ORCID Profile
0000-0003-0505-6495
Current Organisations
University of Goettingen
,
NSW Health Pathology
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Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/MA15065
Abstract: Syphilis, toxoplasmosis, and cytomegalovirus represent disparate entities. The bacterial spirochaete Treponema pallidum ssp. pallidum causes syphilis, the ‘The Great Imitator' the organism's sole natural host is humans and it remains exquisitely sensitive to penicillin. By contrast, the zoonotic parasite Toxoplasma gondii causes toxoplasmosis. Infection is usually self-limited, although serious disease can occur in the immunocompromised. Meanwhile, the human cytomegalovirus (CMV human herpesvirus 5) is a relatively prevalent enveloped DNA betaherpesvirus with infection specific to humans. Despite nomenclatural, ecological and therapeutic disparities, however, these agents exhibit several concordances, including various, and at times, cryptic syndromes in child and often mother congenital infections with potentially devastating outcomes diagnostic dilemmas. This article primarily discusses the latter of these issues in relationship to congenital syphilis and toxoplasmosis in the Australian context.
Publisher: Springer International Publishing
Date: 2015
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/MA16058
Abstract: The threat of antimicrobial resistance (AMR) in bacteria has been escalated to a rightful seat on the global health agenda. In September 2016, for only the fourth time in United Nations (UN) history, the UN General Assembly in New York will meet to focus on a health threat – antimicrobial resistance. Other diseases afforded this level of consultation at the UN were human immunodeficiency virus (HIV), non-communicable diseases and Ebola virus. There are grim predictions for the future in terms of AMR and health security that span income settings. These predictions challenge the premise that minor bacterial infections of childhood are innocuous, and threaten to halt the medical advancements dependant on antibiotic therapy. Those with compromised immune systems, whether endogenous or induced, will be at highest risk. The development and spread of AMR has been, and will continue to be, fanned by the relentless selection pressure of exposure to antibiotics whether used appropriately, unnecessarily or suboptimally, in human health, animal health and agriculture. The distribution of antibiotic resistant bacteria is facilitated by travel and transport. Antimicrobial resistance will affect those in the community and the hospital.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: American Society for Microbiology
Date: 11-2014
DOI: 10.1128/JCM.01573-14
Abstract: Diagnosis of acute HIV is done by patient history and examination and testing of RNA, proviral DNA, and serology using fourth-generation antigen/antibody detection assays. We describe an HIV-1 primary infection with a second diagnostic window of 18 to 34 days on a fourth-generation immunoassay, which would have been missed using some current algorithms. Caution must be exercised when fourth-generation HIV-1 immunoassays are interpreted in isolation, and additional testing should be considered depending on patient risk assessment.
Publisher: Wiley
Date: 20-04-2012
Publisher: Wiley
Date: 19-11-2020
DOI: 10.1111/CEO.13672
Abstract: Antimicrobial resistance (AMR) patterns in bacterial keratitis may fluctuate in a geographic location over time. To investigate any change in AMR patterns in Sydney, Australia. Retrospective case series. All patients with microbial keratitis who underwent a corneal scrape and culture from 2012 to 2016 at the Sydney Eye Hospital. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry identified organisms. The Calibrated Dichotomous Susceptibility method determined antibiotic susceptibilities. Isolated organisms and antibiotic susceptibilities. There were 1084 corneal scrapes from 957 patients. The mean age was 54 years (range 18-100) and 52% were male. Cultures were positive in 711 of 1084 scrapes (66%), with 884 organisms identified. Of the bacteria isolated, 685 of 884 (78%) were Gram-positive and 199 of 884 (22%) were Gram-negative. Overall, the most common bacteria were coagulase-negative Staphylococci (CoNS) (405/884, 46%). Methicillin-resistance was detected in 7% of Staphylococcus aureus isolates (7/103). Methicillin-resistance in CoNS (ie, also cefalotin resistance) was reported in 19% of isolates and ciprofloxacin 8%. For methicillin-sensitive S aureus (MSSA), 5% of isolates were resistant to ciprofloxacin. For Corynebacterium spp., 34% of isolates were resistant to chlor henicol and 9% to ciprofloxacin. The most common Gram-negative bacteria was Pseudomonas aeruginosa (109/199, 55%). One case was resistant to ciprofloxacin. Coagulase-negative staphylococcal species were the most frequently suspected of causing bacterial keratitis. Increased resistance to cefalotin was identified for CoNS and to ciprofloxacin for Corynebacterium spp., MSSA and P aeruginosa compared to a previous study in Sydney in 2002 to 2003.
Publisher: Elsevier BV
Date: 02-2018
Publisher: Wiley
Date: 27-03-2022
DOI: 10.5694/MJA2.51463
Publisher: Oxford University Press (OUP)
Date: 24-01-2018
DOI: 10.1093/JAC/DKY017
Abstract: To identify the genetic basis of resistance as well as to better understand the epidemiology of a recent surge in azithromycin-resistant Neisseria gonorrhoeae in New South Wales, Australia. Azithromycin-resistant N. gonorrhoeae isolates (n = 118) collected from 107 males, 10 females and 1 transsexual between January and July 2017 were genotyped using a previously described iPLEX method. The results were compared with phenotypic resistance profiles and available patient data. The iPLEX results revealed 10 different N. gonorrhoeae genotypes (designated AZI-G1 to AZI-G10) of which three were responsible for the majority of infections AZI-G10 (74.6%, 88 isolates 87 males and 1 transsexual), AZI-G4 (11.0%, 13 isolates 7 males and 6 females) and AZI-G7 (6.8%, 8 isolates 7 males and 1 female). The observed resistance was attributable to one of two different azithromycin resistance mechanisms the 23S rRNA C2611T mutation was identified in 24% of isolates, whereas the majority of resistance (76%) was associated with a meningococcal-type mtrR variant. Additionally, one isolate was found to harbour both the 23S rRNA C2611T mutation and a type XXXIV mosaic penA sequence associated with cephalosporin resistance. These data indicate outbreaks of azithromycin-resistant gonococci amongst networks of MSM and heterosexuals in New South Wales. The results also provide further evidence that azithromycin may soon be an ineffective treatment option for gonococcal infection and highlight the urgent need to explore alternative therapies.
Publisher: Oxford University Press (OUP)
Date: 08-11-2016
DOI: 10.1093/JAC/DKW422
Abstract: Knowledge of contemporary epidemiology of candidaemia is essential. We aimed to identify changes since 2004 in incidence, species epidemiology and antifungal susceptibilities of Candida spp. causing candidaemia in Australia. These data were collected from nationwide active laboratory-based surveillance for candidaemia over 1 year (within 2014-2015). Isolate identification was by MALDI-TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed using Sensititre YeastOne™. A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/105 population. The median patient age was 63 years (56% of cases occurred in males). Of 498 isolates with confirmed species identity, Candida albicans was the most common (44.4%) followed by Candida glabrata complex (26.7%) and Candida parapsilosis complex (16.5%). Uncommon Candida species comprised 25 (5%) isolates. Overall, C. albicans (>99%) and C. parapsilosis (98.8%) were fluconazole susceptible. However, 16.7% (4 of 24) of Candida tropicalis were fluconazole- and voriconazole-resistant and were non-WT to posaconazole. Of C. glabrata isolates, 6.8% were resistant/non-WT to azoles only one isolate was classed as resistant to caspofungin (MIC of 0.5 mg/L) by CLSI criteria, but was micafungin and anidulafungin susceptible. There was no azole/echinocandin co-resistance. We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging.
Publisher: Springer Science and Business Media LLC
Date: 19-02-2022
Publisher: American Society for Microbiology
Date: 17-08-2023
DOI: 10.1128/SPECTRUM.00220-23
Abstract: The key significance of this article is that it details a straightforward method of performing a disc test that can differentiate Staphylococcus aureus isolates that are likely to be associated with a cefazolin inoculum effect and theoretical risk of cefazolin treatment failure from isolates that are less likely to be associated with a cefazolin inoculum effect.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/MA17062
Abstract: Neisseria gonorrhoeae (NG) is an important human bacterial pathogen responsible for more than 78million infections per annum globally1. In Australia and elsewhere, NG infection rates are increasing and, critically, antimicrobial resistance (AMR) in NG poses a substantial threat to health security2. In response, the Australian Gonococcal Surveillance Programme (AGSP) was established in 1979, and has steadfastly evolved since that time to meet the challenges of continuously emerging AMR (Figure 1).
Publisher: Elsevier BV
Date: 02-2019
Publisher: Elsevier BV
Date: 04-2018
Publisher: Australian Government Department of Health
Date: 15-04-2019
Abstract: The Australian Gonococcal Surveillance Programme (AGSP) has continuously monitored antimicrobial resistance in clinical isolates of Neisseria gonorrhoeae from all states and territories since 1981. In 2017, there were 7,835 clinical isolates of gonococci from public and private sector sources tested for in vitro antimicrobial susceptibility by standardised methods. Current treatment recommendations for gonorrhoea for the majority of Australia, is a dual therapeutic strategy of ceftriaxone and azithromycin. Decreased susceptibility to ceftriaxone (Minimum Inhibitory Concentration or MIC value 0.06-0.125 mg/L) was found nationally in 1.06% of isolates, which is lower than that reported in the AGSP Annual Report 2016 (1.7%). The highest proportions were reported from Victoria and Western Australia (urban and rural) (2.1% and 1.4% respectively). Resistance to azithromycin (MIC value ≥1.0 mg/L) was found nationally in 9.3% of isolates, which is approximately double the proportion reported in 2016 (5.0%) and more than three times the proportion reported in 2015 (2.6%). The highest proportions were reported from Victoria (13.5%), South Australia (12.8%) and New South Wales (9.3%). High level resistance to azithromycin (MIC value ≥256 mg/L) was reported in 4 strains nationally in 2017, 2 from Victoria, one from New South Wales, and one from Queensland. The proportion of strains resistant to penicillin in non-remote Australia ranged from 10.3% in non-remote Northern Territory to 44.1% in Tasmania. In remote Northern Territory, penicillin resistance rates remain low (2.5%). In remote Western Australia, penicillin resistance rates continue to increase (6.7%) compared to the previous years, however, there were relatively low numbers of strains available for isolate based testing (n=12). To address this and to monitor resistance and inform treatment guidelines, widespread molecular testing for penicillin resistance in Western Australia is in place, and these data are included in the AGSP. The proportion of strains resistant to ciprofloxacin in non-remote Australia ranged from 17.2% in non-remote Northern Territory to 61% in Tasmania. Ciprofloxacin resistance rates remain comparatively low in remote Northern Territory (1.3%) and remote Western Australia (5.0%).
Publisher: Public Library of Science (PLoS)
Date: 03-04-2019
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/MA14043
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Charles George.