PathWest Laboratory Medicine WA

Nedlands, Australia

PathWest Laboratory Medicine WA

Nedlands, Australia
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Smith D.W.,PathWest Laboratory Medicine WA
Eurosurveillance | Year: 2011

Understanding household transmission of the pandemic influenza A(H1N1)2009 virus, including risk factors for transmission, is important for refining public health strategies to reduce the burden of the disease. During the influenza season of 2009 we investigated transmission of the emerging virus in 595 households in which the index case was the first symptomatic case of influenza A(H1N1)2009. Secondary cases were defined as household contacts with influenzalike illness (ILI) or laboratory-confirmed influenza A(H1N1)2009, occurring at least one day after but within seven days following symptom onset in the index case. ILI developed in 231 of the 1,589 household contacts, a secondary attack rate of 14.5% (95% confidence interval (CI): 12.9-16.4). At least one secondary case occurred in 166 of the 595 households (a household transmission rate of 27.9%; 95% CI: 24.5-31.6). Of these, 127 (76.5%) households reported one secondary case and 39 (23.5%) households reported two or more secondary cases. Secondary attack rates were highest in children younger than five years (p=0.001), and young children were also more efficient transmitters (p=0.01). Individual risk was not associated with household size. Prophylactic antiviral therapy was associated with reduced transmission (p=0.03). The secondary attack rate of ILI in households with a confirmed pandemic influenza A(H1N1)2009 index case was comparable to that described previously for seasonal influenza.

Kazakov D.V.,Charles University | Spagnolo D.V.,PathWest Laboratory Medicine WA | Kacerovska D.,Charles University | Michal M.,Charles University | Michal M.,Bioptical Laboratory
Advances in Anatomic Pathology | Year: 2011

Long considered to be ectopic breast tissue representing the caudal remnants of the milk ridges, anogenital mammary-like glands are nowadays thought to represent a normal constituent of the anogenital area. Lesions involving these glands, benign or malignant, epithelial or stromal manifest a striking similarity to their mammary counterparts. This review addresses the recent literature on lesions of anogenital mammary-like glands and our personal experience with various lesions related to these structures. Discussed are the normal anatomy and histology of these glands as well as the clinical presentation, histopathological and immunohistochemical features, molecular biological aspects, and differential diagnosis of various lesions involving anogenital mammary-like glands, including lactating adenoma, hidradenoma papilliferum, hidradenocarcinoma papilliferum, fibroadenomas, phyllodes tumor, pseudoangiomatous stromal hyperplasia, extramammary Paget disease, and other carcinomas. In addition, "nonspecific" epithelial or stromal changes some of which can be likened to similar changes occurring in a range of benign breast disease, including sclerosing adenosis, columnar cell lesions, ductal lesions and various metaplastic changes affecting epithelium and myoepithelium are discussed. Although lesions of anogenital mammary-like glands are often discussed in many dermatopathology textbooks in the context of cutaneous adnexal neoplasms we advocate that the best approach to the diagnosis of these lesions is to relate them to analogous well recognized lesions occurring in the breast, that is, through the eyes of a breast pathologist. This will enable their recognition, precise classification and should introduce greater uniformity in how they are reported in the literature so that more meaningful clinicopathological comparisons and correlations may be made. Copyright © 2010 by Lippincott Williams & Wilkins.

Collins D.A.,University of Western Australia | Hawkey P.M.,Public Health England | Hawkey P.M.,University of Birmingham | Riley T.V.,University of Western Australia | Riley T.V.,PathWest Laboratory Medicine WA
Antimicrobial Resistance and Infection Control | Year: 2013

While Clostridium difficile infection (CDI) has come to prominence as major epidemics have occurred in North America and Europe over the recent decade, awareness and surveillance of CDI in Asia have remained poor. Limited studies performed throughout Asia indicate that CDI is also a significant nosocomial pathogen in this region, but the true prevalence of CDI remains unknown. A lack of regulated antibiotic use in many Asian countries suggests that the prevalence of CDI may be comparatively high. Molecular studies indicate that ribotypes 027 and 078, which have caused significant outbreaks in other regions of the world, are rare in Asia. However, variant toxin A-negative/toxin B-positive strains of ribotype 017 have caused epidemics across several Asian countries. Ribotype smz/018 has caused widespread disease across Japan over the last decade and more recently emerged in Korea. This review summarises current knowledge on CDI in Asian countries. © 2013 Collins et al.; licensee BioMed Central Ltd.

Klingsberg R.C.,Tulane University | Mutsaers S.E.,PathWest Laboratory Medicine WA | Mutsaers S.E.,Lung Institute of Western Australia | Mutsaers S.E.,University of Western Australia | Lasky J.A.,Tulane University
Respirology | Year: 2010

Most pulmonary consultants are called upon to discuss IPF management with their patients. The gravity of IPF treatment discussion is immense in view of the data that 3- and 5-year mortality rates are approximately 50% and 80%, respectively. Although IPF occurs in older patients with comorbid diseases, most patients with IPF die as a direct consequence of their lung fibrosis. Here, the results of recently completed IPF trials and the rationale for ongoing studies are succinctly reviewed. There are a number of novel agents in clinical trials that are in the earlier stages of development, and there is new evidence supporting palliative therapies, which may help in managing symptoms of IPF, such as cough, without necessarily altering the course of the disease. The information provided herein should facilitate informed physician-patient dialogue. © 2010 Asian Pacific Society of Respirology.

Thomsen N.A.,PathWest Laboratory Medicine WA | Hammer K.A.,University of Western Australia | Riley T.V.,PathWest Laboratory Medicine WA | Riley T.V.,University of Western Australia | And 3 more authors.
International Journal of Antimicrobial Agents | Year: 2013

The aim of this study was to seek additional data on the antimicrobial susceptibility of Staphylococcus spp. after habituation to low levels of the topical antimicrobial agent tea tree (Melaleuca alternifolia) oil. Meticillin-susceptible Staphylococcus aureus (MSSA), meticillin-resistant S. aureus (MRSA) and coagulase-negative staphylococci (CoNS) were habituated to 0.075% tea tree oil for 3 days. Subsequently, the susceptibility of five isolates each of MSSA, MRSA and CoNS to fusidic acid, mupirocin, chloramphenicol, linezolid and vancomycin was determined by Etest, and susceptibility to tea tree oil, terpinen-4-ol, carvacrol and triclosan was determined by agar dilution. Following habituation to 0.075% tea tree oil, antimicrobial MICs differed between control and habituated isolates on 33 occasions (out of a possible 150), with MICs being higher in habituated isolates on 22 occasions. Using clinical breakpoint criteria, one MSSA isolate changed susceptibility category from vancomycin-susceptible (MIC = 2 μg/mL) to intermediate susceptibility (MIC = 3 μg/mL) after habituation in one of two replicates. For the non-antibiotic antimicrobial agents, MICs of habituated and control isolates differed on 12 occasions (out of a possible 120); 10 occasions in MRSA and 2 occasions in MSSA. MICs were higher for habituated isolates on five occasions. However, all the differences were one serial dilution only and were not regarded as significant. Habituation to sublethal concentrations of tea tree oil led to minor changes in MICs of antimicrobial agents, only one of which may have been clinically relevant. There is no evidence to suggest that tea tree oil induces resistance to antimicrobial agents. © 2013 Elsevier B.V. and the International Society of Chemotherapy.

Ng-Hublin J.S.Y.,Murdoch University | Combs B.,OzFoodNet Communicable Disease Control Directorate | MacKenzie B.,PathWest Laboratory Medicine WA | Ryan U.,Murdoch University
Journal of Clinical Microbiology | Year: 2013

This report describes a case of cryptosporidiosis from an immunocompetent patient from Perth, Western Australia, suffering from diarrhea and a spectrum of other symptoms. Molecular identification revealed that this patient was infected with three Cryptosporidium species-Cryptosporidium meleagridis, the Cryptosporidium mink genotype, and an unknown Cryptosporidium species. © 2013, American Society for Microbiology.

Aravena-Roman M.,University of Western Australia | Aravena-Roman M.,PathWest Laboratory Medicine WA | Inglis T.J.J.,University of Western Australia | Inglis T.J.J.,PathWest Laboratory Medicine WA | And 4 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2012

We determined the susceptibilities of 144 clinical and 49 environmental Aeromonas strains representing 10 different species to 26 antimicrobial agents by the agar dilution method. No single species had a predominantly nonsusceptible phenotype. A multidrug nonsusceptible pattern was observed in three (2.1%) clinical strains and two (4.0%) strains recovered from diseased fish. Common clinical strains were more resistant than the corresponding environmental isolates, suggesting that resistance mechanisms may be acquired by environmental strains from clinical strains. Copyright © 2012, American Society for Microbiology. All Rights Reserved.

Slimings C.,University of Western Australia | Riley T.V.,University of Western Australia | Riley T.V.,PathWest Laboratory Medicine WA
Journal of Antimicrobial Chemotherapy | Year: 2014

Objectives: To update the evidence for associations between antibiotic classes and hospital-acquired Clostridium difficile infection (HA-CDI). Methods: Electronic databases of journal articles, scholarly theses and conference proceedings using subject headings and keywords related to CDI and antibiotic exposure were searched. Observational epidemiological studies measuring associations between antibiotic classes and HA-CDI were eligible for inclusion. Pooled ORs and 95% CIs were calculated using a random effects model. Study factors identified a priori were examined as sources of heterogeneity. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Results: Of 569 citations identified, 13 case-control and 1 cohort study (15 938 patients) were included. The strongest associations were found for third-generation cephalosporins (OR = 3.20, 95% CI = 1.80-5.71; n = 6 studies; I2 = 79.2%), clindamycin (2.86, 2.04-4.02; n = 6; I2 = 28.5%), second-generation cephalosporins (2.23, 1.47-3.37; n = 6; I2 = 48.4%), fourth-generation cephalosporins (2.14, 1.30-3.52; n = 2; I2 = 0.0%), carbapenems (1.84, 1.26-2.68; n = 6; I2 = 0.0%), trimethoprim/sulphonamides (1.78, 1.04-3.05; n = 5; I2 = 70%), fluoroquinolones (1.66, 1.17-2.35; n = 10; I2 = 64%) and penicillin combinations (1.45, 1.05-2.02; n = 6; I2 = 54%). The study population and the timing of measurement of antibiotic exposure were the most common sources of heterogeneity. Study quality scored high for seven studies, moderate for six studies and low for one study. Conclusions: The risk of HA-CDI remains greatest for cephalosporins and clindamycin, and their importance as inciting agents should not be minimized. The importance of fluoroquinolones should not be overemphasized, particularly if fluoroquinolone-resistant epidemic strains of C. difficile are absent. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Aravena-Roman M.,University of Western Australia | Aravena-Roman M.,PathWest Laboratory Medicine WA | Harnett G.B.,PathWest Laboratory Medicine WA | Riley T.V.,University of Western Australia | And 4 more authors.
Journal of Clinical Microbiology | Year: 2011

Genotypic characterization of 215 Aeromonas strains (143 clinical, 52 environmental, and 20 reference strains) showed that Aeromonas aquariorum (60 strains, 30.4%) was the most frequently isolated species in clinical and water samples and could be misidentified as Aeromonas hydrophila by phenotypic methods. Copyright © 2011, American Society for Microbiology. All Rights Reserved.

O'Reilly L.C.,PathWest Laboratory Medicine WA
Journal of Microbiological Methods | Year: 2011

The DNA of some bacteria is broken up by Tris-dependent endonuclease activity during the process of sample preparation for pulsed field gel electrophoresis (PFGE). Adding thiourea to the electophoresis buffer for isolates that exhibit DNA degradation has been the method used for many bacterial genera. For a particular group of isolates of Serratia marcescens this method was unsuccessful. A combination of techniques was used to overcome the problem. © 2011 Elsevier B.V.

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