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2. Evaluation of risk prediction scores for adults hospitalized with COVID-19 in a highly-vaccinated population, Aotearoa New Zealand 2022

Author

Maze, Michael James, Williman, Jonathan, Anstey, Rebekah, Best, Emma, Bhally, Hasan, Bryce, Aliya, Chang, Catherina L., Chen, Kevin, Dummer, Jack, Epton, Michael, Good, William R., Goodson, Jennifer, Grey, Corina, Grimwade, Kate, Hancox, Robert J., Hassan, Redzuan Zarool, Hills, Thomas, Hotu, Sandra, McArthur, Colin, Morpeth, Susan, Murdoch, David R., Pease, Fiona Elizabeth, Pylypchuk, Romana, Raymond, Nigel, Ritchie, Stephen, Ryan, Deborah, Selak, Vanessa, Storer, Malina, Walls, Tony, Webb, Rachel, Wong, Conroy, and Wright, Karen

Published
2024
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3. COVID-19–related hospitalizations among Aotearoa, New Zealand children during the Omicron era of SARS-CoV-2

Author

Taylor, Amanda, Best, Emma J., Walls, Tony, Webb, Rachel, Bhally, Hasan, Bryce, Aliya, Chang, Cat L., Chen, Kevin, Dummer, Jack, Epton, Michael, Good, William, Goodson, Jennifer, Grey, Corina, Grimwade, Kate, Hancox, Robert J., Hassan, Redzuan Zarool, Hills, Thomas, Hotu, Sandra, McArthur, Colin, Morpeth, Susan, Murdoch, David R, Pease, Fiona, Pylypchuk, Romana, Raymond, Nigel, Ritchie, Stephen, Ryan, Debbie, Selak, Vanessa, Storer, Malina, Williman, Jonathan, Wong, Conroy, Wright, Karen, and Maze, Michael J.

Published
2024
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6. Strongyloidiasis in Auckland: A ten-year retrospective study of diagnosis, treatment and outcomes of a predominantly Polynesian and Fijian migrant cohort

Author

Cutfield, Tim, primary, Motuhifonua, Soana Karuna, additional, Blakiston, Matthew, additional, Bhally, Hasan, additional, Duffy, Eamon, additional, Lane, Rebekah, additional, Otte, Erik, additional, Swager, Terri, additional, Taylor, Amanda Maree, additional, and Playle, Veronica, additional

Published
2024
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7. Anticoagulation Strategies in Non–Critically Ill Patients with Covid-19

Author

McQuilten, Zoe K., primary, Venkatesh, Balasubramanian, additional, Jha, Vivekanand, additional, Roberts, Jason, additional, Morpeth, Susan C., additional, Totterdell, James A., additional, McPhee, Grace M., additional, Abraham, John, additional, Bam, Niraj, additional, Bandara, Methma, additional, Bangi, Ashpak K., additional, Barina, Lauren A., additional, Basnet, Bhupendra K., additional, Bhally, Hasan, additional, Bhusal, Khema R., additional, Bogati, Umesh, additional, Bowen, Asha C., additional, Burke, Andrew J., additional, Christopher, Devasahayam J., additional, Chunilal, Sanjeev D., additional, Cochrane, Belinda, additional, Curnow, Jennifer L., additional, Das, Santa Kumar, additional, Dhungana, Ashesh, additional, Di Tanna, Gian Luca, additional, Dotel, Ravindra, additional, DSouza, Hyjel, additional, Dummer, Jack, additional, Dutta, Sourabh, additional, Foo, Hong, additional, Gilbey, Timothy L., additional, Giles, Michelle L., additional, Goli, Kasiram, additional, Gordon, Adrienne, additional, Gyanwali, Pradip, additional, Haksar, Dipak, additional, Hudson, Bernard J., additional, Jani, Manoj K., additional, Jevaji, Purnima R., additional, Jhawar, Sachin, additional, Jindal, Aikaj, additional, John, M. Joseph, additional, John, Mary, additional, John, Flavita B., additional, John, Oommen, additional, Jones, Mark, additional, Joshi, Rajesh D., additional, Kamath, Prashanthi, additional, Kang, Gagandeep, additional, Karki, Achyut R., additional, Karmalkar, Abhishek M., additional, Kaur, Baldeep, additional, Koganti, Kalyan Chakravarthy, additional, Koshy, Jency M., additional, Krishnamurthy, Mathew S., additional, Lau, Jillian S., additional, Lewin, Sharon R., additional, Lim, Lyn-li, additional, Marschner, Ian C., additional, Marsh, Julie A., additional, Maze, Michael J., additional, McGree, James M., additional, McMahon, James H., additional, Medcalf, Robert L., additional, Merriman, Eileen G., additional, Misal, Amol P., additional, Mora, Jocelyn M., additional, Mudaliar, Vijaybabu K., additional, Nguyen, Vi, additional, O’Sullivan, Matthew V., additional, Pant, Suman, additional, Pant, Pankaj, additional, Paterson, David L., additional, Price, David J., additional, Rees, Megan A., additional, Robinson, James O., additional, Rogers, Benjamin A., additional, Samuel, Sandhya, additional, Sasadeusz, Joe, additional, Sharma, Deepak, additional, Sharma, Prabhat K., additional, Shrestha, Roshan, additional, Shrestha, Sailesh K., additional, Shrestha, Prajowl, additional, Shukla, Urvi, additional, Shum, Omar, additional, Sommerville, Christine, additional, Spelman, Tim, additional, Sullivan, Richard P., additional, Thatavarthi, Umashankar, additional, Tran, Huyen A., additional, Trask, Nanette, additional, Whitehead, Clare L., additional, Mahar, Robert K., additional, Hammond, Naomi E., additional, McFadyen, James D., additional, Snelling, Thomas L., additional, Davis, Joshua S., additional, Denholm, Justin T., additional, and Tong, Steven Y.C., additional

Published
2023
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8. Anticoagulation and Antiplatelet Strategies in Non-Critically Ill Patients with Covid-19

Author

McQuilten, Zoe, primary, Venkatesh, Balasubramanian, additional, Jha, Vivekanand, additional, Roberts, Jason, additional, Morpeth, Susan, additional, Totterdell, James, additional, McPhee, Grace, additional, Abraham, John, additional, Bam, Niraj, additional, Bandara, Methma, additional, Bangi, Ashpak, additional, Barina, Lauren, additional, Basnet, Bhupendra, additional, Bhally, Hasan, additional, Bhusal, Khemr, additional, Bogati, Umesh, additional, Bowen, Asha, additional, Burke, Andrew, additional, Christopher, Devasahayam, additional, Chunilal, Sanjeev, additional, Cochrane, Belinda, additional, Curnow, Jennifer, additional, Dara Reddy, Varaprasad Babu, additional, Das, Santa, additional, Dhungana, Ashesh, additional, Di Tanna, Gian Luca, additional, Dotel, Ravindra, additional, DSouza, Hyjel, additional, Dummer, Jack, additional, Dutta, Sourabh, additional, Foo, Hong, additional, Gilbey, Timothy, additional, Giles, Michelle, additional, Goli, Kasiram, additional, Gordon, Adrienne, additional, Gyanwali, Pradip, additional, Hudson, Bernard, additional, Jani, Manoj, additional, Jevaji, Purnima, additional, Jhawar, Sachin, additional, Jindal, Aikaj, additional, John, M. Joseph, additional, John, Mary, additional, John, Flavita, additional, John, Oommen, additional, Jones, Mark, additional, Joshi, Rajesh, additional, Kamath, Prashanthi, additional, Kang, Gagandeep, additional, Karki, Achyut, additional, Karmalkar, Abhishek, additional, Kaur, Baldeep, additional, Koganti, Kalyan Chakravarthy, additional, Koshy, Jency, additional, Mathew, S K, additional, Lau, Jilllian, additional, Lewin, Sharon, additional, Lim, Lyn-li, additional, Marschner, Ian, additional, Marsh, Julie, additional, Maze, Michael, additional, McGree, James, additional, McMahon, James, additional, Medcalf, Robert, additional, Merriman, Eileen, additional, Misal, Amol, additional, Mora, Jocelyn, additional, Mudaliar, Vijaybabu, additional, Nguyen, Vi, additional, O'Sullivan, Matthew, additional, Pant, Suman, additional, Pant, Pankaj, additional, Paterson, David, additional, Price, David, additional, Rees, Megan, additional, Robinson, James Owen, additional, Rogers, Benjamin, additional, Samuel, Sandhya, additional, Sasadeusz, Joe, additional, Sharma, Deepak, additional, Sharma, Prabhat, additional, Shrestha, Roshan, additional, Shrestha, Sailesh, additional, Shrestha, Prajowl, additional, Shukla, Urvi, additional, Shum, Omar, additional, Sommerville, Christine, additional, Spelman, Tim, additional, Sullivan, Richard, additional, Thatavarthi, Umashankar, additional, Tran, Huyen, additional, Trask, Nanette, additional, Whitehead, Claire, additional, Mahar, Robert, additional, Hammond, Naomi, additional, McFadyen, James David, additional, Snelling, Thomas, additional, Davis, Joshua, additional, Denholm, Justin, additional, and Tong, Steven YC, additional

Published
2022
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11. A machine learning PROGRAM to identify COVID-19 and other diseases from hematology data

Author

Gladding, Patrick A, primary, Ayar, Zina, additional, Smith, Kevin, additional, Patel, Prashant, additional, Pearce, Julia, additional, Puwakdandawa, Shalini, additional, Tarrant, Dianne, additional, Atkinson, Jon, additional, McChlery, Elizabeth, additional, Hanna, Merit, additional, Gow, Nick, additional, Bhally, Hasan, additional, Read, Kerry, additional, Jayathissa, Prageeth, additional, Wallace, Jonathan, additional, Norton, Sam, additional, Kasabov, Nick, additional, Calude, Cristian S, additional, Steel, Deborah, additional, and Mckenzie, Colin, additional

Published
2021
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17. Effect of piperacillin-tazobactam vs meropenem on 30-day mortality for patients with e coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance

Author

Harris, Patrick N. A., Tambyah, Paul A., Lye, David C., Yin, Mo, Lee, Tau H., Yilmaz, Mesut, Alenazi, Thamer H., Arabi, Yaseen, Falcone, Marco, Bassetti, Matteo, Righi, Elda, Rogers, Benjamin A., Kanj, Souha, Bhally, Hasan, Iredell, Jon, Mendelson, Marc, Boyles, Tom H., Looke, David, Miyakis, Spiros, Walls, Genevieve, Al Khamis, Mohammed, Zikri, Ahmed, Crowe, Amy, Ingram, Paul, Daneman, Nick, Griffin, Paul, Athan, Eugene, Lorenc, Penelope, Baker, Peter, Roberts, Leah, Beatson, Scott A., Peleg, Anton Y., Harris-Brown, Tiffany, and Paterson, David L.

Subjects
Medicine (all)
Published
2018

20. Effect of piperacillin-tazobactam vs meropenem on 30-day mortality for patients with e coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance

Author

Harris, Patrick NA, Tambyah, Paul, Lye, David C, Mo, Yin, Lee, Tau, Yilmaz, Mesut, Alenazi, Thamer, Arabi, Yaseen, Falcone, Marco, Bassetti, Matteo, Righi, Elda, Rogers, Benjamin A, Kanj, Souha, Bhally, Hasan, Iredell, Jon, Mendelson, Marc, Boyles, Tom, Looke, David, Miyakis, Spiros, Walls, Genevieve, Al Khamis, Mohammed, Zikri, Ahmed, Crowe, Amy, Ingram, Paul R, Daneman, Nick, Griffin, Paul, Athan, Eugene, Lorenc, Penelope, Baker, Peter, Roberts, Leah, Beatson, Scott A, Peleg, Anton Y, Harris-Brown, Tiffany, Paterson, David L, Harris, Patrick NA, Tambyah, Paul, Lye, David C, Mo, Yin, Lee, Tau, Yilmaz, Mesut, Alenazi, Thamer, Arabi, Yaseen, Falcone, Marco, Bassetti, Matteo, Righi, Elda, Rogers, Benjamin A, Kanj, Souha, Bhally, Hasan, Iredell, Jon, Mendelson, Marc, Boyles, Tom, Looke, David, Miyakis, Spiros, Walls, Genevieve, Al Khamis, Mohammed, Zikri, Ahmed, Crowe, Amy, Ingram, Paul R, Daneman, Nick, Griffin, Paul, Athan, Eugene, Lorenc, Penelope, Baker, Peter, Roberts, Leah, Beatson, Scott A, Peleg, Anton Y, Harris-Brown, Tiffany, and Paterson, David L

Abstract

IMPORTANCE Extended-spectrum β-lactamases mediate resistance to third-generation cephalosporins (eg, ceftriaxone) in Escherichia coli and Klebsiella pneumoniae. Significant infections caused by these strains are usually treated with carbapenems, potentially selecting for carbapenem resistance. Piperacillin-tazobactam may be an effective "carbapenem-sparing" option to treat extended-spectrum β-lactamase producers. OBJECTIVES To determine whether definitive therapy with piperacillin-tazobactam is noninferior to meropenem (a carbapenem) in patients with bloodstream infection caused by ceftriaxone-nonsusceptible E coli or K pneumoniae. DESIGN, SETTING, AND PARTICIPANTS Noninferiority, parallel group, randomized clinical trial included hospitalized patients enrolled from 26 sites in 9 countries from February 2014 to July 2017. Adult patients were eligible if they had at least 1 positive blood culture with E coli or Klebsiella spp testing nonsusceptible to ceftriaxone but susceptible to piperacillin-tazobactam. Of 1646 patients screened, 391 were included in the study. INTERVENTIONS Patients were randomly assigned 1:1 to intravenous piperacillin-tazobactam, 4.5 g, every 6 hours (n = 188 participants) or meropenem, 1 g, every 8 hours (n = 191 participants) for a minimum of 4 days, up to a maximum of 14 days, with the total duration determined by the treating clinician. MAIN OUTCOMES AND MEASURES The primary outcome was all-cause mortality at 30 days after randomization. A noninferiority margin of 5% was used. RESULTS Among 379 patients (mean age, 66.5 years; 47.8% women) who were randomized appropriately, received at least 1 dose of study drug, and were included in the primary analysis population, 378 (99.7%) completed the trial and were assessed for the primary outcome. A total of 23 of 187 patients (12.3%) randomized to piperacillin-tazobactam met the primary outcome of mortality at 30 days compared with 7 of 191 (3.7%) randomized to meropenem (risk difference, 8.6% [1-s

Published
2018

21. Managing diabetic foot infections: A survey of Australasian infectious diseases clinicians

Author

Commons, Robert, Raby, Edward, Athan, Eugene, Bhally, Hasan, Chen, Sharon, Guy, Stephen, Ingram, Paul, Lai, Katy, Lemoh, Chris, Lim, Lyn-Li, Manning, Laurens, Miyakis, Spiros, O¿Reilly, Mary, Roberts, Adam, Sehu, Marjoree, Torda, Adrienne, Vicaretti, Mauro, Lazzarini, Peter, Commons, Robert, Raby, Edward, Athan, Eugene, Bhally, Hasan, Chen, Sharon, Guy, Stephen, Ingram, Paul, Lai, Katy, Lemoh, Chris, Lim, Lyn-Li, Manning, Laurens, Miyakis, Spiros, O¿Reilly, Mary, Roberts, Adam, Sehu, Marjoree, Torda, Adrienne, Vicaretti, Mauro, and Lazzarini, Peter

Abstract

Background Diabetic foot infections (DFI) present a major morbidity, mortality and economic challenge for the tertiary health sector. However, lack of high quality evidence for specific treatment regimens for patients with DFIs may result in inconsistent management. This study aimed to identify DFI caseload proportion and patterns of clinical practice of Infectious Diseases (ID) Physicians and Trainees within Australia and New Zealand. Methods A cross-sectional online survey of Australian and New Zealand ID Physicians and Trainees was undertaken, to estimate the overall ID caseload devoted to patients with DFIs and assess clinicians’ management practices of patients with DFIs. Results Approximately 28% (142/499) of ID Physicians and Trainees from Australia and New Zealand responded to the survey. DFI made up 19.2% of all ID consultations. Involvement in multidisciplinary teams (MDT) was common as 77.5% (93/120) of those responding indicated their patients had access to an inpatient or outpatient MDT. Significant heterogeneity of antimicrobial treatments was reported, with 82 unique treatment regimens used by 102 respondents in one scenario and 76 unique treatment regimens used by 101 respondents in the second scenario. The duration of therapy and the choice of antibiotics for microorganisms isolated from superficial swabs also varied widely. Conclusions Patients with DFIs represent a significant proportion of an ID clinician’s caseload. This should be reflected in the ID training program. Large heterogeneity in practice between clinicians reflects a lack of evidence from well-designed clinical trials for patients with DFI and highlights the need for management guidelines informed by future trials.

Published
2018

22. Managing diabetic foot infections: a survey of Australasian infectious diseases clinicians

Author

Commons, Robert J, Raby, Edward, Athan, Eugene, Bhally, Hasan, Chen, Sharon, Guy, Stephen, Ingram, Paul R, Lai, Katy, Lemoh, Chris, Lim, Lyn-Lim, Manning, Laurens, Miyakis, Spiros, O'Reilly, Mary, Roberts, Adam, Sehu, Marjoree, Torda, Adrienne, Vicaretti, Mauro, Lazzarini, Peter A, Commons, Robert J, Raby, Edward, Athan, Eugene, Bhally, Hasan, Chen, Sharon, Guy, Stephen, Ingram, Paul R, Lai, Katy, Lemoh, Chris, Lim, Lyn-Lim, Manning, Laurens, Miyakis, Spiros, O'Reilly, Mary, Roberts, Adam, Sehu, Marjoree, Torda, Adrienne, Vicaretti, Mauro, and Lazzarini, Peter A

Abstract

Background: Diabetic foot infections (DFI) present a major morbidity, mortality and economic challenge for the tertiary health sector. However, lack of high quality evidence for specific treatment regimens for patients with DFIs may result in inconsistent management. This study aimed to identify DFI caseload proportion and patterns of clinical practice of Infectious Diseases (ID) Physicians and Trainees within Australia and New Zealand. Methods: A cross-sectional online survey of Australian and New Zealand ID Physicians and Trainees was undertaken, to estimate the overall ID caseload devoted to patients with DFIs and assess clinicians' management practices of patients with DFIs. Results: Approximately 28% (142/499) of ID Physicians and Trainees from Australia and New Zealand responded to the survey. DFI made up 19.2% of all ID consultations. Involvement in multidisciplinary teams (MDT) was common as 77.5% (93/120) of those responding indicated their patients had access to an inpatient or outpatient MDT. Significant heterogeneity of antimicrobial treatments was reported, with 82 unique treatment regimens used by 102 respondents in one scenario and 76 unique treatment regimens used by 101 respondents in the second scenario. The duration of therapy and the choice of antibiotics for microorganisms isolated from superficial swabs also varied widely. Conclusions: Patients with DFIs represent a significant proportion of an ID clinician's caseload. This should be reflected in the ID training program. Large heterogeneity in practice between clinicians reflects a lack of evidence from well-designed clinical trials for patients with DFI and highlights the need for management guidelines informed by future trials.

Published
2018

23. Dominance of ST131 Escherichia coli carrying blaCTX-M in patients with bloodstream infections caused by cephalosporin-resistant strains in Australia, New Zealand and Singapore: whole genome analysis of isolates from a randomised trial

Author

Harris, Patrick N. A., Ben Zakour, Nouri L., Roberts, Leah W., Wailan, Alexander M., Zowawi, Hosam M., Tambyah, Paul A., Lye, David C., Jureen, Roland, Lee, Tau H., Yin, Mo, Izharuddin, Ezlyn, Looke, David, Runnegar, Naomi, Rogers, Benjamin, Bhally, Hasan, Crowe, Amy, Schembri, Mark A., Beatson, Scott, and Paterson, David L.

Subjects
0303 health sciences, 03 medical and health sciences, 030306 microbiology, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, 030304 developmental biology, 3. Good health
Abstract

Synopsis/AbstractObjectivesTo characterise multi-drug resistantEscherichia coliisolated from patients in Australia, New Zealand and Singapore with bloodstream infection (BSI).MethodsWe prospectively collected third-generation cephalosporin resistant (3GC-R)E. colifrom blood cultures obtained from patients enrolled in a randomised controlled trial. Whole genome sequencing was used to characterise antibiotic resistance genes, sequence types (STs), plasmids and phylogenetic relationships. Antibiotic susceptibility was determined using disk diffusion and Etest.ResultsA total of 70E. coliwere included, of which the majority were ST131 (61.4%). BSI was most frequently from a urinary source (69.6%), community-associated (62.9%) and in older patients (median age 71 years [IQR 64-81]). The median Pitt bacteraemia score at presentation was 1 (IQR 0-2, range 0-3) and ICU admission was infrequent (3.1%). ST131 possessed significantly more acquired resistance genes than non-ST131 (p=0.003). Clade C1/C2 ST131 predominated (30.2% and 53.5% of all ST131 respectively) and these were all resistant to ciprofloxacin. All clade A ST131 were community-associated. The predominant ESBL types wereblaCTX-M(78.6% of isolates) and were strongly associated with ST131, with the majorityblaCTX-M-15. Clade C1 was associated withblaCTX-M-14andblaCTX-M-27, whereasblaCTX-M-15predominated in clade C2. Plasmid-mediated AmpC (p-AmpC) genes (mainlyblaCMY-2) were also frequent (17.1%) but were more common with non-ST131 strains (p< 0.001). The majority of plasmid replicon types were IncF.ConclusionsIn a prospective collection of 3GC-RE. colicausing BSI in the Australasian region, community-associated Clade C1/C2 ST131 predominate in association withblaCTX-MESBLs, although a significant proportion of non-ST131 strains carriedblaCMY-2.

Published
2017
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24. Bilateral Neck Pyomyositis Caused by Staphylococcus capitis and Staphylococcus saccharolyticus in a Diabetic Adult

Author

Young, Nicholas and Bhally, Hasan

Subjects
Article Subject
Abstract

We report a case of pyomyositis of the paraspinal neck muscles caused by two coagulase-negative staphylococci: Staphylococcus capitis and Staphylococcus saccharolyticus. Inflammation in the spermatic cords was an additional feature of this infection. Treatment with six weeks of first-generation cephalosporin therapy resulted in complete clinical and radiological resolution.

Published
2017
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28. Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial.

Author

Harris, Patrick N. A., Tambyah, Paul A., Lye, David C., Mo, Yin, Lee, Tau H., Yilmaz, Mesut, Alenazi, Thamer H., Arabi, Yaseen, Falcone, Marco, Bassetti, Matteo, Righi, Elda, Rogers, Benjamin A., Kanj, Souha, Bhally, Hasan, Iredell, Jon, Mendelson, Marc, Boyles, Tom H., Looke, David, Miyakis, Spiros, and Walls, Genevieve

Subjects
PIPERACILLIN, TAZOBACTAM, MEROPENEM, ESCHERICHIA coli diseases, KLEBSIELLA pneumoniae, CEFTRIAXONE, DRUG efficacy, ANTIBIOTICS, BACTEREMIA, COMPARATIVE studies, CAUSES of death, DRUG resistance in microorganisms, ESCHERICHIA coli, KLEBSIELLA, PENICILLIN, RESEARCH methodology, MEDICAL cooperation, RESEARCH, STATISTICAL sampling, EVALUATION research, RANDOMIZED controlled trials, CARBAPENEMS, AMPICILLIN, KLEBSIELLA infections, PHARMACODYNAMICS, THERAPEUTICS
Abstract

Importance: Extended-spectrum β-lactamases mediate resistance to third-generation cephalosporins (eg, ceftriaxone) in Escherichia coli and Klebsiella pneumoniae. Significant infections caused by these strains are usually treated with carbapenems, potentially selecting for carbapenem resistance. Piperacillin-tazobactam may be an effective "carbapenem-sparing" option to treat extended-spectrum β-lactamase producers.Objectives: To determine whether definitive therapy with piperacillin-tazobactam is noninferior to meropenem (a carbapenem) in patients with bloodstream infection caused by ceftriaxone-nonsusceptible E coli or K pneumoniae.Design, Setting, and Participants: Noninferiority, parallel group, randomized clinical trial included hospitalized patients enrolled from 26 sites in 9 countries from February 2014 to July 2017. Adult patients were eligible if they had at least 1 positive blood culture with E coli or Klebsiella spp testing nonsusceptible to ceftriaxone but susceptible to piperacillin-tazobactam. Of 1646 patients screened, 391 were included in the study.Interventions: Patients were randomly assigned 1:1 to intravenous piperacillin-tazobactam, 4.5 g, every 6 hours (n = 188 participants) or meropenem, 1 g, every 8 hours (n = 191 participants) for a minimum of 4 days, up to a maximum of 14 days, with the total duration determined by the treating clinician.Main Outcomes and Measures: The primary outcome was all-cause mortality at 30 days after randomization. A noninferiority margin of 5% was used.Results: Among 379 patients (mean age, 66.5 years; 47.8% women) who were randomized appropriately, received at least 1 dose of study drug, and were included in the primary analysis population, 378 (99.7%) completed the trial and were assessed for the primary outcome. A total of 23 of 187 patients (12.3%) randomized to piperacillin-tazobactam met the primary outcome of mortality at 30 days compared with 7 of 191 (3.7%) randomized to meropenem (risk difference, 8.6% [1-sided 97.5% CI, -∞ to 14.5%]; P = .90 for noninferiority). Effects were consistent in an analysis of the per-protocol population. Nonfatal serious adverse events occurred in 5 of 188 patients (2.7%) in the piperacillin-tazobactam group and 3 of 191 (1.6%) in the meropenem group.Conclusions and relevance: Among patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, definitive treatment with piperacillin-tazobactam compared with meropenem did not result in a noninferior 30-day mortality. These findings do not support use of piperacillin-tazobactam in this setting.Trial Registration: anzctr.org.au Identifiers: ACTRN12613000532707 and ACTRN12615000403538 and ClinicalTrials.gov Identifier: NCT02176122. [ABSTRACT FROM AUTHOR]

Published
2018
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29. Whole genome analysis of cephalosporin-resistant Escherichia coli from bloodstream infections in Australia, New Zealand and Singapore: high prevalence of CMY-2 producers and ST131 carrying blaCTX-M-15 and blaCTX-M-27.

Author

Harris, Patrick N. A., Ben Zakour, Nouri L., Roberts, Leah W., Wailan, Alexander M., Zowawi, Hosam M., Tambyah, Paul A., Lye, David C., Jureen, Roland, Tau H. Lee, Mo Yin, Izharuddin, Ezlyn, Looke, David, Runnegar, Naomi, Rogers, Benjamin, Bhally, Hasan, Crowe, Amy, Schembri, Mark A., Beatson, Scott A., Paterson, David L., and Lee, Tau H

Subjects
GENOMES, CEPHALOSPORINS, ESCHERICHIA coli, DISEASE prevalence, RANDOMIZED controlled trials, BACTEREMIA, BACTERIOPHAGE typing, CLINICAL trials, DRUG resistance in microorganisms, ESCHERICHIA coli diseases, BIOLOGICAL evolution, HYDROLASES, LONGITUDINAL method, SEQUENCE analysis, PHARMACODYNAMICS
Abstract

Objectives: To characterize MDR Escherichia coli from bloodstream infections (BSIs) in Australia, New Zealand and Singapore.Methods: We collected third-generation cephalosporin-resistant (3GC-R) E. coli from blood cultures in patients enrolled in a randomized controlled trial from February 2014 to August 2015. WGS was used to characterize antibiotic resistance genes, MLST, plasmids and phylogenetic relationships. Antibiotic susceptibility was determined using disc diffusion and Etest.Results: A total of 70 3GC-R E. coli were included, of which the majority were ST131 (61.4%). BSI was most frequently from a urinary source (69.6%), community associated (62.9%) and in older patients (median age 71 years). The median Pitt score was 1 and ICU admission was infrequent (3.1%). ST131 possessed more acquired resistance genes than non-ST131 (P = 0.003). Clade C1/C2 ST131 predominated (30.2% and 53.5% of ST131, respectively) and these were all ciprofloxacin resistant. All clade A ST131 (n = 6) were community associated. The predominant ESBL types were blaCTX-M (80.0%) and were strongly associated with ST131 (95% carried blaCTX-M), with the majority blaCTX-M-15. Clade C1 was associated with blaCTX-M-14 and blaCTX-M-27, whereas blaCTX-M-15 predominated in clade C2. Plasmid-mediated AmpC genes (mainly blaCMY-2) were frequent (17.1%) but were more common in non-ST131 (P < 0.001) isolates from Singapore and Brisbane. Two strains carried both blaCMY-2 and blaCTX-M. The majority of plasmid replicon types were IncF.Conclusions: In a prospective collection of 3GC-R E. coli causing BSI, community-associated Clade C1/C2 ST131 predominate in association with blaCTX-M ESBLs, although a significant proportion of non-ST131 strains carried blaCMY-2. [ABSTRACT FROM AUTHOR]

Published
2018
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37. Utility of Extended Blood Culture Incubation for Isolation of Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and KingellaOrganisms: a Retrospective Multicenter Evaluation

Author

Petti, Cathy A., Bhally, Hasan S., Weinstein, Melvin P., Joho, Kim, Wakefield, Teresa, Reller, L. Barth, and Carroll, Karen C.

Abstract

ABSTRACTThe incidence of and average time to detection for Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella(HACEK) bacteria in blood cultures with standard incubation and the utility of extended incubation of blood culture bottles were reviewed at four tertiary care microbiology laboratories. HACEK organisms were isolated from 35 (<0.005%) of 59,203 positive blood cultures. None of 407 blood cultures with extended incubation grew HACEK or other bacteria. Bacteremia from HACEK bacteria is rare, and extended incubation of blood cultures to recover HACEK bacteria is unnecessary.

Published
2006
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38. Bartonella henselae aortic valve endocarditis mimicking systemic vasculitis.

Author

Teoh, Laurence S. G., Hart, Hamish H., Soh, May Ching, Christiansen, Jonathan P., Bhally, Hasan, Philips, Martin S, and Rai-Chaudhuri, Dominic S

Abstract

A 28-year-old man with a bicuspid aortic valve presented with facial droop and slurred speech with several months of constitutional symptoms of night sweats, weight loss and productive cough. Examination confirmed aortic regurgitation, palpable spleen and left facial droop. Multiple peripheral blood cultures were negative. Inflammatory markers, cytoplasmic staining antineutrophil cytoplasmic antibodies (cANCA) and anti-PR3 antibody were all elevated. MRI of the brain and CT of the chest and abdomen confirmed embolic infarcts to brain, kidney and spleen. Transoesophageal echocardiogram (ECG) showed valve vegetations and severe aortic regurgitation. Endocardial Wegener's granulomatosis was considered. Aortic valve replacement was performed. Grindings from aortic valve leaflets were analysed for rpoB gene, which confirmed the presence of Bartonella henselae. Serological assays demonstrated B henselae IgM 20 (normal ..20) and IgG >2048 (normal .. 64). The patient completely recovered after prolonged antibiotic treatment. Culture-negative infective endocarditis may mimic vasculitis and be associated with positive cANCA. Serology and molecular techniques may aid diagnosis. [ABSTRACT FROM AUTHOR]

Published
2010

39. Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial

Author

Peter Baker, Tau H. Lee, Yin Mo, David L. Paterson, Elda Righi, Paul R. Ingram, Nick Daneman, Tom H. Boyles, Leah W. Roberts, Matteo Bassetti, Penelope Lorenc, Marc Mendelson, Amy Crowe, Thamer H. Alenazi, Anton Y. Peleg, Yaseen M. Arabi, Marco Falcone, Benjamin A. Rogers, Patrick N A Harris, Paul M. Griffin, David C. Lye, Mohammed Al Khamis, Mesut Yilmaz, Spiros Miyakis, Souha S. Kanj, Scott A. Beatson, Eugene Athan, Tiffany Harris-Brown, David Looke, Hasan Bhally, Genevieve Walls, Paul A. Tambyah, Jon Iredell, Ahmed Zikri, Harris, Patrick N. A., Lorenc, Penelope, Harris-Brown, Tiffany Univ Queensland, UQ Ctr Clin Res, Brisbane, Qld, Australia, Harris, Patrick N. A. Royal Brisbane & Womens Hosp, Pathol Queensland, Dept Microbiol, Brisbane, Qld, Australia, Looke, David Princess Alexandra Hosp, Infect Management Serv, Brisbane, Qld, Australia, Tambyah, Paul A., Mo, Yin Natl Univ Singapore Hosp, Dept Infect Dis, Singapore, Singapore, Lye, David C., Lee, Tau H. Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore, Lee, Tau H. Tan Tock Seng Hosp, Inst Infect Dis & Epidemiol, Dept Infect Dis, Singapore, Singapore, Lee, Tau H. Nanyang Technol Univ, Lee Kong Chian Sch Med, Singapore, Singapore, Yilmaz, Mesut Istanbul Medipol Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Alenazi, Tamer H., Arabi, Yaseen King Saud Bin Abdulaziz Univ Hlth Sci, Riyadh, Saudi Arabia, Arabi, Yaseen King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia, Falcone, Marco Sapienza Univ Rome, Dept Publ Hlth & Infect Dis, Rome, Italy, Bassetti, Matteo, Righi, Elda Univ Udine, Dept Med, Infect Dis Clin, Udine, Italy, Righi, Elda Santa Maria Misericordia Hosp, Udine, Italy, Rogers, Benjamin A. Monash Univ, Ctr Inflammatory Dis, Melbourne, Vic, Australia, Rogers, Benjamin A. Monash Hlth, Monash Infect Dis, Melbourne, Vic, Australia, Kanj, Souha Amer Univ Beirut, Med Ctr, Dept Internal Med, Div Infect Dis, Beirut, Lebanon, Bhally, Hasan North Shore Hosp, Dept Med & Infect Dis, Auckland, New Zealand, Iredell, Jon Univ Sydney, Marie Bashir Inst Infect Dis & Biosecur, Sydney, NSW, Australia, Iredell, Jon Westmead Hosp, Ctr Infect Dis & Microbiol, Westmead, NSW, Australia, Mendelson, Marc, Boyles, Tom H. Univ Cape Town, Groote Schuur Hosp, Dept Med, Div Infect Dis & HIV Med, Cape Town, South Africa, Looke, David, Griffin, Paul Univ Queensland, Brisbane, Qld, Australia, Miyakis, Spiros Univ Wollongong, Sch Med, Wollongong, NSW, Australia, Miyakis, Spiros Illawarra Hlth & Med Res Inst, Wollongong, NSW, Australia, Miyakis, Spiros Wollongong Hosp, Dept Infect Dis, Wollongong, NSW, Australia, Walls, Genevieve Middlemore Hosp, Dept Infect Dis, Auckland, New Zealand, Al Khamis, Mohammed, Zikri, Ahmed King Fahad Specialist Hosp, Dammam, Saudi Arabia, Crowe, Amy St Vincents Hosp, Dept Infect Dis, Melbourne, Vic, Australia, Crowe, Amy St Vincents Hosp, Dept Microbiol, Melbourne, Vic, Australia, Ingram, Paul Univ Western Australia, Sch Pathol & Lab Med, Crawley, Australia, Ingram, Paul Fiona Stanley Hosp, Dept Infect Dis, Murdoch, WA, Australia, Ingram, Paul PathWest Lab Med, Dept Microbiol, Perth, WA, Australia, Daneman, Nick Univ Toronto, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada, Griffin, Paul Mater Hosp, Dept Med & Infect Dis, Brisbane, Qld, Australia, Griffin, Paul Mater Med Res Inst, Brisbane, Qld, Australia, Griffin, Paul QIMR Berghofer, Brisbane, Qld, Australia, Athan, Eugene Barwon Hlth, Dept Infect Dis, Geelong, Vic, Australia, Athan, Eugene Deakin Univ, Geelong, Vic, Australia, Baker, Peter Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia, Roberts, Leah, Beatson, Scott A. Univ Queensland, Sch Chem & Mol Biosci, Australian Ctr Ecogen, Brisbane, Qld, Australia, Peleg, Anton Y. Monash Univ, Biomed Discovery Inst, Infect & Immun Program, Clayton, Vic, Australia, Peleg, Anton Y. Monash Univ, Dept Microbiol, Clayton, Vic, Australia, Peleg, Anton Y. Monash Univ, Alfred Hosp, Dept Infect Dis, Melbourne, Vic, Australia, Peleg, Anton Y. Monash Univ, Cent Clin Sch, Melbourne, Vic, Australia, Paterson, David L. Royal Brisbane & Womens Hosp, Dept Infect Dis, Brisbane, Qld, Australia, Beatson, Scott -- 0000-0002-1806-3283, Harris, Patrick -- 0000-0002-2895-0345, Runnegar, Naomi J -- 0000-0003-1196-4131, Paterson, David -- 0000-0003-2079-4437, YILMAZ, Mesut -- 0000-0001-8022-7325, and Griffin, Paul -- 0000-0002-1656-421X

Subjects
0301 basic medicine, Male, Carbapenem, Drug Resistance, Penicillanic Acid, Bacteremia, Drug resistance, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Cause of Death, polycyclic compounds, Medicine, 030212 general & internal medicine, Piperacillin-Tazobactam, Piperacillin-Tazobactam, Meropenem, Mortality, E coli, Klebsiella pneumoniae, Escherichia coli Infections, Original Investigation, Tazobactam Drug Combination, education.field_of_study, Ceftriaxone, Bacterial, General Medicine, E coli, Middle Aged, Anti-Bacterial Agents, Klebsiella pneumoniae, Piperacillin/tazobactam, Female, Adult, Aged, Drug Resistance, Bacterial, Escherichia coli, Humans, Klebsiella Infections, Meropenem, Piperacillin, Piperacillin, Tazobactam Drug Combination, Thienamycins, Beta-Lactamases, medicine.drug, medicine.medical_specialty, 030106 microbiology, Population, education, 03 medical and health sciences, Internal medicine, Mortality, business.industry, Piperacillin Plus Tazobactam, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, ESBL Genes, business
Abstract

WOS: 000444341400012 PubMed ID: 30208454 IMPORTANCE Extended-spectrum beta-lactamases mediate resistance to third-generation cephalosporins (eg, ceftriaxone) in Escherichia coli and Klebsiella pneumoniae. Significant infections caused by these strains are usually treated with carbapenems, potentially selecting for carbapenem resistance. Piperacillin-tazobactam may be an effective "carbapenem-sparing" option to treat extended-spectrum beta-lactamase producers. OBJECTIVES To determine whether definitive therapy with piperacillin-tazobactam is noninferior to meropenem (a carbapenem) in patients with bloodstream infection caused by ceftriaxone-nonsusceptible E coli or K pneumoniae. DESIGN, SETTING, AND PARTICIPANTS Noninferiority, parallel group, randomized clinical trial included hospitalized patients enrolled from 26 sites in 9 countries from February 2014 to July 2017. Adult patients were eligible if they had at least 1 positive blood culture with E coli or Klebsiella spp testing nonsusceptible to ceftriaxone but susceptible to piperacillin-tazobactam. Of 1646 patients screened, 391 were included in the study. INTERVENTIONS Patients were randomly assigned 1: 1 to intravenous piperacillin-tazobactam, 4.5 g, every 6 hours (n = 188 participants) or meropenem, 1 g, every 8 hours (n = 191 participants) for a minimum of 4 days, up to a maximum of 14 days, with the total duration determined by the treating clinician. MAIN OUTCOMES AND MEASURES The primary outcome was all-cause mortality at 30 days after randomization. A noninferiority margin of 5% was used. RESULTS Among 379 patients (mean age, 66.5 years; 47.8% women) who were randomized appropriately, received at least 1 dose of study drug, and were included in the primary analysis population, 378 (99.7%) completed the trial and were assessed for the primary outcome. A total of 23 of 187 patients (12.3%) randomized to piperacillin-tazobactam met the primary outcome of mortality at 30 days compared with 7 of 191 (3.7%) randomized to meropenem (risk difference, 8.6%[1-sided 97.5% CI, -infinity to 14.5%]; P = .90 for noninferiority). Effects were consistent in an analysis of the per-protocol population. Nonfatal serious adverse events occurred in 5 of 188 patients (2.7%) in the piperacillin-tazobactam group and 3 of 191 (1.6%) in the meropenem group. CONCLUSIONS AND RELEVANCE Among patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, definitive treatment with piperacillin-tazobactam compared with meropenem did not result in a noninferior 30-day mortality. These findings do not support use of piperacillin-tazobactam in this setting. University of Queensland; Australian Society for Antimicrobials (ASA); International Society for Chemotherapy (ISC); National University Hospital Singapore Clinician Researcher Grant [NUHSRO/2014/121/CRG/07]; Australian Infectious Disease Centre; Australian Genome Research Facility; Royal College of Pathologists of Australasia (RCPA) Foundation; Study, Education, and Research Committee (SERC) of Pathology Queensland; National Health and Medical Research Council (NHMRC) Career Development Fellowship; Australian Postgraduate Award from the University of Queensland; NHMRC Career Development and Practitioner Fellowship; NHMRC Practitioner Fellowship The study was sponsored by the University of Queensland. This study was funded by grants from the Australian Society for Antimicrobials (ASA), International Society for Chemotherapy (ISC), National University Hospital Singapore Clinician Researcher Grant NUHSRO/2014/121/CRG/07. Whole-genome sequencing was funded by grants from the Australian Infectious Disease Centre and Australian Genome Research Facility; the Royal College of Pathologists of Australasia (RCPA) Foundation; and the Study, Education, and Research Committee (SERC) of Pathology Queensland. Dr Beatson was supported by a National Health and Medical Research Council (NHMRC) Career Development Fellowship during the course of the trial. Dr Harris was supported by an Australian Postgraduate Award from the University of Queensland. Dr Peleg was supported by a NHMRC Career Development and Practitioner Fellowship during the course of the trial. Dr Paterson was supported by a NHMRC Practitioner Fellowship during the course of the trial.

Published
2018

40. Outpatient parenteral antimicrobial therapy for patients with Enterococcus faecalis endocarditis using continuous infusion IV benzylpenicillin plus IV ceftriaxone.

Author

Briggs S, Duffy E, Bhally H, Broom M, Campbell P, Lane R, McBride S, Walls G, and Dalton S

Abstract

Background: Many patients with Enterococcus faecalis endocarditis are clinically stable and able to leave hospital before completing antibiotic treatment, but data are lacking regarding some outpatient treatment options., Objectives: To assess the outcomes for adults with E. faecalis endocarditis receiving outpatient parenteral antimicrobial therapy (OPAT) with continuous infusion IV benzylpenicillin plus bolus/continuous infusion IV ceftriaxone., Patients and Methods: We retrospectively reviewed adults who received at least 2 weeks duration of OPAT for E. faecalis endocarditis with the above treatment regimen in the Auckland and Christchurch regions between July 2019 and September 2022., Results: Forty-four patients met inclusion criteria. Fifteen were female (34%). The median age was 80 (IQR 71.5 to 84) years. Twenty-two (50%) had prosthetic valve (PV), 15 (34%) native valve (NV), 3 (7%) NV and/or cardiac implantable electronic device (CIED) infection, 3 (7%) PV and/or CIED infection, and 1 (2%) repaired valve endocarditis. Patients received a median of 16.5 days inpatient and 28 days OPAT antibiotic treatment. The 12 month outcome was cure ( n  = 25; 57%), antibiotic suppression ( n  = 9; 20%), relapse ( n  = 2; 5%; both possible) or death ( n  = 8; 18%). Compared with a historical cohort treated with OPAT continuous infusion IV benzylpenicillin plus bolus IV gentamicin, there was no difference in the relapse rate., Conclusions: This study adds to the accumulating evidence supporting the treatment of E. faecalis endocarditis with OPAT continuous infusion IV benzylpenicillin plus bolus/continuous infusion IV ceftriaxone. This is an option for patients requiring further antibiotic treatment at the time of hospital discharge., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Published
2024
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