Western Sydney LHD Centre for Infectious Diseases and Microbiology Public Health

Our Scientific Advisory Committee (SAC) includes experts in infectious diseases and public health and nominated representatives from Western Sydney LHD and NSW Health Pathology. It provides advice to the director and management committee on research direction and strategies. The committee meets each year at the CIDM-PH Colloquium, where researchers present their results and future plans.

Chair
Professor David Smith, Director, Infectious Diseases and Microbiology, PathWest WA.

Members
University of Western Australia

• Dr Jeremy McAnulty (Director, Health Protection NSW); member since 2004.
• Professor Peter Collignon (Infectious Diseases and Microbiology, The Canberra Hospital, ACT); member since 2007.
• Professor Tania Sorrell (University of Sydney); member since 2004.
• Dr Cliff Meldrum (Director of Genomics, NSW Health Pathology); member since 2017.
• Professor Lyn Gilbert (Sydney Institute for Infectious Diseases and Sydney Health Ethics); newly appointed SAC member, Director of CIDM-PH from 2004 to 2013, Senior Investigator from 2014 to 2021.
• Kathy Dempsey, NSW Chief ICP and HAI Advisor, NSW CEC, newly appointed member.

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.
 

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, Campylobacter, Salmonella, 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 3 cases of unknown infection in Tasmania as Francisella tularensis. 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.

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

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 levels. 

Professors Tania Sorrell, Wieland Meyer and Sharon Chen have been working on developing ICU candidiasis risk-assessment tools to improve therapeutic decisions and patient outcomes. 

They pioneered nationally standardised, 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

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.

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) 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.

Diagnostic services

Our diagnostic services include:

• microscopy and culture of specimens
• identification of yeasts and moulds
• antifungal drug susceptibility testing of yeasts and moulds including periodic surveillance of resistance patterns:
  • anidulafungin
  • amphotericin B
  • caspofungin
  • fluconazole
  • flucytosine
  • itraconazole
  • micafungin
  • posaconazole
  • voriconazole
• serological tests:
  • aspergillus (galactomannan) antigen testing
  • cryptococcal antigen testing
  • immunodiffusion to detect antibodies to Histoplasma
  • immunodiffusion to detect antibodies to Coccidioides
• nucleic acid-based detection tests from clinical specimens
  • aspergillus PCR
  • panfungal PCR
  • pneumocystis PCR
• identification and susceptibility testing of aerobic actinomycetes including Nocardia
• environmental air sampling (not NATA-accredited).

Clinical services

We provide phone advice to help you select the most appropriate test or specimen type for your patient or clinical setting. 

Our specialist medical mycology team can help you understand test results. We provide on-site (Westmead and Blacktown Hospitals) clinical consultation in medical mycology to all patients with suspected or diagnosed fungal infections. 

Our Infectious Diseases physicians and microbiologists meet weekly or fortnightly with teams in: 

• Haematology and bone marrow transplantation
• Renal Medicine and transplantation; and
• Intensive care unit.

We work with other specialist units in Western Sydney Local Health District to develop and review guidelines for using antifungal medicines including both the prophylaxis and treatment of fungal infections. 

We also develop guidelines for sampling and monitoring air and the environment, with regards to fungal content of ambient air.

Our team advises on air quality before and during building construction projects.

As part of the University of Sydney, our staff are involved in the education of medical mycology to:

• medical, science and veterinary students
• postgraduate medical.

We contribute to national and internal seminars and symposia and provide state-wide training in laboratory mycology for the Royal College of Pathologists examinations in Microbiology.

Some of our research includes:

• coordination of national medical mycology surveillance studies:
  • Canididaemia (2004-2007 and 2014-2015)
  • non-aspergillus mould infections
  • cryptococcus gattii infections
• antifungal drug resistance and susceptibility:
  • evaluation of antifungal susceptibilities of novel antifungal drugs
  • echinocandin resistance in candida glabrata
  • azole resistance in aspergillus fumigatus
  • whole genome sequencing of candida
• Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) based identification of uncommon and difficult to identify fungal pathogens
• genotyping of fungal pathogens.

We have long-term collaborations with:

• National Centre for Immunisation Research and Surveillance (NCIRS)
• Centre for Health Informatics, Australian Institute of Health Innovation, and School of Biotechnology and Biomolecular Sciences, University of NSW
• Centre for Values, Ethics and the Law in Medicine (VELiM), The University of Sydney

Our senior researchers have helped set up several NHMRC Centres of Research Excellence. These centres have strengthened our partnerships with research and healthcare organisations across NSW:

• CRE in Critical Infections (University of Sydney and Westmead Hospital)
• CRE in Tuberculosis Control and Prevention (Centenary and Woolcock Institutes)

Our close links with the Marie Bashir Institute for Infectious Diseases and Biosecurity are provide us with new opportunities for interdisciplinary research collaboration with researchers in other faculties of the University of Sydney.