Publications by authors named "Paul D R Johnson"

We describe two locally acquired cases of Mycobacterium ulcerans infection (Buruli ulcer) in the town of Batemans Bay on the east coast of New South Wales (NSW), Australia, 150 km north of Eden, the only other place in NSW where Buruli ulcer has likely been locally acquired. Genomic analysis showed that the bacterial isolates from the cases were identical but belonged to a phylogenetically distinct M. ulcerans clade that was most closely related to the isolate from the earlier case in Eden to the south.

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Background: Antimicrobial stewardship (AMS) guidelines now recommend antifungal stewardship (AFS) interventions to improve the management of invasive fungal diseases (IFDs). AFS programmes have not been reported in Australia.

Aims: To determine the monitoring of antifungal use, AFS strategies and targets, and barriers to AFS implementation in Australian hospitals.

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Article Synopsis
  • There's a significant lack of critical knowledge that is slowing down efforts to address Buruli ulcer (BU), a neglected tropical disease.
  • A new human infection model for BU is being proposed to investigate how the disease interacts with the host and to test prevention and treatment options.
  • The authors have shared a preliminary protocol for this study, seeking input from the scientific community and stakeholders before refining it for official review by an institutional board.
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  • Alphavirus infections are spread by mosquitoes, whereas the transmission method of Mycobacterium ulcerans, responsible for Buruli ulcer, is still debated.
  • Research using notification data from Victoria, Australia, from 2017 to 2022 shows a close correlation between the seasons of alphavirus and Buruli ulcer cases.
  • This alignment supports the theory that Mycobacterium ulcerans could also be transmitted by mosquitoes.
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Critical scientific questions remain regarding infection with Mycobacterium ulcerans, the organism responsible for the neglected tropical disease, Buruli ulcer (BU). A controlled human infection model has the potential to accelerate our knowledge of the immunological correlates of disease, to test prophylactic interventions and novel therapeutics. Here we present microbiological evidence supporting M.

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Buruli ulcer, a chronic subcutaneous infection caused by Mycobacterium ulcerans, is increasing in prevalence in southeastern Australia. Possums are a local wildlife reservoir for M. ulcerans and, although mosquitoes have been implicated in transmission, it remains unclear how humans acquire infection.

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Article Synopsis
  • Vancomycin-resistant enterococci (VRE) infections, particularly from specific genotypes, are becoming more common, highlighting the need for genomic studies to understand their evolution.
  • Researchers conducted a genomic analysis of a vancomycin-resistant enterococcus strain that emerged from a previously susceptible strain, identifying three major genomic variations including an integrative conjugative element and two structural changes in the genome.
  • The study suggests that the mobile genetic elements responsible for these variations are widespread and can be transferred across different bacterial genera, which is important for addressing the growing issue of antimicrobial resistance despite the low incidence of this specific VRE strain.
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Introduction: Mycobacterium ulcerans (MU) causes Buruli ulcer (Buruli), a geographically restricted infection that can result in skin loss, contracture and permanent scarring. Lesion-location maps compiled from more than 640 cases in south eastern Australia suggest biting insects are likely involved in transmission, but it is unclear whether MU is brought by insects to humans or if MU is already on the skin and inoculation is an opportunistic event that need not be insect dependent.

Methods: We validated a PCR swab detection assay and defined its dynamic range using laboratory cultured M.

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Critical knowledge gaps regarding infection with Mycobacterium ulcerans, the cause of Buruli ulcer (BU), have impeded development of new therapeutic approaches and vaccines for prevention of this neglected tropical disease. Here, we review the current understanding of host-pathogen interactions and correlates of immune protection to explore the case for establishing a controlled human infection model of M. ulcerans infection.

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Background: Buruli ulcer (BU) is a neglected tropical disease caused by infection of subcutaneous tissue with . BU is commonly reported across rural regions of Central and West Africa but has been increasing dramatically in temperate southeast Australia around the major metropolitan city of Melbourne, with most disease transmission occurring in the summer months. Previous research has shown that Australian native possums are reservoirs of and that they shed the bacteria in their fecal material (excreta).

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  • The study investigates COVID-19 severity (hospitalization and death rates) among residents of residential aged care facilities (RACFs) in Victoria, Australia, during Delta and Omicron epidemic periods.
  • Results show that the hospitalization risk (HR) and case fatality risk (CFR) were significantly lower during the Omicron period compared to Delta, with vaccination status playing a crucial role in reducing these risks.
  • The findings emphasize the importance of staying up-to-date with vaccinations to mitigate COVID-19 severity among elderly residents, as males and those with longer intervals since last vaccination faced higher risks.
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Objectives: To conduct a pilot study implementing combined genomic and epidemiologic surveillance for hospital-acquired multidrug-resistant organisms (MDROs) to predict transmission between patients and to estimate the local burden of MDRO transmission.

Design: Pilot prospective multicenter surveillance study.

Setting: The study was conducted in 8 university hospitals (2,800 beds total) in Melbourne, Australia (population 4.

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Laboratory-confirmed infection with Mycobacterium ulcerans is currently notifiable to health departments in several jurisdictions. Accurate surveillance is imperative to understanding current and emerging areas of endemicity and to facilitate research into a neglected tropical disease with poorly-understood transmission dynamics. The state of Victoria currently reports some of the highest numbers of M.

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Background: Due to regional shortages some health services have proposed using surgical masks manufactured from sterilisation wrap. However, there has been little assessment of the safety of this practice. Therefore, we developed our own prototypes and evaluated whether they met regulatory standards.

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Background: Buruli ulcer is a necrotising infection of skin and soft tissue caused by Mycobacterium ulcerans (M. ulcerans). Buruli ulcer most often occurs on limbs, and it is hypothesized this is explained by direct exposure to the environment.

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Article Synopsis
  • - A 36-year-old man on infliximab for Crohn's disease developed a large abscess in his back, which extended to the epidural space.
  • - The abscess was caused by methicillin-susceptible bacteria, leading to treatment involving drainage and antibiotics (flucloxacillin), along with a temporary stop of infliximab.
  • - This case is notable as it's the first report of a significant paraspinal abscess complication linked to infliximab therapy, highlighting potential risks of this medication.
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Buruli ulcer (BU) is a destructive soft-tissue infection caused by the environmental pathogen Mycobacterium ulcerans. In response to rising BU notifications in the state of Victoria, Australia, we reviewed all cases that occurred during 2011-2016 to precisely map the time and likely place of M. ulcerans acquisition.

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Purpose Of Review: To outline key drivers and components of antifungal stewardship (AFS) programmes, the evidence for specific interventions, and methods to assess performance of programmes.

Recent Findings: Recent developments in antifungal resistance and breakthrough invasive fungal diseases have increased the urgency for effective AFS. In practice, however, few hospitals have dedicated AFS programmes.

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Background: Buruli ulcer has been increasing in incidence in southeastern Australia with unclear transmission mechanisms. We aimed to investigate the link between rainfall and case numbers in two endemic areas of the state of Victoria; the Bellarine and Mornington Peninsulas.

Methodology: We created yearly and monthly graphs comparing rainfall with local Buruli ulcer incidence for the period 2004-2016 by endemic region and then considered a range of time lag intervals of 0-24 months to investigate patterns of correlation.

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  • Alcohol-based disinfectants, especially hand rubs, are crucial for controlling hospital infections, but there's an increasing number of infections caused by alcohol-tolerant pathogens.
  • A study found that hospital isolates of these pathogens became 10 times more resistant to alcohol after 2010, making traditional disinfection methods less effective.
  • Genetic analyses revealed mutations in the bacteria that help them better absorb and metabolize carbohydrates, indicating that their adaptation poses new challenges for infection control in hospitals.*
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