Bacterial infection tuberculosis

Western Sydney Local Health District

Research Activities

Molecular epidemiology & surveillance of communicable diseases

CIDM-PH is a leader in development and implementation of new microbial strain-typing methods, designed to facilitate inter-laboratory harmonisation, to support multijurisdictional outbreak investigations and global surveillance of drug-resistant pathogens. Our researchers are chief investigators in the NHMRC Centre for Research Excellence (CRE) in Health Informatics and the CRE in Tuberculosis (TB) Control and Prevention. This has particular importance because of rapid emergence of drug resistant Mycobacterium tuberculosis (MTB) in the Asia-Pacific region, which can only be contained by better understanding of factors that facilitate transmission. Rapid, accurate microbiological methods improve understanding of microbial epidemiology, extend the evidence base for disease prevention and management strategies and provide timely information for clinical and public health action. Methods must be cost-effective and easily transferable to ensure widespread laboratory implementation. We apply whole genome sequencing (WGS) of pathogens to supplement and enhance traditional typing methods.

CIDM-PH is a major partner in the NSW Pathogen Genomics Initiative.  We use whole genome sequencing (WGS) and pathogen genomics to radically improve pathogen virulence profiling and to supplement and enhance traditional typing methods.

Bacterial epidemiology & disease surveillance

Our aim is to develop and implement rapid, discriminatory bacterial strain-typing to facilitate detection and monitoring, elucidate inter-strain differences in transmissibility and evolution of successful lineages. We also contribute to NSW and national initiatives in rapid diagnostics and public health surveillance of antibiotic resistance. CIDM-PH has established a program of translational research in novel bacterial genotyping and antibiotic resistance profiling systems for surveillance of invasive pneumococcal, CampylobacterSalmonella, methicillin resistant Staphylococcus aureus (MRSA), VRE and Clostridium difficile infections. Our program of research helps to reduce hospital MRSA transmission byrapid MRSA strain-typing and transmission alerts to trigger timely intervention.

Our readiness was tested recently when we identified the causative agent of three cases of unknown infection in Tasmania as Francisella tularensis (http://wwwnc.cdc.gov/eid/article/18/9/11-1856_article). CIDM-PH is a major participant in the University of Sydney’s Marie Bashir Institute for Infectious Diseases and Biosecurity, which offers new collaborative research and funding opportunities by bringing together researchers in human and veterinary infectious diseases, epidemiology, public health law, ethics and social sciences.

Antibiotic resistance surveillance & rapid diagnostics

Professor Jon Iredell and his team have been examining markers of antibiotic resistance in gram-negative pathogens in order to develop and implement methods of direct detection of these pathogens and to facilitate prospective national surveillance.

Fungal epidemiology & Invasive infections

Invasive and endemic fungal diseases have been recognised as a considerable public health challenge. Our investigators have been examining molecular epidemiology of the fungal pathogens Candida, Cryptococcus, Scedosporium and Trichophyton at global, local and institutional levelsProfessors Tania Sorrell, Wieland Meyer and Sharon Chen have been working ondeveloping ICU candidiasis risk-assessment tools to improve therapeutic decisions and patient outcomes. They pioneered nationally standardized, rapid methods for early detection; genotype databases to identify highly virulent fungal strains and validated novel strain-typing and national database to investigate Pneumocystis pneumonia community and hospital outbreaks

Viral epidemiology & disease surveillance

Our researchers develop, validate and translate into practice advanced methods of testing for emerged and emerging viral pathogens.  Examples, of successful research translation include novel rapid methods for genotyping varicella zoster, encephalotropic enteroviruses and adenoviruses. Our research interests are focused at timely, appropriate interventions to reduce influenza transmission and optimise management by rapid detection of novel subtypes and DR mutations, in humans and birds in our region. Next generation sequencing is being used to investigate the clinical relevance of low frequency drug resistance mutations in hepatitis C virus, and high throughput assays are being developed for clinical resistance testing.

Medical Entomology

CIDM-PH works in partnership with researchers from the Department of Medical Entomology, The University of Sydney (including Marie Bashir Institute for Infectious Diseases and Biosecurity) in order to characterize medically important biological vectors in Australia and support local councils in NSW in mosquito-borne disease risk research and planning strategies to reduce disease risks in coastal communities.

Some of the current projects include an investigation of arbovirus vectors associated with urban mangroves, interactions between mosquitoes, pathogens and urban waterbird populations and a review of risk assessment guidelines for constructed wetlands in Western Sydney. Contributions are also being made to expert panels on management of tick-related health risks and exotic mosquito threats.