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August 2023 NCICT Newsletter

View the August NCIC Seminar

Prof Karin Thursky and Mr Nikhil Singh

Exploring the Pros and Cons of Fluoroquinolone Prophylaxis in Neutropenic Fever HERE.

World Sepsis Day,

Sept 13th

We are also hosting World Sepsis Day activities on Sept 13th, with plenty of cupcakes and give away’s. Keep your eyes out for our AMS NP Belinda Lambros if you are in the precinct.

ANZMIG Mycology Masterclass 2023

2nd - 4th November

NCIC Presenters: A/Prof Ben Teh and Dr Michelle Yong

Dear all,

September is looking like another busy month for NCIC with plenty of upcoming meetings and activities. Next week I will be giving the NCIC Seminar for September on New Antifungals. Sept 7th at 12.30pm. You can register for the zoom link below. 

International Visitors

September is also a busy month for visitors to our centre. We will be hosting Drs Galadriel Pellejero from Spain,  Dr Daphne Lau from Hong Kong and Dr Yan and Shih Han Chen from Taiwan. Drs Pellejero and Lau will be joining us for several months to observe our clinical practice and AMS activities in particular. While Dr Yan and Shih Han will be joining us for 2 weeks to learn how we run our clinical trial group. Welcome to all our International visitors!

Eureka Prize

Congratulations also to our colleagues at the Doherty Professor Katherine Kedzierska, PhD FAHMS and Dr Oanh Nguyen on your much deserved Eureka prize! It is wonderful collaborating with your group and the insights into vaccine responses in cancer are so valuable to our patients. Enjoy this wonderful recognition of your contribution to science.

NCIC Symposium and Workshop

In person, Friday 6th October 2023, 10am-4pm, Graduate House, UoM

Pathways to better infection care in cancer

A full day symposium providing a comprehensive update on new pathways of care and novel interventions to deliver best practice care for treating and preventing infection in cancer. This symposium will be practical and interactive, with the opportunity to speak with experts in infectious diseases, health services research and implementation to help tailor interventions to your setting.

Venue: Graduate house, University of Melbourne, Melbourne, Australia.  220 Leicester Street Carlton VIC 3053

Target audience: Medical, nursing, pharmacy practitioners involved in cancer care, including regional centres.

Ticket price: $150 for medical practitioners, $50 for nurses/pharmacist/allied health

Feature Paper

Risky business: The impact of antimicrobial prescribing on multidrug-resistant Gram-negative BSIs in acute myeloid leukemia patients.

Transplant Infectious Disease

Beatrice Z Sim, Monica A Slavin, Abby P Douglas

The editorial written by our fellow Dr Beatrice Sim under the guidance of Dr Abby Douglas and Prof Monica Slavin discusses a paper in TID correlating duration of antibiotics and emergence of resistant gram negative infection in AML patients. The theme of shorter duration of antibiotics is also discussed in the paper by Imlay, Laundy et al and is one we are focussing on with upcoming studies in collaboration with our haematology colleagues. A/Prof Gab Haeusler is already conducting an electronic medical record-embedded randomised clinical trial comparing shorter course antibiotics to standard course in children with fever and neutropenia at RCH and MCRI and we are currently in the process of designing a similar study in adult patients. This topic is very relevant to our patients and we aim to soon add to the evidence around stopping antibiotics early in stable patients with fever and neutropenia.

Recent publications

Shorter antibiotic courses in the immunocompromised: the impossible dream? Imlay et al

The antifungal pipeline for invasive fungal diseases: what does the future hold? Neoh et al

Parvovirus B19 in stem cell transplantation. Kinsella et al

Invasive fungal infections after CLAG-M/CLAG chemotherapy for acute myeloid leukemia and high-grade myeloid neoplasms. Lindsay et al

Invasive aspergillosis in liver transplant recipients. Melenotte et al

Multidrug-resistant Enterobacterales infections in abdominal solid organ transplantation. Pilmis et al

Risky business: The impact of antimicrobial prescribing on multidrug-resistant Gram-negative BSIs in acute myeloid leukemia patients. Sim et al

Rezafungin versus caspofungin for treatment of candidaemia and invasive candidiasis (ReSTORE): a multicentre, double-blind, double-dummy, randomised phase 3 trial. Thompson et al

Kind regards

Prof Monica Slavin, MBBS, MD, FRACP, FAAHMS
Head, Department Infectious Disease, Peter MacCallum Cancer Centre

Professor of Infection in Cancer and Transplantation, University of Melbourne Department of Infectious Diseases and the Sir Peter MacCallum Department of Oncology

Director, National Centre for Infections in Cancer and Transplantation

July 2023 NCICT Newsletter

Dear all,

We are very proud to announce two new grants, one to Prof Leon Worth, “Appling artificial intelligence for surveillance of infections in cancer”, and one to Prof Karin Thursky “Optimising real world data use to drive cancer care delivery and research”. Both were awarded through the MRFF National Critical Research Infrastructure Initiative, to a total value of over $5.5 million over the next 5 years. Congratulations to both, we are looking forward to working closely with NCIC collaborators at RMIT (School of Computer Science), Biogrid, Melbourne Health and UoM (Centre for digital transformation of Health) on these initiatives.  These initiatives will be crucial to driving research froward in the current era of data science, big data and artificial intelligence.

Our very own AMS NP Belinda Lambros represented NCICT in Adelaide at the Cancer Nurses Society of Australia (CNSA) annual meeting, giving a workshop in Advanced Practice of ID. Great work Bel!

Congratulations also to NCIC PhD Dr Beatrice Sim on her appointment to the ASID council as a new representative.

Seminars and Journal Club

NCICT Journal Club

Monthly, Fridays 12 pm

The next NCICT Journal Club series is this Friday July 28th 12-1 pm with NCICT NP Belinda Lambros and nurse PhD candidate Alison Lemoh presenting. Sign up for a live link to the NCIC Journal Club series HERE.

Papers:

Quality of life and mortality in older adults with sepsis after one-year follow up: A prospective cohort study demonstrating the significant impact of frailty. Dong et al

A call for better doctor nurse collaboration: A qualitative study of the experiences of junior doctors and nurses in escalating care for deteriorating ward patients. Legido-Quigley et al

Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review. Chua et al

 

NCICT Seminar series

Upcoming

Thursday August 3rd, 12.30-1.30

Exploring the Pros and Cons of Fluoroquinolone Prophylaxis in Neutropenic Fever

Prof Karin Thrursky and Nikhil Singh

Register for link HERE

Previous

Dr Michelle Yong: New developments in managing CMV in transplant recipients

View HERE

Feature Paper

COVID-19 infection among patients with cancer in Australia from 2020 to 2022: a national multicentre cohort study

The Lancet Regional Health - Western Pacific

Victoria G. Hall, Beatrice Z. Sim, Chhay Lim, Christopher Hocking, Teddy Teo, Naomi Runnegar, Peter Boan, Christopher H. Heath, Natalie Rainey, Megan Lyle, Christopher Steer, Eunice Liu, Cassandra Doig, Kate Drummond, Patrick G.P. Charles, Katharine See, Lyn-Li Lim, Omar Shum, Narin Bak, Sue-Anne Mclachlan…Benjamin W. Teh.

The largest study to date into the pandemic’s impact on Australian cancer patients - a uniquely vulnerable group - has found the rate of deaths did not meet international projections and attributes the wide uptake of COVID vaccinations, less severe omicron variant and early intervention antiviral treatments, as saving lives. 

The study led by NCICT PhD candidate Dr Victoria Hall and Dr Ben Teh assessed 620 cancer patients across 15 Australian hospitals who caught COVID-19 from March 2020 to April 2022. 

 All-cause mortality in these patients in the 100 days after their COVID-19 infection was 10.6% overall – well below the mortality figures seen internationally of 30% to 38% for patients with blood cancers, considered one of the highest risk groups.

 “We found overall that one in ten Australian cancer patients who caught COVID-19 died within 100 days of the infection, either as a result of COVID-19 or an unrelated cause, and while this is a significant loss of human life it is well short of what was seen elsewhere for this vulnerable patient group,”  

“Contributing factors include that most Australian cancer patients caught COVID-19 in early 2022 during the Omicron wave and after COVID vaccines had become widely available, and there were also measures in place to rapidly detect infections and provide early protective antiviral treatments to this group.”

Dr Hall said that this study found that the Omicron variant also appears to be less severe than previous strains in patients with cancer, similar to what has been suggested in the general population. The average age of Australian cancer patients who caught COVID-19 was 63.5 years, with slightly more men (50.6%) and overall, 73.4% were vaccinated against COVID-19.

The rate of deaths declined over the course of the pandemic, with all-cause mortality in 2020 at 25.6% but in 2022 it was 8.1% in patients with cancer and COVID-19.

 “Just as we saw deaths in this vulnerable group decline over time there were also consistent drops in the rate of patients needing a hospital stay of more than 24 hours, those who required oxygen or an ICU stay, and those who required mechanical ventilation,” Dr Hall said. 

Kind regards

Prof Monica Slavin, MBBS, MD, FRACP, FAAHMS
Head, Department Infectious Disease, Peter MacCallum Cancer Centre

Professor of Infection in Cancer and Transplantation, University of Melbourne Department of Infectious Diseases and the Sir Peter MacCallum Department of Oncology

Director, National Centre for Infections in Cancer and Transplantation

May 2023 NCICT Newsletter

Dear all,

 April was an incredibly busy month for conference attendance.

 ECCMID

I was honoured to give the opening plenary lecture (entitled Frontiers in the diagnosis and management of infections in the immunocompromised host) at the European Conference on Clinical Microbiology and Infectious Diseases (ECCMID); the largest international Infectious Diseases meeting attended by 15,000 delegates, May 2023, Coppenhagen. 

Also present to represent Peter Mac and the Infectious diseases research being conducted by the National Centre for Infections in Cancer and Transplantation (NCICT) were Prof Karin Thursky, A/Prof Gabrielle Haeusler, Drs Michelle Yong, Victoria Hall, Daniel Yeoh, Gemma Reynolds and Ms Kar Yee Yong. All listed presented research and Dr Ben Teh also attended to support presentations by PhD students.

ASID

We had 3 PhD candidates presenting as well as one masters of public health student represent at ASID. Highlights include being awarded a lifetime member and having my name on the Adelaide oval scoreboard

Otherhighlights were Dr Shio Yen Tio winning the 2023 ANZMIG Mycology SIG award and meeting Professor Glaukenflucken.

@NCICancer twitter has now reached influencer status with over 1000 followers

 

May also saw NCICT Drs, Michelle Yong, Liv Smibert, Beatrice Sim, Megan Crane and Shio Yen Tio attend the Fred Hutch Symposium on Infections in the immunocompromised Host in Seattle and Rachel Woolstencroft, Drs Ben Teh, Zoe Neoh and Karin Thursky present at the Peter Mac Research Symposium. Jason Trubiano held a highly successful drug allergy symposium at the Doherty shortly after his appointment to full Professor. Congratulations Prof Trubiano!

Seminars and Journal Club

NCICT Journal Club

Monthly, Fridays 12 pm

The third of the 2023 monthly NCICT Journal Club series is this Friday June 2nd 12-1 pm with Dr. Morgan Rose presenting. Sign up for a live link to the NCIC Journal Club series HERE.

 

NCICT Seminar series

Thursday June 8th, 12.30-1.30

Dr Michelle Yong: New developments in managing CMV in transplant recipients

Register for link

Feature Paper

Current epidemiology and clinical features of Cryptococcus infection in patients without HIV infection: a multicentre study in 46 hospitals from Australia and New Zealand.

Clin Infect Dis. 2023 May 26:ciad321. doi: 10.1093/cid/ciad321. Epub ahead of print. PMID: 37235212.

Coussement J, Heath CH, Roberts MB, Lane RJ, Spelman T, Smibert OC, Longhitano A, Morrissey O, Nield B, Tripathy M, Davis JS, Kennedy KJ, Lynar SA, Crawford LC, Crawford SJ, Smith BJ, Gador-Whyte AP, Haywood R, Mahony AA, Howard JC, Walls GB, O'Kane GM, Broom MT, Keighley CL, Bupha-Intr O, Cooley L, O'Hern JA, Jackson JD, Morris AJ, Bartolo C, Tramontana AR, Grimwade KC, Au Yeung V, Chean R, Woolnough E, Teh BW, Chen SC, Slavin MA; Australian and New Zealand study group for cryptococcosis in patients without HIV infection.

During his 2 years at NCIC in Melbourne, visiting ID physician Dr Julien Coussement completed this study of cryptococcosis in patients without HIV infection showing that in Australia and New Zealand this is by far the most common population in which cryptococcosis is seen. Whilst around 60% of this population have a recognised form of immunocompromise, the rest do not. Signs and symptoms may be subtle, or not present at all, as evidenced by the 16% of cases where cryptococcosis was an incidental finding on imaging performed for another reason. Interestingly, in this population CNS involvement was often predicted by a high serum cryptococcal antigen or fungemia. This work helps our understanding of the infection outside of the population of people living with HIV. Congratulations Julian for co-ordinating the 46 sites in Australia and New Zealand-no mean feat! Many thanks to all our collaborators who are acknowledged as authors or as members of the Australian and New Zealand study group for cryptococcosis in patients without HIV infection in the journal and on-line.

Kind regards

Prof Monica Slavin, MBBS, MD, FRACP, FAAHMS
Head, Department Infectious Disease, Peter MacCallum Cancer Centre

Professor of Infection in Cancer and Transplantation, University of Melbourne Department of Infectious Diseases and the Sir Peter MacCallum Department of Oncology

Director, National Centre for Infections in Cancer and Transplantation

March 2023 NCICT Newsletter

Dear all,

For this month’s newsletter I am pleased to feature our newly promoted General Manager, Infectious Diseases, Peter MacCallum Cancer Centre- Dr Megan Crane PhD, MIDI. Megan began with us in 2017 as the Research Manager for the newly awarded NCIC Centre for Research Excellence with 10 years’ experience as a laboratory Post Doc in Immunology. Over her last 6 years as Research Manager, she has been instrumental in developing and implementing the strategic, operational and business plans of the department, growing the department from 10 people with an annual operating budget of $500,000 to a multidisciplinary clinical research team of 36 with an annual budget of $2 million. During this time Megan also completed a Masters of Infectious Disease Intelligence (UNSW).   I am extremely pleased to have supported Megan in her promotion to General Manager of ID at Peter Mac, a well deserved reflection of her hard work and commitment to world’s best cancer care.  

 

Congratulations Megan, we look forward to continued growth and development of the National Centre for Infections in Cancer and Transplantation.

Congratulations also to Drs Shio Yen Tio and Beatrice Sim on being successful recipients of an  Abstract and Travel Stipend Award - 4th Symposium on Infectious Diseases in the Immunocompromised Host, to present their work at Fred Hutch, Seattle in May this year. Drs Sim and Tio and other NCICT researchers will be attending to share experience and build collaborations with the international transplant infectious diseases community. We are also looking forward to seeing many of our ID colleagues at ASID 2023 this weekend and will have 3 abstracts presented by our research team.

We also have 7 abstracts to be presented at ECCMID and I will be giving a keynote lecture on Frontiers in Infection in the ICH.  Well done to the team for having abstracts accepted at these 3 important meetings.

Seminars and Journal Club

NCICT Journal Club

Monthly, Fridays 12 pm

The second of the 2023 monthly NCICT Journal Club series is this Friday March 31st 12-1pm with Dr. Gemma Reynolds (paper) and Dr. Pedro Puerta (Fungal Infection in ICH) .Sign up for a live link to the NCIC Journal Club series HERE.

 

You can now view the recording of Prof Graeme Forrest who gave a fantastic presentation at the NCICT Seminar Series on AMS in TID HERE

 

The Straight and Marrow Podcast

Podcast | Straight and Marrow

Dr Michelle Yong (guest episode 13), an infectious diseases expert, answers all of our questions about infectious diseases in bone marrow transplant patients. We discuss neutrophils, cytomegalovirus, preventative measures and discuss what is the real “F” word in transplantation.

Publication highlight

Robust SARS-CoV-2 T cell responses with common TCRαβ motifs towards COVID-19 vaccines in haematological malignancy patients impacting B cell immunity

Thi H O Nguyen, Louise C Rowntree, Lilith F Allen, Brendon Y Chua, Lukasz Kedzierski, Chhay Lim, Masa Lasica, G Surekha Tennakoon, Natalie R Saunders, Megan Crane, Lynette Chee, John F Seymour, Mary Ann Anderson, Ashley Whitechurch, E Bridie Clemens, Wuji Zhang, So Young Chang, Jennifer R Habel, Xiaoxiao Jia, Hayley A McQuilten, Anastasia A Minervina, Mikhail V Pogorelyy, Priyanka Chaurasia, Jan Petersen, Tejas Menon, Luca Hensen, Jessica Neil, Francesca L Mordant, Hyon-Xhi Tan, Aira F Cabug, Adam K Wheatley, Stephen J Kent, Kanta Subbarao, Theo Karapanagiotidis, Han Huang, Lynn K Vo, Natalie L Cain, Suellen Nicholson, Florian Krammer, Grace Gibney, Fiona James, Janine M Trevillyan, Jason A Trubiano, Jeni Mitchell, Britt Christensen, Katherine A Bond, Deborah A Williamson, Jamie Rossjohn, Jeremy Chase Crawford, Paul G Thomas, Karin A Thursky, Monica A Slavin, Constantine S Tam, Benjamin W Teh, Katherine Kedzierska

Published in Cell Reports Medicine (preprints), led by University of Melbourne Professor Katherine Kedzierska (Doherty Institute), in collaboration with Associate Professor Benjamin Teh, Professor Monica Slavin, Surekha Tennakoon, Natalie Suanders, Dr Megan Crane  and Professor Jason Trubiano (NCICT).

Despite being heavily immunocompromised, haematology patients generate strong cellular immune responses against SARS-CoV-2 after vaccination, on par with that of healthy individuals. The research team undertook the most comprehensive analysis of adaptive SARS-CoV-2 immunity to date in haematology patients of varying diseases and treatments across three doses of COVID-19 vaccination in comparison to healthy individuals.

Professor Kedzierska says that the study provides key insights for future immunisation strategies with vaccines such as influenza which predominantly induce B cell immune responses.

“What we have shown is that people with co-morbidities that have a heavily impacted B cell immune arm, can have an mRNA vaccine to elicit T cells and give them that extra level of protection,” Professor Kedzierska says

Associate Professor Teh says this research is important for clinicians working with blood cancer patients.

“Clinicians can be confident that it is safe and beneficial for their patients, who are heavily immunocompromised and vulnerable to severe COVID-19 infection, to receive vaccination against SARS-CoV-2. Regardless of their diseases and treatments, COVID-19 vaccination generates strong T cell immunity in this group,” Associate Professor Teh says.

Recent Publications

Survey of treatment practices for immunocompromised patients with COVID-19 in Australasia.

Moso MA, Sasadeusz J, Morrissey CO, Bond K, Guy S, Slavin MA, Dendle C.Intern Med J. 2023 Mar 17. doi: 10.1111/imj.16064. Online ahead of print.PMID: 36929677

 Invasive aspergillosis in liver transplant recipients.

Melenotte C, Aimanianda V, Slavin M, Aguado JM, Armstrong-James D, Chen YC, Husain S, Van Delden C, Saliba F, Lefort A, Botterel F, Lortholary O.Transpl Infect Dis. 2023 Mar 16:e14049. doi: 10.1111/tid.14049. Online ahead of print.PMID: 36929539 Review.

 Infectious complications of bispecific antibody therapy in patients with multiple myeloma.

Sim BZ, Longhitano A, Er J, Harrison SJ, Slavin MA, Teh BW.Blood Cancer J. 2023 Mar 10;13(1):34. doi: 10.1038/s41408-023-00808-8.PMID: 36894539 Free PMC article. No abstract available

View all NCICT publications HERE

Kind regards

Prof Monica Slavin, MBBS, MD, FRACP, FAAHMS
Head, Department Infectious Disease, Peter MacCallum Cancer Centre

Professor of Infection in Cancer and Transplantation, University of Melbourne Department of Infectious Diseases and the Sir Peter MacCallum Department of Oncology

Director, National Centre for Infections in Cancer and Transplantation

A new model of care for Australia

Published this month in Supportive Care Cancer, we report on the implementation of a nurse led program sending patients at low risk of medical complications from neutropenic fever following chemo, home,  to be managed in an outpatient setting.

Read the full study HERE

Our results show a reduction in median length of hospital stay from 4.0 to 1.1 days and a reduction in admission cost from $8,580 to $2,360 with a net cost benefit of $71,895. Not to mention that there's "No Place Like Home".

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