ORCID Profile
0000-0001-7733-7072
Current Organisations
Fiona Stanley Hospital
,
Pathwest Laboratory Medicine
,
Royal Perth Hospital
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Publisher: Wiley
Date: 13-09-2023
DOI: 10.1111/IMJ.16226
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/IMJ.15511
Abstract: Subcutaneous (SC) administration of ertapenem in outpatient parenteral antimicrobial therapy (OPAT) services may be a practical alternative to intravenous delivery for complicated infections. The clinical features and outcomes according to route of administration were compared from a large Australian OPAT service. Chronic renal impairment was more common in the SC group, reflecting an opportunity for route of administration as a vein preservation strategy. Adverse events were uncommon and successful outcomes were not different between the groups.
Publisher: Wiley
Date: 25-03-2023
DOI: 10.1111/IMJ.16071
Abstract: Antimicrobial resistance and therapy‐related adverse effects make Mycobacterium abscessus treatment challenging. Omadacycline is a novel, bioavailable aminomethylcycline with favourable in vitro activity against M. abscessus . To describe a case report and review the published literature describing outcomes for M. abscessus infections treated with omadacycline. Systematic literature review. We identified three articles that, in addition to our case report, describe 18 patients. Pulmonary infections were most frequent. Minimum inhibitory concentrations were reported for two isolates (0.25 and 0.5 mg/L). Despite half the patients starting omadacycline because of failure of prior therapy, 15 (83%) had a favourable outcome, defined as ‘cure’, ‘improvement’ or ‘clinical success’ as determined by the primary study authors. One patient (6%) discontinued omadacycline because of gastrointestinal intolerance. Although the limited observational data and in vitro susceptibility results are encouraging, randomised control trials are required to determine the role of omadacycline as part of combination therapy for this most difficult‐to‐treat pathogen.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2014
DOI: 10.1007/S10900-013-9745-2
Abstract: Vietnamese immigrants in Australia represent the second largest Vietnamese community in developed countries, following the United States. However, limited information is available about prevalence of type 2 diabetes (T2D) and the relative roles of socio-demographic characteristics, lifestyle factors, and Vietnamese ethnicity per se in this population. This study investigated the prevalence of T2D and its risk factors in older Vietnam-born Australians, in comparison to native-born Australians. The study used baseline questionnaire data from 787 Vietnam- and 196,866 Australia-born in iduals (≥45 years), who participated in the 45 and Up Study, which is Australia's largest population-based cohort study. Country of birth specific prevalence of T2D and its risk factors were age-standardised to the 2006 Australian population (≥45 years). Multivariable logistic regression models were built for each group to assess the relationship between T2D and socio-demographic characteristics, family history of diabetes, lifestyle factors and health status. Compared to Australia-born counterparts, Vietnam-born in iduals had significantly (p < 0.001) higher age-standardised prevalence of T2D (14.7 vs 7.4 %) and significantly (p < 0.001) lower levels of vegetable consumption (≥5 serves/day, 19.4 vs 33.5 %), physical activity (≥5 sessions/week, 68.7 vs 78.5 %) and overweight and obesity (body mass index ≥25 kg/m(2), 21.5 vs 62.7 %). The increased risk of T2D associated with a family history of diabetes for Vietnam-born people [adjusted odds ratio (OR) 7.14, 95 % CI 4.15-12.28] was almost double that for Australia-born people (OR 3.77, 95 % CI 3.63-3.90). The patterns of association between T2D and other factors were similar between the two groups. The findings suggest a genetic predisposition to T2D in people of Vietnamese ethnicity. Reducing lifestyle risk factors for diabetes and better management of diabetes are priorities for Vietnam-born populations.
Publisher: Wiley
Date: 20-10-2022
DOI: 10.1111/IMJ.15906
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/IMJ.14251
Abstract: Among 125 inpatients with diabetic foot infections managed by a multidisciplinary foot ulcer unit, knowledge of methicillin-resistant Staphylococcus aureus colonisation status assisted decision-making to prescribe appropriately or with-hold empiric anti-methicillin-resistant Staphylococcus aureus therapy. Despite adherence to national guidelines, apparent overuse of anti-pseudomonal therapy was frequent, providing potential antimicrobial stewardship opportunities.
Publisher: SAGE Publications
Date: 12-04-2022
DOI: 10.1177/11297298211009361
Abstract: Outpatient parenteral antimicrobial therapy (OPAT) delivery using peripherally inserted central catheters is associated with a risk of catheter related thrombosis (CRT). In idualised preventative interventions may reduce this occurrence, however patient selection is h ered by a lack of understanding of risk factors. We aimed to identify patient, infection or treatment related risk factors for CRT in the OPAT setting. Retrospective case control study (1:3 matching) within OPAT services at two tertiary hospitals within Australia. Over a 2 year period, encompassing OPAT delivery to 1803 patients, there were 19 cases of CRT, giving a prevalence of 1.1% and incidence of 0.58/1000 catheter days. Amongst the cases of CRT, there were nine (47%) unplanned readmissions and two (11%) pulmonary emboli. Compared to controls, cases had a higher frequency of malposition of the catheter tip (4/19 (21%) vs 0/57 (0%), Although CRTs during OPAT are infrequent, they often have clinically significant sequelae. Identification of modifiable vascular access related predictors of CRT should assist with patient risk stratification and guide risk reduction strategies.
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.DIABRES.2014.01.013
Abstract: In comparison to Australia-born patients with type 2 diabetes (n=14,197), Vietnam-born patients (n=152) had significantly higher risks of mortality (any-cause and diabetes-specific) while experiencing similar rates of readmission for diabetes and co-morbidities. The findings may reflect delays in seeking care and suboptimal diabetes care in Vietnamese immigrants. Further investigation into quality of diabetes care in Vietnamese immigrant populations is needed.
Publisher: Springer Science and Business Media LLC
Date: 22-09-2021
Publisher: Korean Society of Infectious Diseases and Korean Society for Chemotherapy
Date: 2021
DOI: 10.3947/IC.2021.0023
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/IMJ.15003
Abstract: Although common, antimicrobial allergy labels (AAL) rarely reflect immunologically‐mediated hypersensitivity and can lead to poorer outcomes from alternative antimicrobial agents. Antimicrobial stewardship programs are ideally placed to assess AAL early as a means of improving antimicrobial use. To quantify the prevalence of AAL in patients referred for antimicrobial stewardship review and assess their impact on antibiotic prescribing, patient mortality, hospital length of stay, readmission and rates of multidrug‐resistant infections. We conducted a retrospective analysis of adult patients referred for inpatient antimicrobial prospective audit and feedback rounds (PAFR) through an electronic referral system ( eReferrals ) over a 12‐month period in 2015. Outcome data were collected for a period of 36 months following the initial review. Of the 639 patient records reviewed, 630 met inclusion criteria 103 (16%) had an AAL, of which 82 (13%) had reported allergies to β‐lactam antibiotics. Those with AAL were significantly less likely to be receiving guideline‐recommended antimicrobial therapy (50% vs 64%, P = 0.0311) however, there were no significant difference in mortality, hospital length of stay, readmission or increased incidence of multidrug‐resistant infections. Our cohort demonstrated that AAL was associated with reduced adherence to antibiotic guidelines. The lack of association with adverse outcomes may reflect limitations within the study including retrospective cohort study numbers and observational nature, further skewed by high rates of poor documentation. A clear opportunity exists for antimicrobial stewardship programs to incorporate allergy assessment, de‐labelling, challenge and referral into these rounds.
Publisher: MDPI AG
Date: 13-02-2014
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Paul Ingram.