DOI: 10.1093/JAC/DKG011
Abstract: Melioidosis is caused by the Gram-negative bacillus Burkholderia pseudomallei. Most clinical reports of disease are from south-east Asia and northern Australia. The organism is intrinsically resistant to most commonly available antibiotics. Standard therapy includes ceftazidime either alone or in combination with co-trimoxazole. The clinical advantage in adding co-trimoxazole has never been determined nor has the activity of newer, fourth-generation cephalosporins, such as cefepime, been studied in the treatment of this condition. BALB/c mice have been shown to represent an animal model of melioidosis. This animal model was used in this study to compare the efficacy of ceftazidime and cefepime alone or with co-trimoxazole, in the therapy of melioidosis. Antibiotic levels in the mice were determined by HPLC, and dosing was modified to keep plasma antibiotic levels at or above the MIC for the organism-antibiotic combination for a significant part of a 12 h period. Bacterial load, as determined by splenic counts, showed that ceftazidime in combination with co-trimoxazole was the most effective therapeutic option. The animal model described in this study can be used as a preliminary evaluation of therapeutic options for melioidosis.
Spatial analysis of melioidosis distribution in a suburban area
Publisher: Cambridge University Press (CUP)
Date: 22-01-2010
DOI: 10.1017/S0950268809991634
Abstract: Burkholderia pseudomallei , the causative agent of melioidosis is associated with soil. This study used a geographic information system (GIS) to determine the spatial distribution of clinical cases of melioidosis in the endemic suburban region of Townsville in Australia. A total of 65 cases over the period 1996–2008 were plotted using residential address. Two distinct groupings were found. One was around the base of a hill in the city centre and the other followed the old course of a major waterway in the region. Both groups (accounting for 43 of the 65 cases examined) are in areas expected to have particularly wet topsoils following intense rainfall, due to soil type or landscape position.
Another Killer of the Australian Bush: A Rapidly Fatal Meningoencephalitis in a Child
Publisher: Oxford University Press (OUP)
Date: 15-05-2010
DOI: 10.1086/652145
Relative uptake of technetium 99m stannous colloid by neutrophils and monocytes is altered by gram-negative infection
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.NUCMEDBIO.2004.08.001
Abstract: Gram-negative infection alters phagocytic cell function hence, it could affect phagocytic uptake of inorganic colloids by these cells. Neutrophil and monocyte uptake of technetium 99m stannous colloid (99mTc SnC) in whole blood was measured in 10 patients with gram-negative infection (Burkholderia pseudomallei) and 7 controls. Mean uptake per in idual neutrophil was reduced in infection. Uptake per monocyte was not significantly different. Blood from six normal in iduals was incubated with lysed B. pseudomallei and colloid, which showed reduced neutrophil uptake, but increased monocyte uptake. These results indicate that uptake of 99mTc SnC stannous colloid can be used to measure alteration in phagocytic cell function. They suggest that infection with B. pseudomallei is associated with reduced phagocytosis by in idual neutrophils, possibly through toxic effects of bacterial products. This could have immunopathogenic consequences for this gram-negative infection and may explain why it responds to granulocyte colony-stimulating factor.
Reproducibility of the Kids-BESTest and the Kids-Mini-BESTest for Children With Cerebral Palsy
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.APMR.2018.12.021
Abstract: To evaluate the reproducibility, including reliability and agreement, of the Kids Balance Evaluation Systems Test (Kids-BESTest) and the short form of Kids-BESTest (Kids-Mini-BESTest) for measuring postural control in school-aged children with cerebral palsy. Psychometric study of intrarater, interrater, and test-retest reliability and agreement. Clinical laboratory and home. Convenience s le of children (N=18) aged 8 to 17 years with ambulant cerebral palsy (CP) (Gross Motor Function Classification System I-II) with spastic or ataxic motor type. Not applicable. Postural control was assessed using the Kids-BESTest and the Kids-Mini-BESTest. An experienced physiotherapist assessed all children in real time and the testing session was videotaped. The same physiotherapist viewed and scored the video twice, at least 2 weeks apart, to assess intrarater reproducibility. Another experienced physiotherapist scored the same video to determine interrater reproducibility. Thirteen children returned for a repeat assessment with the first physiotherapist within 6 weeks and their test-retest performance was rated in real time and with video. Excellent reliability was observed for both the Kids-BESTest (intraclass correlation coefficient [ICC] 0.96-0.99) and Kids-Mini-BESTest (ICC 0.79-0.98). The smallest detectable change was good to excellent for all Kids-BESTest agreement analyses (5%-9%), but poor to good for Kids-Mini-BESTest analyses (9%-16%). The Kids-BESTest shows an excellent ability to discriminate postural control abilities of school-aged children with CP and it has a low smallest detectable change, suitable for use as a preintervention and postintervention outcome measure. Although the Kids-Mini-BESTest is 5 to 10 minutes shorter to administer, it has poorer reproducibility and focuses only on falls-related balance, which excludes 2 domains of postural control.
Different ways to balance the spine: Subtle changes in sagittal spinal curves affect regional muscle activity
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2009
Application of PCR-Based Tools to Explore Strongyloides Infection in People in Parts of Northern Australia.
Publisher: MDPI AG
Date: 08-12-2017
Improved diagnosis of melioidosis using a 2-dimensional immunoarray
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.DIAGMICROBIO.2013.07.009
Abstract: Melioidosis is caused by the Gram negative bacterium Burkholderia pseudomallei. The gold standard for diagnosis is culture, which requires at least 3-4 days obtaining a result, hindering successful treatment of acute disease. The existing indirect haemagglutination assay (IHA) has several disadvantages, in that approximately half of patients later confirmed culture positive are not diagnosed at presentation and a subset of patients are persistently seronegative. We have developed 2 serological assays, an enzyme-linked immunosorbent assay (ELISA), and a 2-dimensional immunoarray (2DIA), capable of detecting antibodies in patient sera from a greater proportion of IHA-negative patient subsets. The 2DIA format can distinguish between different LPS serotypes. Currently, the 2DIA has a sensitivity and specificity of 100% and 87.1%, respectively, with 100% of culture-positive, IHA-negative s les detected. The ELISA has a sensitivity and specificity of 86.2% and 93.5%, respectively, detecting 67% of culture-positive, IHA-negative s les. The ELISA and 2DIA tests described here are more rapid and reliable for serological testing compared to the existing IHA.
Cryptococcosis—the impact of delay to diagnosis
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.CMI.2016.04.022
Abstract: Cryptococcosis is a mycotic disease caused by the yeast Cryptococcus sp. It is associated with significant mortality and morbidity, including long-term neurological sequelae. It is not known whether the high morbidity observed is related to a delay in diagnosis. A retrospective chart review of all cryptococcal infections that had been diagnosed in the region between 1997 and 2015 was performed. Twenty-nine cases were identified. Overall mortality rate was 10.3%, with an attributable mortality rate of 6.9%. Forty-five per cent of patients with central nervous system involvement developed long-term neurological deficits. Significant associations were noted between those with and without long-term neurological deficits and in both time from onset of symptoms to diagnosis (median of 45.5 days versus 18.5 days, respectively) and time from presentation to diagnosis (median 14.5 days versus 7 days, respectively). In addition, raised intracranial pressure (p 0.03) and female gender (p 0.02) were significantly associated with poor neurological outcomes. This highlights the importance of early diagnosis and the need to limit raised intracranial pressure to minimize long-term neurological deficits.
Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain
Publisher: MDPI AG
Date: 29-01-2022
Abstract: Poor communication is an important factor contributing to health disparity. This study sought to investigate clinicians’ perspectives about communicating with Aboriginal and Torres Strait Islander patients with pain. This multi-site and mixed-methods study involved clinicians from three pain management services in Queensland, Australia. Clinicians completed a survey and participated in focus groups. Clinicians rated the importance of communication training, their knowledge, ability, and confidence in communicating with Aboriginal and Torres Strait Islander patients using a 5-point Likert scale. Rating scores were combined into low (scores 1–2) moderate (score 3) and high (scores 4–5). Informed by an interpretive description methodology, thematic analysis of focus group data was used to identify the communication needs and training preferences of clinicians. Overall (N = 64), 88% of clinicians rated the importance of communication training when supporting Aboriginal and Torres Strait Islander patients as “high”. In contrast, far fewer clinicians rated as “high” their knowledge (28%), ability (25%) and confidence (28%) in effectively communicating with Aboriginal and Torres Strait Islander patients. Thematic analysis identified three areas of need: knowledge of Aboriginal and Torres Strait Islander cultures, health beliefs, and understanding cross-cultural cues. Communication skills can be learned and training, in the form of a tailored intervention to support quality engagement with Aboriginal and Torres Strait Islander patients, should combine cultural and communication aspects with biomedical knowledge.
Prospective evaluation of beta-lactamase detection in penicillin susceptible Staphylococcus aureus by interpretation of the penicillin disc edge
Publisher: Cold Spring Harbor Laboratory
Date: 26-09-2019
DOI: 10.1101/776880
Abstract: Penicillin susceptible Staphylococcus aureus (PSSA) may occasionally be encountered as a cause of complicated S. aureus infection, such as endocarditis or bloodstream infections. Clinicians may choose to treat these patients with penicillin over a semi-synthetic penicillin derivative, such as flucloxacillin or oxacillin, due to a favourable Pk/Pd profile. In this study, we prospectively evaluated the penicillin disc (1-IU) method for detection of blaZ , with interpretation of the penicillin edge according to EUCAST recommendations. 472 PSSA isolates were collected between September 2014 to December 2015 from three clinical microbiology laboratories in Queensland, Australia. Initial antimicrobial susceptibility testing was performed by the Vitek 2 system. Real-time PCR for blaZ was performed following phenotypic testing with the 1-IU penicillin disc and the PCR used as the gold standard for detection of penicillinase. The prevalence of blaZ amongst the isolates was 7%. The sensitivity, specificity, positive predictive value and negative predictive value of the penicillin disc method was 97%, 95%, 61% and 100% when compared to blaZ PCR. In summary, the penicillin disc zone size and edge interpretation is a reliable method for detection of blaZ in S. aureus isolates that otherwise test susceptible to penicillin by Vitek 2 AST.
Misidentification of Brucella suis as Ochrobactrum anthropi in a Patient with Septic Arthritis
Publisher: Elsevier BV
Date: 04-2016
Seropositivity to Burkholderia pseudomallei does not reflect the development of cell-mediated immunity
Publisher: Oxford University Press (OUP)
Date: 12-2008
Quantifying Muscle Size Asymmetry in Adolescent Idiopathic Scoliosis Using Three-dimensional Magnetic Resonance Imaging
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-07-2023
DOI: 10.1097/BRS.0000000000004715
Abstract: This is a case-control study of prospectively collected data. To quantify paraspinal muscle size asymmetry in adolescent idiopathic scoliosis (AIS) and determine if this asymmetry is i) greater than observed in adolescent controls with symmetrical spines and ii) positively associated with skeletal maturity using Risser grade, scoliosis severity using the Cobb angle, and chronological age in years. AIS is a three-dimensional deformity of the spine which occurs in 2.5-3.7% of the Australian population. There is some evidence of asymmetry in paraspinal-muscle activation and morphology in AIS. Asymmetrical paraspinal muscle forces may facilitate asymmetrical vertebral growth during adolescence. An asymmetry index [Ln(concave/convex volume)] of i) deep and ii) superficial paraspinal-muscle volumes, at the level of the i) major curve apex (Thoracic 8-9 th vertebral level) and ii) lower-end vertebrae ( LEV , Thoracic 10-12 th vertebral level), was determined from 3D Magnetic Resonance Imaging (MRI) of 25 adolescents with AIS (all right thoracic curves), and 22 healthy controls (convex=left) all female, 10-16 years. Asymmetry index of deep paraspinal-muscle volumes was greater in AIS (0.16±0.20) than healthy spine controls (-0.06±0.13) at the level of the apex ( P .01, linear mixed-effects analysis), but not LEV ( P .05). Asymmetry index was positively correlated with Risser grade (r=0.50, P .05) and scoliosis Cobb angle (r=0.45, P .05), but not age (r=0.34, P .05). There was no difference in the asymmetry index of superficial paraspinal muscle volumes between AIS and controls ( P .05). The asymmetry of deep apical paraspinal-muscle volume in AIS at the scoliosis apex is greater than that observed at equivalent vertebral levels in controls and may play a role in the pathogenesis of AIS.
Clinical presentation of rheumatic fever in an endemic area
Publisher: BMJ
Date: 29-10-2009
Abstract: This study documented whether patients diagnosed with acute rheumatic fever (ARF) in North Queensland, Australia, conformed to the 1992 Revised Jones Criteria (RJC). The authors aimed to determine whether inclusion of subclinical carditis (SCC) and monarthritis as major manifestations and a low-grade temperature as a minor manifestation in the RJC are justified in this population. A retrospective review of patients in whom the diagnosis of ARF relied on the experience of clinicians and who were admitted to the Townsville and Cairns Base Hospitals between 1997 and 2007 was undertaken. Of the 98 cases reviewed, 71.4% satisfied the RJC. Modification of the RJC increased the rate of criteria satisfaction to 91.8%. On presentation, 27 patients had SCC. Of the patients with SCC followed up, 70.5% had long-term valvular consequences. In populations endemic for ARF, monarthritis, SCC and a low-grade temperature should be included in the RJC.
Evaluation of the Remel RapID NF Plus Rapid Biochemical Method for Identification of Burkholderia pseudomallei
Publisher: American Society for Microbiology
Date: 06-2014
DOI: 10.1128/JCM.00025-14
Abstract: Typical methods for the identification of Burkholderia pseudomallei colonies produce results in 18 h. The Remel RapID NF Plus kit produces results in 4 h. We used the kit for 190 stored B. pseudomallei isolates and correctly identified 189 of them. This kit produces consistent results for known B. pseudomallei isolates.
Correction for Johnson et al., Complete Genome Sequences for 59 Burkholderia Isolates, Both Pathogenic and Near Neighbor
Publisher: American Society for Microbiology
Date: 28-04-2016
Successful outcome from foot orthoses and exercises for patellofemoral pain predicted by static foot measurement – A case study
Publisher: Elsevier BV
Date: 12-2015
Outbreak of adenovirus type 4 conjunctivitis in South Australia
Publisher: Wiley
Date: 12-1993
Abstract: An outbreak of adenovirus type 4 conjunctivitis occurred in South Australia between April and November 1992. Eye swabs were submitted by general practitioners and ophthalmologists who had seen patients with clinical conjunctivitis or keratitis. Apart from interfamilial spread, there were no other common epidemiological factors. Adenovirus was isolated from the eye swabs of 38 patients. Isolates were typed by neutralisation tests and restriction endonuclease cleavage patterns and found to be adenovirus type 4. This report serves to illustrate an infrequent cause of epidemic conjunctivitis, namely adenovirus type 4. There was no demonstrable focus of the outbreak.
Activity of tigecycline in the treatment of acute Burkholderia pseudomallei infection in a murine model
Publisher: Elsevier BV
Date: 11-2006
DOI: 10.1016/J.IJANTIMICAG.2006.07.022
Abstract: Burkholderia pseudomallei is the causative agent of melioidosis. Standard therapy includes ceftazidime alone or in combination with co-trimoxazole. Tigecycline, a novel agent, has displayed activity against B. pseudomallei. We evaluated the in vivo efficacy of tigecycline using a murine model of melioidosis. Mice were infected with either a high or low virulence B. pseudomallei isolate followed by administration of antibiotics alone or in combination (tigecycline, ceftazidime, tigecycline plus ceftazidime) for 7 days. Bacterial loads were assessed up to 7 days and survival was determined up to 7 days post infection. Tigecycline in combination with ceftazidime was the most effective and conferred the lowest mortality, suggesting the use of this new agent in B. pseudomallei infection.
An in vitro study of the efficacy of rifampicin and minocycline coated umbilical venous catheters
Publisher: Elsevier BV
Date: 03-2001
DOI: 10.1016/S0924-8579(00)00339-3
Abstract: The use of antibiotic coated catheters has been proposed as a means of reducing catheter related sepsis. In this study, an in vitro comparison of bacterial colonisation rates was made between uncoated umbilical venous catheters and catheters coated with rif icin and minocycline. The following parameters were determined the direct antimicrobial effect of coated and uncoated catheter segments against a range of organisms associated with line sepsis, the assessment of the decline in antimicrobial activity in coated catheters immersed in plasma and the inhibitory efficacy of the catheters to colonisation over a 28-day period. Minocycline and rif icin coated umbilical catheters showed a superior inhibitory effect and prevented colonisation with the commoner line-related organisms, when compared with uncoated catheters. The inhibitory effect declined after 14 days in the human plasma. Resistance to colonisation in vitro may not extend beyond 21 days.
Demonstration of a cell-mediated immune response in melioidosis.
Publisher: Oxford University Press (OUP)
Date: 15-07-2002
DOI: 10.1086/341222
Abstract: Melioidosis is a bacterial infection caused by Burkholderia pseudomallei. The aim of this study was to determine whether a cell-mediated adaptive immune response against B. pseudomallei developed in patients who had recovered from melioidosis. Lymphocyte proliferation assays were done on peripheral blood mononuclear cells from patients (n=13) and control subjects (n=10) to determine the lymphocyte response to B. pseudomallei antigens. Production of interferon-gamma and interleukin-10 was also determined. Activation of T cell subsets was assessed by fluorescence-activated cell sorter analysis, using antibodies to CD4, CD8, and CD69 antigens. Lymphocyte proliferation and interferon-gamma production in response to B. pseudomallei antigens were significantly higher (P<.001 for both) in patients than in control subjects. There was also an increase in the percentage of activated CD4+ (P<.004) and activated CD8+ T cells (P<.035) in cell cultures from patients. The development of such a cell-mediated immune response in patients may be essential for their survival.
Yarning about pain: evaluating communication training for health professionals at persistent pain services in Queensland, Australia
Publisher: Research Square Platform LLC
Date: 21-06-2022
DOI: 10.21203/RS.3.RS-1740247/V1
Abstract: Background: Providing cultural education to health professionals is essential in improving the quality of care and the outcomes for Aboriginal and Torres Strait Islander patients. This study reports the evaluation of a novel training workshop used as an intervention to improve communication with Aboriginal and Torres Strait Islander patients at persistent pain services. Methods : In this single-arm intervention study, health professionals undertook a one-day workshop, which included cultural capability and communication skills training based on a clinical yarning framework. The workshop was delivered across three adult persistent pain clinics in Queensland. At the end of the training, participants completed a retrospective pre ost evaluation questionnaire (5 points Likert scale , 1=very low to 5=very high) , to rate their perceived importance of communication training, their knowledge, ability, and confidence to communicate effectively. Participants also rated their satisfaction with the training and suggested improvements for future interventions. Results: Fifty-seven health professionals were trained (N= 57/111 51% participation rate), 51 completed an evaluation questionnaire (n=51/57 90% response rate). Significant improvements in the perceived importance of communication training, knowledge, ability and confidence to effectively communicate with Aboriginal and Torres Strait Islander patients were identified ( p .001 ). The greatest increase was in the perceived confidence pre-training mean of 2.96 (SE=0.11) to the post-training mean of 4.02 (SE=0.09). Conclusion: This patient-centred communication training, delivered through a novel model that combines cultural capability and the clinical yarning framework applied to the pain management setting, was highly acceptable and significantly improved participants’ perceived competence. This method is transferrable to other health system sectors seeking to train their clinical workforce with culturally sensitive communication skills.
Comparison of Routine Bench and Molecular Diagnostic Methods in Identification of Burkholderia pseudomallei
Publisher: American Society for Microbiology
Date: 05-2009
DOI: 10.1128/JCM.02507-08
Abstract: This study compared the identification of Burkholderia pseudomallei with that of related organisms. Bench tests and latex agglutination were compared with molecular identification. Using bench tests and latex agglutination alone, 100% (30/30) of B. pseudomallei isolates were correctly identified. Amoxicillin-clavulanate susceptibility testing was also a good and simple discriminatory test.
Cardiac Myosin Epitopes for Monitoring Progression of Rheumatic Fever
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2011
Q fever: a recent ‘outbreak’ in Townsville
Publisher: Wiley
Date: 04-2003
Comparison of the Susceptibilities of Burkholderia pseudomallei to Meropenem and Ceftazidime by Conventional and Intracellular Methods
Publisher: American Society for Microbiology
Date: 08-2004
DOI: 10.1128/AAC.48.8.2999-3005.2004
Abstract: The effect of the two antibiotics ceftazidime and meropenem on a collection of 46 Burkholderia pseudomallei isolates representing clinical and environmental sources across northern Australia was investigated by using a series of in vitro test methods. The susceptibility testing methods used included Kirby-Bauer disk diffusion, Etest MIC, broth microdilution MIC, and a modification of the microdilution method in which Acanthamoeba cells were added to simulate the effect of a professional phagocytic cell on test outcome. In a semiquantitative validation coculture series, the majority of bacteria were intracellular up to a multiplicity of infection of 10 bacteria to one ameba. The optical density and bacterial count (log 10 CFU/ml) correlated across the range tested ( r 2 = 0.77 P 0.0001). Susceptibility test results were compared against clinical outcomes. The MICs of ceftazidime were consistently higher than those of meropenem by all three methods. The MICs of both agents were significantly higher when Acanthamoeba trophozoites were added to the broth microdilution method. Conventional and intracellular MIC results were consistent for clinical isolates from the Western Australian outbreak cluster despite the wide variety of clinical outcomes. Further development of the intracellular MIC method is expected to help assess the efficacy of antimicrobial agents on this bacterial species in an intracellular setting.
Clinical Burkholderia pseudomallei isolates from Queensland carry diverse bimABm genes that are associated with central nervous system disease and are phylogenomically distinct from other Australian strains
Publisher: Cold Spring Harbor Laboratory
Date: 18-05-2021
DOI: 10.1101/2021.05.16.21257282
Abstract: Burkholderia pseudomallei is an environmental gram-negative bacterium that causes the disease melioidosis and is endemic in many countries of the Asia-Pacific region. In Australia, the mortality rate remains high at approximately 10%. The bacterium is almost exclusively found in the endemic region, which spans the Northern Territory, Western Australia and North Queensland. However, Queensland infections remain understudied compared to those of the Northern Territory. This pilot study aimed to assess the prevalence of central nervous system disease associated variant bimABm, identify circulating antimicrobial resistance mutations and genetically distinct strains from Queensland, via comparative genomics. From 76 clinical isolates, we identified the bimABm variant in 20 (26.3%) isolates and in 9 (45%) of the isolates with documented central nervous system infection (n=18). Explorative analysis suggests a significant association between isolates carrying the bimABm variant and central nervous system disease (OR 2.8, 95% CI 1.3-6.0, P=0.009) compared with isolates carrying the wildtype bimABp, with the possibility of additional driving factors. Furthermore, 50% of isolates were identified as novel multi-locus sequence types (STs), while the bimABm variant was more commonly identified in isolates with novel sequence STs, compared to those of previously described STs. Additionally, mutations associated with acquired antimicrobial resistance were only identified in 14.5% of all genomes. The findings of this research have provided clinically relevant genomic data of B. pseudomallei in Queensland and suggest that the bimABm variant may enable risk stratification for the development CNS complications and be a potential therapeutic target.
Is spinal neuromuscular function asymmetrical in adolescents with idiopathic scoliosis compared to those without scoliosis?: A narrative review of surface EMG studies
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.JELEKIN.2022.102640
Abstract: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity occurring between ages of 10-18 years. We aimed to present a reasoned synthesis of the published evidence for and against asymmetrical paraspinal muscle activation in AIS. PubMed and Embase databases were searched using terms: adolescent idiopathic scoliosis AND electromyogra* (EMG). Identified studies (n = 94) were screened for eligibility. We identified 16 studies, from which 136 EMG outcome measures contributed to the review. For EMG onset, one of two studies provided evidence of earlier muscle activation on the convex compared to concave side of the spine, particularly in those with progressive AIS. For EMG litude, 43 outcome measures provided evidence of convex > concave activation, 85 outcomes supported no difference between sides, and 8 outcomes supported concave > convex activation. Greater activity on the convex than concave side was more commonly demonstrated at the scoliosis curve apex level, in people with single right thoracic [progressive] curves, during postural tasks. Further research is needed to determine the relationships between muscle activity asymmetry and spinal curve parameters in a variety of motor tasks. Recommendations are provided to improve methodological quality for future studies of spinal neuromuscular function in AIS, as well as more comprehensive and transparent reporting of methods and results.
Combination antimicrobial therapy of acute burkholderia pseudomallei infection in a mouse model
Publisher: Elsevier BV
Date: 1999
Abstract: Burkholderia pseudomallei is the causative agent of melioidosis, a disease endemic in tropical and subtropical regions of South-East Asia and Northern Australia. Antimicrobial therapy regimens for treatment of acute septicemic melioidosis are of variable efficacy. Ceftazidime is the current antibiotic of choice and is commonly administered with other agents such as cotrimoxazole or doxycycline. The emergence of resistant strains of B. pseudomallei and the persistence of high mortality rates prompted the present study. Using an established mouse model of acute disseminated B. pseudomallei infection, we compared the efficacy of ceftazidime versus cefpirome in combination with cotrimoxazole or chlor henicol therapy in vivo. Control mice that were infected but did not receive antibiotic therapy died within 96 hours of infection. No deaths occurred in treatment groups receiving either cephalosporin or cotrimoxazole, despite the demonstrated resistance of B. pseudomallei to cotrimoxazole in vitro. The mortality rate in treatment groups receiving either cephalosporin and chlor henicol was 66%. These results demonstrate a comparable level of efficacy between ceftazidime and cefpirome for treatment of acute B. pseudomallei infection in mice.
Central nervous system tuberculosis: A disease from P apua N ew G uinea in N orth Q ueensland
Publisher: Wiley
Date: 03-2013
DOI: 10.1111/JPC.12107
Abstract: To describe cases of confirmed central nervous system (CNS) tuberculosis seen at the major tertiary referral centre of North Queensland over a 10-year period. This is a retrospective case series-based study of all cases of proven Mycobacterium tuberculosis infection of the CNS presenting to a major tertiary referral centre of North Queensland between 2000 and 2010. Five cases of confirmed CNS tuberculosis were identified over the 10-year period with two deaths. All were from Papua New Guinea with a mean age of 7 years. Imaging and early microbiological diagnosis was critical in making the diagnosis. HIV infection was not a contributing factor. Multidrug resistance was inferred or confirmed in two cases. CNS tuberculosis is a disease being increasingly seen in North Queensland among children from Papua New Guinea. Anticipation of multidrug resistance is important in the immediate management of suspected cases.
Evaluation of the Dual Path Platform syphilis point of care test in North Queensland
Publisher: Elsevier BV
Date: 12-2015
VIBRIO CHOLERAE NON-O1 FACIAL CELLULITIS IN A NORTH QUEENSLAND, AUSTRALIAN CHILD
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2001
DOI: 10.1097/00006454-200105000-00020
Abstract: Vibrio cholerae is an uncommon cause of cellulitis in Australia. Most reported cases worldwide have involved marine or brackish water contact. A recognized risk factor for acquiring this infection is chronic liver disease secondary to hepatitis B. We describe a case of extensive facial cellulitis caused by Vibrio cholerae non-O1, non-0139, in an 11-year-old indigenous girl from North Queensland, Australia, who was hepatitis B surface antigen-negative. Treatment consisted of extensive debridement, antibiotics, hyperbaric oxygen and facial reconstructive surgery. Early microbiologic diagnosis and a combined therapeutic approach are important in the management of this condition.
Overrepresentation of Diabetes in Soft Tissue Nontuberculous Mycobacterial Infections
Publisher: American Society of Tropical Medicine and Hygiene
Date: 07-09-2016
Cerebral phaeohyphomycosis caused by Cladophialophora bantiana in a patient with chronic lymphocytic leukemia
Publisher: Elsevier BV
Date: 07-2006
The utility of the syphilis enzyme immunoassay IgM in the diagnosis of congenital syphilis
Publisher: Elsevier BV
Date: 11-2020
Bacteraemia caused by beta-haemolytic streptococci in North Queensland: changing trends over a 14-year period
Publisher: Elsevier BV
Date: 08-2011
Quantifying Typical Progression of Adolescent Idiopathic Scoliosis
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-09-2023
The double burden: a new-age pandemic meets an ancient infection
Publisher: Oxford University Press (OUP)
Date: 25-08-2014
Abstract: Tuberculosis is responsible for significant morbidity and mortality in the tropics. Active TB develops when host defences are impaired. Epidemiological evidence and studies addressing the double burden of communicable and non-communicable diseases demonstrate a clear association between diabetes and susceptibility to TB, treatment failure and complications. The immune mechanisms involved in host-pathogen interactions in co-morbid TB-diabetes are not well defined and require further investigation. This combined with the increase in diabetes predominately in low- and middle-income countries where TB is prevalent has major health implications.
Is ‘ideal’ sitting posture real?: Measurement of spinal curves in four sitting postures
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1016/J.MATH.2008.06.001
Abstract: There is a lack of quantitative evidence for spinal postures that are advocated as 'ideal' in clinical ergonomics for sitting. This study quantified surface spinal curves and examined whether subjects could imitate clinically 'ideal' directions of spinal curve at thoraco-lumbar and lumbar regions: (i) flat - at both regions (ii) long lordosis - lordotic at both regions (iii) short lordosis - thoracic kyphosis and lumbar lordosis. Ten healthy male subjects had 3-D motion sensors adhered to the skin so that sagittal spinal curves were represented by angles at thoracic (lines between T1-T5 and T5-T10), thoraco-lumbar (T5-T10 and T10-L3) and lumbar regions (T10-L3 and L3-S2). Subjects attempted to imitate pictures of spinal curves for the flat, long lordosis, short lordosis and a slumped posture, and were then given feedback/manual facilitation to achieve the postures. Repeated measures analysis of variance was used to compare spinal angles between posture and facilitation conditions. Results show that although subjects imitated postures with the same curve direction at thoraco-lumbar and lumbar regions (slumped, flat or long lordosis), they required feedback/manual facilitation to differentiate the regional curves for the short lordosis posture. Further study is needed to determine whether the clinically proposed 'ideal' postures provide clinical advantages.
The utility of cerebrospinal fluid parameters in the early microbiological assessment of meningitis
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.DIAGMICROBIO.2012.02.010
Abstract: The measurement of cerebrospinal fluid (CSF) protein, glucose, and white cell count (WCC) is an essential part of the initial examination of CSF. The aim of this study was to determine the utility of CSF parameters in assessing the likely aetiological agent. A total of 2290 CSF s les from a 13-year period were retrospectively reviewed. The initial parameters were compared between bacterial, viral, and cryptococcal meningitis and cases where no pathogen was found. A protein concentration of <600 mg/L and a WCC <90 × 10(6)/L were found to be optimal cut-offs for excluding bacterial meningitis. A WCC of <25 × 10(6)/L was found to be optimal for excluding cryptococcal meningitis and a WCC of <10 × 10(6) for excluding viral meningitis. Decreased glucose concentration was found to be a poor indicator of the aetiological agent.
Improving the imaging report in patients with acute intracerebral hemorrhage
Publisher: Springer Science and Business Media LLC
Date: 26-10-2000
Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis
Publisher: Springer Science and Business Media LLC
Date: 02-08-2019
Candidaemia with uncommon Candida species: Predisposing factors, outcome, antifungal susceptibility, and implications for management
Publisher: Elsevier BV
Date: 07-2009
DOI: 10.1111/J.1469-0691.2009.02821.X
Abstract: The risk factors for and clinical features of bloodstream infection with uncommon Candida spp. (species other than C. albicans, C. glabrata, C. parapsilosis, C. tropicals and C. krusei) are incompletely defined. To identify clinical variables associated with these species that might guide management, 57 cases of candidaemia resulting from uncommon Candida spp. were analysed in comparison with 517 episodes of Candida albicans candidaemia (2001-2004). Infection with uncommon Candida spp. (5.3% of candidaemia cases), as compared with C. albicans candidaemia, was significantly more likely to be outpatient-acquired than inpatient-acquired (15 of 57 vs. 65 of 517 episodes, p 0.01). Prior exposure to fluconazole was uncommon (n=1). Candida dubliniensis was the commonest species (n=22, 39%), followed by Candida guilliermondii (n=11, 19%) and Candida lusitaniae (n=7, 12%).C. dubliniensis candidaemia was independently associated with recent intravenous drug use (p 0.01) and chronic liver disease (p 0.03), and infection with species other than C. dubliniensis was independently associated with age<65 years (p 0.02), male sex (p 0.03) and human immunodeficiency virus infection (p 0.05). Presence of sepsis at diagnosis and crude 30-day mortality rates were similar for C. dubliniensis-related, non-C. dubliniensis-related and C. albicans-related candidaemia. Haematological malignancy was the commonest predisposing factor in C. guilliermondii (n=3, 27%) and C. lusitaniae (n=3, 43%) candidaemia. The 30-day mortality rate of C. lusitaniae candidaemia was higher than the overall death rate for all uncommon Candida spp. (42.9% vs. 25%, p not significant). All isolates were susceptible to hotericin B, voriconazole, posaconazole, and caspofungin five strains (9%) had fluconazole MIC values of 16-32 mg/L. Candidaemia due to uncommon Candida spp. is emerging among hospital outpatients certain clinical variables may assist in recognition of this entity.
Challenges in the microbiological diagnosis and management of hVISA infections
Publisher: Elsevier BV
Date: 06-2011
Streptococcal toxic shock syndrome in North Queensland—a case controlled review of clinical and molecular determinants
Publisher: Elsevier BV
Date: 04-2006
Q fever – immune responses and novel vaccine strategies
Publisher: Future Medicine Ltd
Date: 18-10-2023
Acceptability of a Pain History Assessment and Education Chatbot (Dolores) Across Age Groups in Populations With Chronic Pain: Development and Pilot Testing
Publisher: JMIR Publications Inc.
Date: 06-10-2023
DOI: 10.2196/47267
Biogeography of Burkholderia pseudomallei in the Torres Strait Islands of Northern Australia
Publisher: American Society for Microbiology
Date: 08-2013
DOI: 10.1128/JCM.00418-13
Abstract: It has been hypothesized that biogeographical boundaries are a feature of Burkholderia pseudomallei ecology, and they impact the epidemiology of melioidosis on a global scale. This study examined the relatedness of B. pseudomallei sourced from islands in the Torres Strait of Northern Australia to determine if the geography of isolated island communities is a determinant of the organisms' dispersal. Environmental s ling on Badu Island in the Near Western Island cluster recovered a single clone. An additional 32 clinical isolates from the region were sourced. Isolates were characterized using multilocus sequence typing and a multiplex PCR targeting the flagellum gene cluster. Gene cluster analysis determined that 69% of the isolates from the region encoded the ancestral Burkholderia thailandensis -like flagellum and chemotaxis gene cluster, a proportion significantly lower than that reported from mainland Australia and consistent with observations of isolates from southern Papua New Guinea. A goodness-of-fit test indicated that there was geographic localization of sequence types throughout the archipelago, with the exception of Thursday Island, the economic and cultural hub of the region. Sequence types common to mainland Australia and Papua New Guinea were identified. These findings demonstrate for the first time an environmental reservoir for B. pseudomallei in the Torres Strait, and multilocus sequence typing suggests that the organism is not randomly distributed throughout this region and that seawater may provide a barrier to dispersal of the organism. Moreover, these findings support an anthropogenic dispersal hypothesis for the spread of B. pseudomallei throughout this region.
Identification of Burkholderia pseudomallei by Use of the Vitek Mass Spectrometer
Publisher: American Society for Microbiology
Date: 05-2019
DOI: 10.1128/JCM.00081-19
Abstract: Burkholderia pseudomallei is the causative agent of melioidosis. This condition most often presents as pneumonia and bacteremia, with mortality rates of 9% to 70%.
Neuromelioidosis: Craniospinal MRI Findings in Burkholderia pseudomallei Infection
Publisher: Wiley
Date: 10-08-2015
DOI: 10.1111/JON.12282
Abstract: To investigate magnetic resonance imaging (MRI) findings of central nervous system (CNS) infection with Burkholderia pseudomallei. Retrospective analysis of 10 patients (5 male and 5 female, age range from 13 to 69 years) with CNS melioidosis confirmed on culture of blood, sputum, cerebrospinal fluid, brain biopsy, and postmortem brain tissue. Clinical data were collected and MRI brain and/or spine were independently reviewed. Seven patients with brain parenchymal or intramedullary spinal cord lesions demonstrated rim-enhancing microabscesses with propensity for white matter tracts including the corticospinal tracts, corpus callosum, and cerebellar peduncles. Three of these 7 patients also showed thickening and enhancement of the trigeminal nerves with contiguous spread to brain stem trigeminal nuclei. Three patients had isolated extraaxial disease with findings including meningeal enhancement, extradural abscess, skull osteomyelitis, and scalp abscess. Spread of microabscesses along white matter tracts and frequent trigeminal nerve involvement are unique imaging characteristics of CNS melioidosis. These findings may provide insight into potential mechanisms for B. pseuodomallei entry into the CNS through direct axonal transport in cranial nerves bypassing the blood brain barrier. Prompt recognition of the neuroimaging features of this potentially fatal infection may allow for early microbiological culture and treatment.
Problems with the use of a lateral flow assay in the serodiagnosis of brucellosis
Publisher: Elsevier BV
Date: 12-2011
Reproducibility of the Balance Evaluation Systems Test (BESTest) and the Mini-BESTest in school-aged children
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.GAITPOST.2017.04.010
Abstract: This study evaluated the intra-rater, inter-rater and test-retest reproducibility of the Full-BESTest and Mini-BESTest when assessing postural control in children. Thirty-four children aged 7-17 years participated in intra-rater and inter-rater evaluation, and 22 children repeated assessment six weeks later for evaluation of test-retest reliability. Postural control was assessed using the Full Balance Evaluation Systems Test (Full-BESTest) and the short-form Mini-BESTest. Intra-rater, inter-rater and test-retest reproducibility were examined using video assessment. Test-retest reproducibility was also assessed in real-time. Reproducibility was examined by agreement and reliability statistics. Agreement was calculated using percentage of agreement, Limits of Agreement and Smallest Detectable Change. Reliability was calculated using Intra-class Correlation Coefficients. Results showed that the reliability of Total Scores was excellent for the Full-BESTest for all conditions (all ICCs>0.82), whereas the Mini-BESTest ranged from fair to excellent (ICC=0.56-0.86). Percentage of Domain Scores with good-excellent reliability (ICCs>0.60) was slightly higher for the Full-BESTest (66%) compared to the Mini-BESTest (59%). Smallest Detectable Change scores were good to excellent for the Full-BESTest (2%-6%) and for the Mini-BESTest (5%-10%) relative to total test scores. Both the Full-BESTest and Mini-BESTest can discriminate postural control abilities within and between days in school-aged children. The Full-BESTest has slightly better reproducibility and a broader range of items, which could be the most useful version for treatment planning. We propose minor modifications to improve reproducibility for children, and indicate the modified version by the title Kids-BESTest. Future psychometric research is recommended for specific paediatric clinical populations.
Preliminary report on the northern Australian melioidosis environmental surveillance project
Publisher: Cambridge University Press (CUP)
Date: 10-2004
DOI: 10.1017/S0950268804002663
Abstract: An environmental surveillance programme was developed to determine whether water supplies could be a source of Burkholderia pseudomallei as noted during previous melioidosis outbreak investigations. Water supplies to communities in the three northern Australian jurisdictions (Western Australia, Northern Territory and Queensland) were s led periodically during 2001 and 2002. Water and soil s les were collected from communities known to have had recent culture-positive melioidosis cases and nearby communities where no cases had been diagnosed. Clinical isolates of B. pseudomallei obtained from northern Australian patients during 2001 and 2002 were compared with the environmental B. pseudomallei isolates by ribotyping and pulsed-field gel electrophoresis. B. pseudomallei was isolated from 11 distinct locations, all in the Northern Territory, seven of which were associated with culture-positive melioidosis cases ( case at three locations). Water was implicated as a possible environmental source of melioidosis in six locations. A variety of free-living amoebae including Acanthamoeba and Hartmannella spp. that are potential hosts to B. pseudomallei were recovered from environmental specimens. Culturable B. pseudomallei was not found to be widely dispersed in the environments s led.
Neurologic Melioidosis in a Child
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
Postural Control Performance on the Functional Reach Test: Validity of the Kids-Balance Evaluation Systems Test (Kids-BESTest) Criteria
Publisher: Elsevier BV
Date: 06-2021
In vitro activity of ceftaroline against Burkholderia pseudomallei
Publisher: Oxford University Press (OUP)
Date: 05-02-2014
DOI: 10.1093/JAC/DKU012
Brucellosis in Northern Australia
Publisher: American Society of Tropical Medicine and Hygiene
Date: 05-10-2010
Melioidosis Diagnostic Workshop, 20131
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 02-2015
Paediatric Salmonellosis—Differences between Tropical and Sub-Tropical Regions of Queensland, Australia
Publisher: MDPI AG
Date: 10-04-2019
DOI: 10.3390/TROPICALMED4020061
Abstract: Salmonellosis is an important cause of morbidity in tropical regions.This study aims to describe the epidemiology of non-typhoidal Salmonellae (NTS) in children presenting to public hospitals in Queensland, Australia, over the past 20 years, with a focus on differences between tropical and sub-tropical zones in the region. This is a retrospective and descriptive cohort study of 8162 NTS positive s les collected in 0–17-year-olds from the Queensland public hospital pathology database (Auslab) over a 20-year period from 1997 to 2016. There were 2951 (36.2%) positive NTS s les collected in tropical zones and 5211 (63.8%) in the sub-tropical zones of Queensland, with a total of 8162 over the region. The tropical zone contributed a disproportionately higher number of positive NTS s les by population sub-analysis. Of the specimens collected, 7421 (90.92%) were faecal, 505 (6.2%) blood, 161 (1.97%) urine, 13 (0.16%) cerebrospinal fluid (CSF) and 62 of other origin. Other categories of specimen types isolated include swab, fluid, aspirate, lavage, bone, tissue, isolate and pus, and these were not included in sub-analysis. The most commonly identified serovars were Salmonella Typhimurium, Salmonella Virchow and Salmonella Saintpaul. This is the first and largest study that emphasises the high burden of invasive and non-invasive NTS infections resulting in hospital presentations in the paediatric population of tropical north Queensland, compared to the sub-tropics.
A Prospective Study of Melioidosis After Environmental Exposure of Healthy Participants to Burkholderia pseudomallei During a Muddy Endurance Challenge
Publisher: American Society of Tropical Medicine and Hygiene
Date: 04-2015
Q Fever awareness and risk profiles among agricultural show attendees.
Publisher: Wiley
Date: 11-07-2022
DOI: 10.1111/AJR.12896
Abstract: To assess awareness and risk of Q fever among agricultural show attendees. University of New England's Farm of the Future Pavilion, 2019, Sydney Royal Agricultural Show. Participants were ≥18 years, fluent in English, Australian residents, and gave their informed consent. Participants reported whether they had ever heard of Q fever and then completed the 'Q Tool' (www.qfevertool.com), which was used to assess participants' demographics and risk profiles. Cross-tabulations and logistic regression analyses were used to examine the relationship between these factors. A total of 344 participants were recruited who, in general, lived in major NSW cities and were aged 40-59 years. 62% were aware of Q fever. Living in regional/remote areas and regular contact with livestock, farms, abattoirs and/or feedlots increased the likelihood of Q fever awareness. Direct or indirect contact with feral animals was not associated with Q fever awareness after controlling for the latter risk factors. 40% of participants had a high, 21% a medium, and 30% a low risk of exposure. Slightly less than 10% reported a likely existing immunity or vaccination against Q fever. Among those who were not immune, living in a regional or remote area and Q fever awareness were independently associated with increased likelihood of exposure. Awareness of Q fever was relatively high. Although 61% of participants had a moderate to high risk of exposure to Q fever, they had not been vaccinated. This highlights the need to explore barriers to vaccination including accessibility of providers and associated cost.
Bacteraemias in tropical Australia: changing trends over a 10-year period
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.DIAGMICROBIO.2012.11.017
Abstract: Bacteraemia is an important cause of morbidity and mortality worldwide. This is the largest reported study of bacteraemias in Australia. The presence of organisms endemic to the tropical region and the changing trends described have significant implications for empirical antibiotic therapy. This retrospective study examined 8976 blood cultures from Townsville Hospital, a regional Australian hospital located in the tropics over a 10-year period. The rate of bacteraemic episodes during the study period was 10.12 per 1000 admissions. Intravenous devices (18.7%), immunosuppressive therapy (16.1%), and urinary tract infections (16.1%) were important sources for bacteraemia. The most common organisms were Staphylococcus aureus (20.9%) and Escherichia. coli (15.6%). A significant reduction was observed in S. aureus susceptibility to clindamycin (P < 0.05) and in E. coli susceptibility to gentamicin. Organisms isolated that were of relevance to the tropics of Australia included Burkholderia pseudomallei, Group A streptococcus, and Brucella suis.
Primary amoebic meningoencephalitis in North Queensland: the paediatric experience
Publisher: AMPCo
Date: 10-2016
DOI: 10.5694/MJA15.01223
Abstract: Primary amoebic meningoencephalitis (PAM) is a fulminant, diffuse haemorrhagic meningoencephalitis caused by Naegleria fowleri, with an almost invariably fatal outcome. In Australia and the developed world, PAM remains a rare disease, although it is very likely that large numbers of cases go undetected in developing countries. N. fowleri is a thermophilic, free-living amoeba with a worldwide distribution. It is acquired when contaminated fresh water is flushed into the nose and penetrates the central nervous system via the cribriform plate. Clinical features are similar to those of bacterial meningitis, but it does not respond to standard therapy and rapid progression to death occurs in most cases. Some survivors have been reported these patients received early treatment with hotericin B in combination with a variety of other medications. Our review describes the local and worldwide experience of this disease and its clinical features, and discusses the associated diagnostic challenges. We hope that by detailing the local response to a recent case, and the outcomes of our public health c aign, we can improve the knowledge of this rare disease for doctors working in rural and remote Australia.
Determinants of mortality in non-neutropenic ICU patients with candidaemia
Publisher: Springer Science and Business Media LLC
Date: 2009
DOI: 10.1186/CC7964
Comparative in vitro susceptibility of Burkholderia pseudomallei to cefpirome, ceftazidime and cefepime
Publisher: Elsevier BV
Date: 1997
DOI: 10.1080/00313029700169235
Abstract: We report a new method of esophagogastrostomy after proximal gastrectomy, side overlap with fundoplication by Yamashita (SOFY) in 2017. Recently, even better treatment results can be obtained by modifying the SOFY method. We describe the technical details of the modified SOFY (mSOFY) after laparoscopic proximal gastrectomy. The stomach was dissected in the short axis direction and the esophagus was dissected in the left and right direction. After the proximal gastrectomy, the bilateral diaphragmatic crus were dissected to enhance gastric elevation. After confirming that the esophagus overlapped more than 5 cm at the center of the remnant stomach (we call it SOFY check), the remnant stomach was suture-fixed to the dissected diaphragmatic crus. The right wall of the esophageal stump and the remnant stomach were anastomosed using the full length of a 45 mm-linear stapler. The entry hole was closed in a direction that did not widen the anastomotic hole. Both sides of the esophagus, remnant stomach, and diaphragmatic crus were suture-fixed on the cranial side 1-2 cm away from the anastomosis. Moreover, the left wall and lower end of the esophagus was suture-fixed to the remnant stomach. The preserved dorsal esophageal wall is pressed and flattened by pressure from the pseudofornix, which is the reflux prevention mechanism. The mSOFY method had favorable treatment outcomes. In conclusion, mSOFY can be one of the safe and feasible reconstruction methods after laparoscopic proximal gastrectomy.
Neurologic Melioidosis
Publisher: American Society of Tropical Medicine and Hygiene
Date: 04-09-2013
Adolescent idiopathic scoliosis 3D vertebral morphology, progression and nomenclature: a current concepts review
Publisher: Springer Science and Business Media LLC
Date: 18-04-2021
Comparison of Automated and Nonautomated Systems for Identification of Burkholderia pseudomallei
Publisher: American Society for Microbiology
Date: 12-2002
DOI: 10.1128/JCM.40.12.4625-4627.2002
Abstract: The identification of Burkholderia pseudomallei , the causative agent of melioidosis, is usually not difficult in laboratories in areas where it is endemic. With the increase in international travel and the threat of bioterrorism, it has become more likely that laboratories in areas where it is not endemic could encounter this organism. The increase in the use of and dependence upon automated identification systems makes accurate identification of uncommonly encountered organisms such as B. pseudomallei critically important. This study compares the manual API 20NE and 20E identification systems with the automated Vitek 1 and 2 systems. A total of 103 B. pseudomallei isolates were tested and correctly identified in 98%, 99%, 99%, and 19% of cases, respectively. The failure of the Vitek 2 to correctly identify B. pseudomallei was largely due to differences in the biochemical reactions achieved compared to expected values in the database. It is suggested that this deficiency in the Vitek 2 may be due to the large number of uncertain results reported for these isolates. These results reduce the discriminating ability of the instrument to distinguish between uncommonly encountered isolates such as those of B. pseudomallei .
Utility of the Legionella urinary antigen
Publisher: Wiley
Date: 08-2019
DOI: 10.1111/IMJ.14381
Can we predict the outcome for people with patellofemoral pain? A systematic review on prognostic factors and treatment effect modifiers
Publisher: BMJ
Date: 13-12-2016
DOI: 10.1136/BJSPORTS-2016-096545
Abstract: Patellofemoral pain (PFP) is a multifactorial and often persistent knee condition. One strategy to enhance patient outcomes is using clinically assessable patient characteristics to predict the outcome and match a specific treatment to an in idual. A systematic review was conducted to determine which baseline patient characteristics were (1) associated with patient outcome (prognosis) or (2) modified patient outcome from a specific treatment (treatment effect modifiers). 6 electronic databases were searched (July 2016) for studies evaluating the association between those with PFP, their characteristics and outcome. All studies were appraised using the Epidemiological Appraisal Instrument. Studies that aimed to identify treatment effect modifiers underwent a checklist for methodological quality. The 24 included studies evaluated 180 participant characteristics. 12 studies investigated prognosis, and 12 studies investigated potential treatment effect modifiers. Important methodological limitations were identified. Some prognostic studies used a retrospective design. Studies aiming to identify treatment effect modifiers often analysed too many variables for the limiting s le size and typically failed to use a control or comparator treatment group. 16 factors were reported to be associated with a poor outcome, with longer duration of symptoms the most reported (>4 months). Preliminary evidence suggests increased midfoot mobility may predict those who have a successful outcome to foot orthoses. Current evidence can identify those with increased risk of a poor outcome, but methodological limitations make it difficult to predict the outcome after one specific treatment compared with another. Adequately designed randomised trials are needed to identify treatment effect modifiers.
Triple-dose contrast-enhanced images in neurologically symptomatic HIV-positive patients
Publisher: Springer Science and Business Media LLC
Date: 19-04-2000
Abstract: Our purpose was to determine whether triple-dose delayed contrast-enhanced images would improve lesion detection in patients with symptomatic human immunodeficiency virus (HIV) infection. We reviewed 33 MRI studies on 29 patients. Single-dose immediate T1-weighted spin-echo (1x-T1) images were compared with delayed triple-dose images (D3x-T1). Two neuroradiologists decided which technique showed more lesions, increased lesion conspicuity and/or altered the radiologic diagnosis. The D3x-T1 technique improved lesion detection in 14 of 29 patients (48%). In two patients (7%), the improvement changed the radiologic diagnosis by showing new meningeal lesions.
Epidemiological cut-off value of clinical isolates of Burkholderia pseudomallei from Northern Queensland to meropenem, ceftazidime, trimethoprim/sulfamethoxazole and doxycycline by the microbroth dilu
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.JGAR.2017.04.012
Abstract: Melioidosis is caused by the bacterium Burkholderia pseudomallei. The most common antibiotics used to treat melioidosis in Australia are meropenem, ceftazidime, trimethoprim/sulfamethoxazole (SXT) and doxycycline. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Clinical and Laboratory Standards Institute (CLSI) do not provide standards for assessing the susceptibility of B. pseudomallei for these agents. The International Standards Organisation (ISO) microbroth dilution method is accepted both by the CLSI and EUCAST as the gold standard of antimicrobial susceptibility testing. Many previous studies of the susceptibility of B. pseudomallei used Etest or disk diffusion and presented the results as aggregate data. Etest and disk diffusion methods have not been standardised for B. pseudomallei and aggregate data cannot be used to determine an epidemiological cut-off value (ECOFF). An ECOFF is vital for the setting of clinical breakpoints. In this study, minimum inhibitory concentrations (MICs) of meropenem, ceftazidime, SXT and doxycycline were assessed by microbroth dilution for a library of 234 well characterised clinical isolates of B. pseudomallei from Northern Queensland, Australia. The resultant histograms and aggregate data represent the first MIC profile of a large library of B. pseudomallei that has been successfully produced using microbroth dilution. The MIC profiles can be used to contribute towards a determination of an ECOFF for this species for these agents, which will aid in the setting and refining of clinical breakpoints for the most important antimicrobials used to treat melioidosis.
Comparison of Melioidosis Indirect Hemagglutination Assay between Three Testing Laboratories in Australia
Publisher: American Society for Microbiology
Date: 13-04-2023
DOI: 10.1128/SPECTRUM.04949-22
Abstract: This study found significant discrepant results between three Australian centers offering the melioidosis indirect hemagglutination assay (IHA), despite testing the same s les. We have highlighted that the IHA is a nonstandardized test, which had different source antigens at each of the different laboratories.
Hospital acquired viral respiratory tract infections: An underrecognized nosocomial infection
Publisher: Elsevier BV
Date: 08-2020
MYCOBACTERIAL SOFT TISSUE INFECTIONS IN NORTH QUEENSLAND
Publisher: Wiley
Date: 05-2007
DOI: 10.1111/J.1445-2197.2007.04062.X
Abstract: Mycobacterial soft tissue infections are a heterogeneous group of infections that usually require a variety of therapeutic methods for cure. North Queensland has an environment, which predisposes to several such infections. The aim of this study was to assess the incidence and epidemiology of mycobacterial soft tissue infections in North Queensland and to review surgical and non-surgical interventions in these conditions. This study was a retrospective review of all patients with a proven mycobacterial soft tissue infection, seen between 1997 and 2005 in a tertiary referral centre in North Queensland. In total, 34 patients were identified. The most common causative organisms were Mycobacterium fortuitum (44%), M. ulcerans (17.6%) and M. abscessus (11.8%). The risk factors identified were the male sex, lower-limb involvement and preceding trauma including surgery. Twenty-four (70.6%) patients had surgical excision or debridement with a variety of adjuvant antimicrobial therapies. There were eight (23.5%) local recurrences. The optimal management of soft tissue mycobacterial infections includes early microbiological identification based on tissue biopsy, appropriate combination antimicrobial therapy and early wide surgical excision where appropriate. North Queensland has a unique environment, which may predispose to these infections. An awareness of this is essential to surgical practice in the region.
Use of antigens derived from Burkholderia pseudomallei, B. thailandensis, and B. cepacia in the indirect hemagglutination assay for melioidosis.
Publisher: American Society for Microbiology
Date: 11-2007
DOI: 10.1128/CVI.00197-07
Abstract: The serological diagnosis of melioidosis is carried out using the indirect hemagglutination assay. We looked at the reactivity of sera from culture-proven cases of melioidosis from north Queensland against antigens derived from Burkholderia pseudomallei , B. thailandensis , and B. cepacia . Cross-reactivity between sera from culture-positive cases of melioidosis and B. thailandensis was demonstrated.
Characterisation and molecular typing of Burkholderia pseudomallei: Are disease presentations of melioidosis clonally related?
Publisher: Wiley
Date: 1998
Cost‐effectiveness of respiratory syncytial virus prophylaxis with palivizumab
Publisher: Wiley
Date: 05-2006
DOI: 10.1111/J.1440-1754.2006.00850.X
Abstract: A monoclonal antibody, palivizumab, directed against respiratory syncytial virus (RSV) has been shown to decrease hospitalisation rates. Because of its expense, the cost-effectiveness of this agent should be determined for high-risk groups. To determine characteristics of RSV infection in Townsville and the economic feasibility of palivizumab immunoprophylaxis in high-risk groups. Cases of RSV-positive bronchiolitis were retrospectively identified. Cases were grouped according to recognised risk factors. The hypothetical costs of palivizumab immunoprophylaxis for infants at risk were calculated. The rate of hospitalisation with RSV-positive lower respiratory tract infection was 22 per 1000 live births but increased to 50 per 1000 among Indigenous babies born weighing <2500 g. The cost of preventing an admission in each of the identified high-risk groups, based on drug costs alone, ranged from AD 69,861 to AD 88,547. Palivizumab was not cost-effective in the prophylaxis of RSV in the high-risk group of infants tested here.
GPS-based 6-minute walk test for people with persistent pain: a validation study (Preprint)
Publisher: JMIR Publications Inc.
Date: 27-02-2023
Abstract: he 6-minute walk test (6MWT) is a common method to assess the exercise capacity of people with many health conditions, including persistent pain. However, it is conventionally performed with in-person supervision in a hospital or clinic, therefore requiring staff resources. It may also be difficult when in-person supervision is unavailable, such as during the COVID-19 pandemic or when the person is geographically remote. his study aimed to assess the validity of a GPS-based smartphone app to measure walking distance as an alternative to the conventional 6MWT, in a persistent pain population. eople with persistent pain (n=36) were recruited to complete: 1) a conventional 6MWT and 2) 6MWT measured by a smartphone app using the global positioning system (GPS). Tests were performed in random order, separated by a 15-minute rest. The 95% limits of agreement were calculated using the Bland-Altman method, with a specified maximum allowable difference of 100m. he mean 6MWD measured by the GPS-based smartphone app was 13.2m higher (SD 46, 95%CI [−2.7, 29.1]) than the 6MWD assessed in the conventional manner. The 95% limits of agreement were 103.9m (95%CI [87.4, 134.1]) and −77.6m (95%CI [−107.7, −61.0]), which exceeded the maximum allowable difference. n in iduals with persistent pain, the two methods of assessing 6MWT may not be interchangeable due to limited validity. Future research is needed to improve the accuracy of the GPS-based approach. Despite its limitations, the GPS-based 6MWT may still have value as a tool for remote monitoring that could allow in iduals with persistent pain to self-administer frequent assessments of their functional capacity in their home environment.
Related Organisations
Royal Australian And New Zealand College Of Obstetricians And Gynaecologists
Location: Australia
Royal College Of Physicians
Location: United Kingdom of Great Britain and Northern Ireland
Royal College Of Pathologists Of Australia
Location: No location found
Related Funding Activities
No related grants have been discovered for Robert Norton.