We aim to improve healthcare systems, patient safety and management of critical infections. We integrate innovative clinical, scientific and biotechnological solutions for diagnosis, surveillance and management.
The critically ill are the most vulnerable people in our health system and their care is highly resource intensive. Most admissions to intensive care units are precipitated or complicated by infection, which is the most common cause of preventable mortality and adds billions of dollars to the annual cost of health care.
We work on severe infections in the critically ill, and the ecology and genetics of antibiotic resistance. We're developing tools for real-time diagnosis, tracking of specific pathogens, and developing next-generation informatics to tailor prescribing for individuals, improve hospital infection control and track outbreaks of highly transmissible or antibiotic-resistant pathogens.
We are finding new ways to manage major infection risk by selective modification of human bacterial ecosystems. We're also committed to translating our research into effective practice and policy.
We're based at the Westmead Millenium Institute for Medical Research.
Infectious diseases are a leading cause of death worldwide with new infectious agents emerging each year. Our researchers seek to understand the body’s immune responses to infectious agents such as bacteria, viruses, parasites and fungi. The study of infectious diseases and immunology at the Sydney Medical School covers laboratory, clinic and population studies, and involves all organ systems and crosses all medical specialties.
Two bacterial species E. coli and K. pneumoniae are most responsible for septic shock, acquire antimicrobial resistance (AMR) via a mobile gene pool. The most important vectors of this AMR are self-transmissible (conjugative) plasmids. Specific genetic modules (addiction systems, replicons, entry exclusion systems etc.) on plasmids seem to be primary determinants of plasmid-plasmid/plasmid-host relationships and in AMR epidemiology. We have shown for the first time that a bacterial population can be restored to an antibiotic susceptible state in vivo by manipulating addiction and replication modules of specific AMR plasmids (PLoS One 2017 12:e0172913). Here we examine the impact of these modules on AMR plasmid epidemiology and their capacity for manipulation to protect the microbiome from invasive plasmids.
Nature offers remedies to the spread of dangerous antibiotic resistant bacteria in the form of predatory viruses (bacteriophages). In this project, we will define optimal mixtures of these for killing problem bacterial types, the mechanisms by which bacterial resistance develops, the best approach to identifying susceptible bacteria and to using these viruses to eradicate them, and we will test a carefully optimised bacteriophage therapy in humans colonised by the dangerous E. coli ST131 strain.
This is an investigator-led research project sanctioned by FDA, TGA and Western Sydney Local Health District (WSLHD) HREC to investigate phage and bacterial kinetics as well as the possibility of beneficial clinical outcomes of phage therapy. This is a collaborative project between WSLHD, Westmead Institute for Medical Research and AmpliPhi BioSciences led by Prof Jon Iredell and managed by A/P Ruby Lin. The treatment plan is in conjunction with the prescribed antibiotics treatment regime, involving intravenous bacteriophage (AB-SA01) administration for 14 days, with 90 days follow-up for patients with severe S. aureus infections. Data (such as markers of inflammation) are prospectively collected starting with patient’s admission and consent. Patients are offered therapy before in vitro susceptibility data is known if the treating physicians believe the delay is not in the patient’s interests. The aim is to test whether AB-SA01 is safe and well tolerated when administered via intravenous infection in critically ill patients with staphylococcal infection. We also aim to address whether staphylococcal bacteraemic burden declines after bacteriophage administration.
Research team:
We will study patients within a large trial of gut decontamination, in which antibiotics are given in advance to reduce the risk of infection. Specifically, we will determine whether there is any increased antibiotic resistance and even biodiversity loss, as some fear. This is a one-off chance to provide essential data that can help us design better national policies for antibiotic resistance control and a true personalised medicine approach to resistance and infection in ICU.
Email
critical.infection@sydney.edu.au
Phone
+61 2 8627 3411
Mailing address
Level 4, Westmead Millennium Institute,
176 Hawkesbury Road, Westmead NSW 2145
