PathWest Laboratory Medicine Western Australia

Nedlands, Australia

PathWest Laboratory Medicine Western Australia

Nedlands, Australia
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Johansen C.A.,University of Western Australia | Johansen C.A.,PathWest Laboratory Medicine Western Australia | Williams S.H.,Columbia University | Melville L.F.,The Northern Territory Government | And 11 more authors.
Emerging Infectious Diseases | Year: 2017

In northern Western Australia in 2011 and 2012, surveillance detected a novel arbovirus in mosquitoes. Genetic and phenotypic analyses confirmed that the new flavivirus, named Fitzroy River virus, is related to Sepik virus and Wes-selsbron virus, in the yellow fever virus group. Most (81%) isolates came from Aedes normanensis mosquitoes, providing circumstantial evidence of the probable vector. In cell culture, Fitzroy River virus replicated in mosquito (C6/36), mammalian (Vero, PSEK, and BSR), and avian (DF-1) cells. It also infected intraperitoneally inoculated weanling mice and caused mild clinical disease in 3 intracranially inoculated mice. Specific neutralizing antibodies were detected in sentinel horses (12.6%), cattle (6.6%), and chickens (0.5%) in the Northern Territory of Australia and in a subset of humans (0.8%) from northern Western Australia. © 2017, Centers for Disease Control and Prevention (CDC). All rights reserved.

Grant K.A.,Epidemiology Unit | Fielding J.E.,Epidemiology Unit | Fielding J.E.,Australian National University | Mercer G.N.,Australian National University | And 7 more authors.
Australian and New Zealand Journal of Public Health | Year: 2012

Objective: To describe the epidemiological characteristics of the 2009 H1N1 pandemic virus (pH1N1) over the 2009 and 2010 influenza seasons in Australia and New Zealand (NZ) and compare them with expectations based on previous pandemics. Methods: Laboratory-confirmed influenza and influenza-like illness (ILI) data were collected from established general practitioner sentinel surveillance schemes in NZ, Victoria and Western Australia (WA) throughout the 2009 and 2010 winter influenza seasons. Respiratory swabs from a sample of ILI patients were tested for influenza type and subtype. ILI rates and laboratory-confirmed influenza data were analysed by age group and over time. Morbidity, mortality and reproductive number data were collated from the published literature. Results: Peak ILI rates and the percentage of influenza-positive swabs from ILI patients from all sentinel surveillance schemes were considerably lower in 2010 than 2009. Compared to the population, cases of ILI were over-represented in the young. While the age distributions in NZ and WA remained consistent, ILI cases were significantly younger in Victoria in 2009 compared to 2010. In Victoria, laboratory-confirmed pH1N1 comprised up to 97% of influenza-positive swabs in 2009 but only 56-87% in 2010. Mortality and hospitalisations were lower in 2010. The effective reproduction number (R) for pH1N1 was estimated to be 1.2-1.5 in NZ and WA, similar to estimated R values for seasonal influenza. Data from the surveillance systems indicated differences in the epidemiology of pH1N1 compared to expectations based on previous pandemics. In particular, there was no evidence of a second pandemic wave associated with increased mortality, and complete influenza strain replacement did not occur. Implications: Pandemic planning needs to accommodate the potential for influenza viruses to produce pandemics of various infectiousness and degrees of severity. © 2012 Public Health Association of Australia.

Bright J.-A.,ESR Ltd | Allen C.,Health Services Support Agency | Fountain S.,Australian Federal Police | Gray K.,Forensic Science Service Tasmania | And 5 more authors.
Australian Journal of Forensic Sciences | Year: 2014

This paper describes the analysis of population data typed using the Promega PowerPlex 21 multiplex for the three major sub populations within Australia. Samples from 1427 declared Australian Aboriginal, 546 Pure Aboriginals from the Northern Territory, 990 Asian, and 1707 Caucasian individuals representing were analysed. Departures from Hardy-Weinberg equilibrium (HWE) and linkage equilibrium (LE) were assessed using exact tests. The Aboriginal populations were shown to display significant departures from equilibrium. All four subpopulation databases are of suitable size for the purpose of estimating allele frequencies. © 2014 Australian Academy of Forensic Sciences.

Cabrera-Serrano M.,University of Western Australia | Cabrera-Serrano M.,University of Seville | Junckerstorff R.C.,Royal Perth Hospital | Junckerstorff R.C.,University of Western Australia | And 6 more authors.
Muscle and Nerve | Year: 2015

Introduction: Mutations in the choline kinase beta (CHKB) gene are associated with a congenital muscular dystrophy with giant mitochondria at the periphery of muscle fibers. Methods: We describe a patient of Italian origin in whom whole-exome sequencing revealed a novel homozygous nonsense mutation, c.648C>A, p.(Tyr216*), in exon 5 of CHKB. Results: The patient presented with limb-girdle weakness and hypotonia from birth with mental retardation, and had sudden and transient deteriorations of muscle strength with acute intercurrent illnesses. Previously undescribed sarcolemmal overexpression of utrophin was noted in the muscle biopsy. Conclusions: Pathological features broaden the description of the entity and provide new insight in the pathogenic mechanisms. This case highlights the usefulness of next-generation sequencing in the diagnosis of rare and incompletely understood conditions. © 2014 Wiley Periodicals, Inc.

Bremner A.P.,University of Western Australia | Feddema P.,Diagnostica Stago | Leedman P.J.,University of Western Australia | Leedman P.J.,Royal Perth Hospital | And 12 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Context: In cross-sectional studies, serum TSH concentrations increase with age. This has not been examined longitudinally, and it is uncertain whether the TSH increase reflects healthy aging or occult thyroid failure. Methods: We measured serum TSH, free T4, thyroid peroxidase, and thyroglobulin antibodies in 1100 participants in the 1981 and 1994 Busselton Health Surveys and derived a reference group of 908 individuals without thyroid disease or thyroid antibodies. We examined changes in thyroid function longitudinally and, in 781 participants, explored associations with the CAPZB polymorphism rs10917469. Results: At 13 yr follow-up, mean serum TSH increased from 1.49 to 1.81 mU/liter, a change in mean TSH (ATSH) of 0.32 mU/liter [95% confidence interval (CI) 0.27, 0.38, P < 0.001], whereas mean free T4 concentration was unchanged (16.6 vs. 16.6 pmol/liter, P = 0.7). The TSH increase was most marked in the elderly, such that gender-adjusted ATSH increased by 0.08 mU/liter (95% CI 0.04, 0.11) for each decade of baseline age. People with higher baseline TSH values had proportionally smaller increases in TSH, with each additional 1.0 mU/liter of baseline TSH associated with a 0.13 mU/liter decrease (age and gender adjusted) in ATSH (95% CI 0.09, 0.16). The ATSH did not differ significantly by CAPZB genotype. Conclusions: Aging is associated with increased serum TSH concentrations, with no change in free T4 concentrations. The largest TSH increase is in people with the lowest TSH at baseline. This suggests that the TSH increase arises from age-related alteration in the TSH set point or reduced TSH bioactivity rather than occult thyroid disease. Copyright © 2012 by The Endocrine Society.

Patole S.K.,King Edward Memorial Hospital for Women | Patole S.K.,University of Western Australia | Rao S.C.,Princess Margaret Hospital for Children | Rao S.C.,University of Western Australia | And 7 more authors.
PLoS ONE | Year: 2016

Background Systematic reviews of randomised controlled trials report that probiotics reduce the risk of necrotising enterocolitis (NEC) in preterm neonates. Aim To determine whether routine probiotic supplementation (RPS) to preterm neonates would reduce the incidence of NEC. Methods The incidence of NEC ≥ Stage II and all-cause mortality was compared for an equal period of 24 months 'before' (Epoch 1) and 'after' (Epoch 2) RPS with Bifidobacterium breve M-16V in neonates <34 weeks. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. Results A total of 1755 neonates (Epoch I vs. II: 835 vs. 920) with comparable gestation and birth weights were admitted. There was a significant reduction in NEC ≥ Stage II: 3% vs. 1%, adjusted odds ratio (aOR) = 0.43 (95%CI: 0.21-0.87); 'NEC ≥ Stage II or all-cause mortality': 9% vs. 5%, aOR = 0.53 (95%CI: 0.32-0.88); but not all-cause mortality alone: 7% vs. 4%, aOR = 0.58 (95% CI: 0.31-1.06) in Epoch II. The benefits in neonates <28 weeks did not reach statistical significance: NEC ≥ Stage II: 6% vs. 3%, aOR 0.51 (95%CI: 0.20-1.27), 'NEC ≥ Stage II or all-cause mortality', 21% vs. 14%, aOR = 0.59 (95%CI: 0.29-1.18); all-cause mortality: 17% vs. 11%, aOR = 0.63 (95%CI: 0.28-1.41). There was no probiotic sepsis. Conclusion RPS with Bifidobacterium breve M-16V was associated with decreased NEC ≥Stage II and 'NEC ≥Stage II or all-cause mortality' in neonates <34 weeks. Large sample size is required to assess the potential benefits of RPS in neonates <28 weeks. © 2016 Patole et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Patole S.K.,King Edward Memorial Hospital for Women | Patole S.K.,University of Western Australia | Keil A.D.,PathWest Laboratory Medicine Western Australia | Nathan E.,King Edward Memorial Hospital for Women | And 7 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Background: Gut development, function and colonisation are impaired in animal models of prematurity with intrauterine growth restriction (IUGR). The effect of Bifidobacterium breve (B. breve) supplementation on faecal bifidobacteria in small for gestational age (SGA: birth weight <10th centile due to IUGR) preterm infants is not known. Objective: We compared B. breve M-16V supplementation effect on faecal bifidobacteria in preterm (<33 weeks) SGA versus non-SGA infants in the two arms of our randomised controlled trial. Results: There were no baseline differences in the proportion of detectable B. breve counts between SGA versus non-SGA infants [probiotic: 7 (33%) versus 22 (42%), p = 0.603; placebo: 1 (6%) versus 1 (2%), p = 0.429]. B. breve counts did not differ between SGA and non-SGA infants in response to treatment (p = 0.589), after adjusting for baseline count (p < 0.001) and treatment allocation (p < 0.001). An interaction term between growth status and treatment showed negligible change (p = 0.938). Probiotic treated SGA infants reached full feeds earlier than SGA controls (HR 2.00, 95% CI 1.05–3.82, p = 0.035): Median (IQR): 16 (12–26) versus 19 (11–25) days, after adjustment for age at starting feeds and gestation <28 weeks. Conclusion: Response to B. breve M-16V supplementation was not significantly different in preterm (<33 weeks) SGA versus non-SGA infants. © 2016 Taylor & Francis.

PubMed | University of Western Australia, Telethon Kids Institute, Copenhagen University and PathWest Laboratory Medicine Western Australia
Type: Journal Article | Journal: Respirology (Carlton, Vic.) | Year: 2016

Airway eosinophilia is associated with an increased risk of asthma exacerbations; however, the impact on the severity of exacerbations is largely unknown. We describe the sputum inflammatory phenotype during asthma exacerbation and correlate it with severity and treatment response.Patients presenting to hospital with an asthma exacerbation were recruited during a 12-month period and followed up after 4 weeks. Induced sputum was collected at both visits. Patients underwent spirometry, arterial blood gas analysis, fractional exhaled nitric oxide analysis, white blood cell counts and a screening for common respiratory viruses and bacteria. An eosinophilic exacerbation (EE) was defined as having sputum eosinophils 3% and a non-eosinophilic exacerbation as < 3% (NEE).A total of 47 patients were enrolled; 37 (79%) had successful sputum induction at baseline, of whom 43% had sputum eosinophils 3% (EE). Patients with EE had a significantly lower forced expiratory volume in 1 s (FEVOur findings suggest that eosinophilic asthma exacerbations may be clinically more severe than NEEs, supporting the identification of these higher risk patients for specific interventions.

Mulrennan S.,Sir Charles Gairdner Hospital | Tempone S.S.,PathWest Laboratory Medicine Western Australia | Ling I.T.W.,Sir Charles Gairdner Hospital | Williams S.H.,PathWest Laboratory Medicine Western Australia | And 6 more authors.
PLoS ONE | Year: 2010

Background: From the first case reports of pandemic influenza (H1N1) 2009 it was clear that a significant proportion of infected individuals suffered a primary viral pneumonia. The objective of this study was twofold; to assess the utility of the CURB-65 community acquired pneumonia (CAP) severity index in predicting pneumonia severity and ICU admission, and to assess the relative sensitivity of nasopharyngeal versus lower respiratory tract sampling for the detection of pandemic influenza (H1N1) CAP. Methods: A retrospective cohort study of 70 patients hospitalised for pandemic influenza (H1N1) 2009 in an adult tertiary referral hospital. Characteristics evaluated included age, pregnancy status, sex, respiratory signs and symptoms, smoking and alcohol history, CURB-65 score, co-morbidities, disabling sequelae, length of stay and in-hospital mortality outcomes. Laboratory features evaluated included lymphocyte count, C-reactive protein (CRP), nasopharyngeal and lower respiratory tract pandemic influenza (H1N1) 2009 PCR results. Results: Patients with pandemic (H1N1) 2009 influenza CAP differed significantly from those without pneumonia regarding length of stay, need for ICU admission, CRP and the likelihood of disabling sequelae. The CURB-65 score did not predict CAP severity or the need for ICU admission (only 2/11 patients admitted to ICU had CURB-65 scores of 2 or 3). Nasopharyngeal specimens for PCR were only 62.9% sensitive in CAP patients compared to 97.8% sensitivity for lower respiratory tract specimens. Conclusions: The CURB-65 score does not predict severe pandemic influenza (H1N1) 2009 CAP or need for ICU admission. Lower respiratory tract specimens should be collected when pandemic (H1N1) 2009 influenza CAP is suspected. © 2010 Mulrennan et al.

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