The research of the Infectious Diseases Group focuses on improving the diagnosis, treatment and prevention of infectious diseases in children. It comprises both clinical and laboratory-based research studies. The clinical research aspect includes randomised controlled trials, observational studies and systematic reviews of best practice. Our laboratory research encompasses basic and applied medical microbiology, as well as immunological studies to explore the mechanisms by which pathogens cause disease and their interaction with the host immune response.
We have a particular interest in infections that are important to child health worldwide such as tuberculosis and other respiratory infections, diarrhoeal illnesses and neonatal sepsis. A key focus of our current work is the investigation of the heterologous effects of BCG vaccination. The team are investigating the hypothesis that the immunomodulatory effects of BCG influence the development of infant immunity to enhance protection against infections and reduce susceptibility to allergic disease.
BCG vaccination to Reduce the impact of COVID-19 in Australian healthcare workers following Coronavirus Exposure (BRACE) Trial
4,000 health care workers are about to be given the tuberculosis vaccine to see if it can help shield them from coronavirus. It's hoped the vaccine will boost their immune systems and prevent them from getting sick. | @CandiceWyatt10 #covid19australia #coronavirusaustralia pic.twitter.com/NbAIPhVnlF— 10 News First Melbourne (@10NewsFirstMelb) March 27, 2020
MIS BAIR - BCG for allergy and infection reduction study
Our research uses a combination of basic, clinical and epidemiology research to investigate a wide range of topics including:
- BCG vaccination to Reduce the impact of COVID-19 in Australian healthcare workers following Coronavirus Exposure (BRACE) Trial
- Heterologous effects of vaccines
- Childhood tuberculosis
- Immune response to BCG
- Clinical infectious diseases
- E. coli diarrhoeal disease research
The BRACE trial
BCG vaccination to Reduce the impact of COVID-19 in Australian healthcare workers following Coronavirus Exposure
In addition to protecting against its target disease, tuberculosis, BCG vaccine has beneficial off-target (‘heterologous’ or ‘non-specific’) effects on the immune system that provide protection against a diverse range of pathogens, including viral infections 1,2. The ability of BCG vaccination to enhance the immune response could be exploited to provide protection against COVID-19.
- It is almost inevitable that the COVID-19 pandemic (caused by SARS-CoV-2) will dramatically worsen placing a great strain on hospital resources. In the Southern hemisphere, this is likely to coincide with the influenza season.
- Health care worker absenteeism due to COVID-19 and other respiratory infections will exacerbate the pressure on the health care system.
- There are currently no vaccines or other prophylactic therapeutic interventions available to protect health care workers at the frontline exposed to SARS-CoV-2.
- BCG vaccination induces changes in the innate immune system that lead to a stronger response to subsequent infections - this relatively new finding has been termed ‘trained immunity’ 3.
- In a human challenge model, BCG vaccination reduced viraemia by over 70% and improved anti-viral responses using the yellow fever vaccine virus as an experimental viral infection. This virus is a single-stranded, positive-sense RNA virus like SARS-CoV-2 4.
- In animal models, BCG protects against mortality from a range of viral infections, including single-stranded, positive sense RNA viruses 5,6.
- In two randomised trials in adults (one in the elderly), BCG reduced the incidence of acute upper respiratory tract infections by 70-80% 7,8.
- Two epidemiological studies (including a 25-year study of over 150,000 children from 33 countries) reported a ~40% lower risk of acute lower respiratory tract infections in BCG-vaccinated children 9,10.
- BCG vaccination has been associated with increased immune responses to subsequent infant vaccines 11,12.
- In high-mortality settings, BCG vaccination reduces all-cause infant mortality by more than a third and protection is observed within 7 days of vaccination 13.
- A recent WHO-commissioned systematic review concluded that BCG vaccine had beneficial off-target effects. WHO subsequently recommended further randomised trials to provide more information about these effects 14.
Relevance & Significance
If BCG vaccination protects against COVID-19, this has implications beyond the effect on the individual, by potentially reducing spread of the virus and the burden on healthcare costs and resources. It has clear global significance, as this is a readily available and cheap intervention that could be used in future pandemics before a disease-specific vaccine is developed.
Enhanced immunity induced by BCG vaccination will provide protection against COVID-19 (symptomatic disease or severity of illness).
Primary Objective (over 6 months)
To determine whether, in HCW in Australia exposed to SARS-CoV-2 (Participants), does BCG vaccination (Intervention) compared with no BCG vaccination (Comparator) reduce the prevalence and severity (hospitalisation or death) of COVID-19 (Outcome) measured over the 6 months following randomisation (Time).
- A multi-centre randomised controlled trial in HCW in Australia at risk of SARS-CoV-2 exposure.
- Outcomes collected and measured by the following:
- Self-reported online-based questionnaires
- Regular telephone/SMS follow-up
- Healthcare records
- Biospecimens for confirmation of SARS-CoV-2 infection.
- Immunological sub-study.
Safety of BCG and Revaccination
BCG vaccination in immunocompetent adults is considered safe even if they have previously been vaccinated with BCG or have previously been exposed to tuberculosis 7,15,16.
BCG adverse effects (e.g. injection site abscess) are rare; >120 million doses given each year worldwide.
A repeat dose of BCG vaccine improves off-target protection.
For more information visit the BRACE Trial webpage.
Heterologous effects of vaccines
Bacillus Calmette–Guérin (BCG) vaccine which is given to over 80% of infants worldwide to protect against TB, has an additional substantial effect on all-cause infant mortality in high-mortality settings by providing ‘heterologous’ or ‘non-specific’ protection against other infections. It is believed that this results from the well-established immunomodulatory effects of BCG. These beneficial non-specific effects of BCG may also include reducing susceptibility to allergic disease such as food allergy, eczema and asthma.
The MIS BAIR randomised controlled trial
The Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) is an Australian NHMRC-funded randomised controlled trial (RCT) that will assess the effect of neonatal BCG vaccination on clinical allergy and infection outcomes in infants in Melbourne. Over 1200 infants were randomised to BCG or no BCG at birth and will be followed up for five-years.
Using three-six monthly online questionnaires together with clinial test to determine the prevalence of allergy to food and other allergens, MIS BAIR will determine if BCG vaccination leads to a reduction the following clinical outcomes by one and five years of age
- food sensitisation
- lower respiratory tract infection
- asthma (5 years only)
Non-specific immunological effects
Our unique cohort of BCG vaccinated and BCG naïve infants who are being followed up longitudinally from birth in the MIS BAIR study provides us with the unparalleled opportunity to investigate the immunological and molecular mechanisms by which BCG mediates beneficial heterologous protective immunity.
To this end, in addition to the clinical allergy and infection outcomes, we are collecting a large number of biosamples, for immunological and studies. These include the following:
- venous blood at seven days, six months, one year and five years of age
- stool samples daily for the first seven days of life and at one year of age for microbiome analyses
The BabyBAIR study
In this cohort study we are investigating how BCG vaccination modifies the immune response to subsequent (in vitro) challenge with viral and bacterial pathogens unrelated to TB in healthy children and young adults.
ELVIS (Early Life Vaccine Immunity Study)
This is a randomised controlled trial to determine the heterologous effects of BCG and Hepatitis B vaccination at birth on neonatal immune responses.
It is designed to investigate the possible interaction between these two vaccines on the innate and adaptive immune response in the first 7 days of life.
Approximately 1.3 million new cases of active TB occur in children under 15 years of age and TB claims the lives of over half a million children annually, despite TB being a treatable disease. Our TB research focuses on creating new techniques for the diagnosis of childhood TB, and understanding the immune response and adverse events of BCG (the current TB vaccine). We have a number of clinical and epidemiological projects.
Biomarkers for immunodiagnosis and monitoring of TB
We have identified novel Mycobacterium tuberculosis (MTB)-specific cytokine response biomarkers in blood that have the potential to improve the immune-based diagnosis of TB and, critically, distinguish between active TB and latent TB infection (LTBI).
Our current studies assess the validity of these biomarkers, TST and IGRA in children in both high and low TB prevalence settings.
This NHMRC funded study recruited 149 children and found a number of novel cytokine responses that can distinguish between TB-uninfected and TB-infected children. In addition, some of these cytokines have the ability to distinguish between latent TB infection and active TB.
Further participants are currently being recruited to validate these findings in children in Melbourne children. Also, the TB biomarkers identified in this project are currently undergoing further investigation in two further studies (VIDA and the Peru project) in adults and children. These studies will assess the performance of the biomarkers in different age-groups and settings (low and high TB prevalence), a key step in the development of a novel TB test for clinical use.
Peru childhood TB diagnosis project
This NHMRC funded study will recruit children in Lima, Peru, to determine sensitivity and specificity of our novel biomarkers in children in a high TB prevalence setting. This validation is a critical step in the development of a new generation of low cost, point-of-care immunodiagnostic assays for TB. In this prospective cohort study, we are enrolling over 400 children children aged 0-14 years which suspected active TB or who are household contacts of adult TB patients and thus at high risk of latent TB infection or TB disease.
Epidemiology of childhood TB in Victoria
- Epidemiology of active TB in Victoria
- Study of the management of child contacts of adults with TB in Victoria
Mycobacterial-specific response to BCG
In addition to investigating the non-specific effects of BCG we are also investigating the mycobacterial-specific response to BCG immunisation. These studies are investigating the immune response to BCG and the influence of vaccine strain, age of administration (birth vs 2 months, and child vs adult) and maternal vaccination on response to BCG. Further studies will be undertaken as part of the MIS BAIR and BabyBAIR studies
Clinical infectious diseases
Research is conducted in close collaboration with the clinical infections diseases team at The Royal Children’s Hospital. We have a large number of ongoing projects on a wide range of topics including the following.
- VANC trial: RCT of continuous versus intermittent dosing of vancomycin in neonates
- Antibiotic penetration of CSF
- Staphylococcus aureus bacteraemia in children
- Candida study
- Stethocloud project
E. coli diarrhoeal disease research
Understanding how Escherichia coli causes diarrhoea
We are studying E. coli to discover how certain types are able to cause diarrhoea and other diseases. The aim of this research is to develop tools that will allow us to distinguish pathogenic from harmless E. coli varieties and to develop interventions to treat and prevent infections with these bacteria.
Prevention of infections with enterotoxigenic Escherichia coli
Enterotoxin-producing strains of E. coli are an important cause of diarrhoea and death in children in developing countries, and the commonest cause of travellers' diarrhoea worldwide. As no effective vaccines are available for these infections, we are investigating a novel technique for vaccine delivery to develop one. We are also working on strategies to prevent travellers' diarrhoea that do not require immunisation.
1. Pollard AJ, Finn A, Curtis N. Non-specific effects of vaccines: plausible and potentially important, but implications uncertain. Arch Dis Child 2017; 102(11): 1077-81.
2. Higgins JP, Soares-Weiser K, Lopez-Lopez JA, Kakourou A, Chaplin K, Christensen H, Martin NK, Sterne JA, Reingold AL. Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review. BMJ (Clinical research ed) 2016; 355: i5170.
3. Kleinnijenhuis J, Quintin J, Preijers F, Joosten LA, Ifrim DC, Saeed S, Jacobs C, van Loenhout J, de Jong D, Stunnenberg HG, Xavier RJ, van der Meer JW, van Crevel R, Netea MG. Bacille Calmette-Guerin induces NOD2-dependent nonspecific protection from reinfection via epigenetic reprogramming of monocytes. Proc Natl Acad Sci U S A 2012; 109(43): 17537-42.
4. Arts RJW, Moorlag S, Novakovic B, Li Y, Wang SY, Oosting M, Kumar V, Xavier RJ, Wijmenga C, Joosten LAB, Reusken C, Benn CS, Aaby P, Koopmans MP, Stunnenberg HG, van Crevel R, Netea MG. BCG Vaccination Protects against Experimental Viral Infection in Humans through the Induction of Cytokines Associated with Trained Immunity. Cell Host Microbe 2018; 23(1): 89-100 e5.
5. Freyne B, Marchant A, Curtis N. BCG-associated heterologous immunity, a historical perspective: intervention studies in animal models of infectious diseases. Trans R Soc Trop Med Hyg 2015; 109(4): 287.
6. Moorlag S, Arts RJW, van Crevel R, Netea MG. Non-specific effects of BCG vaccine on viral infections. Clin Microbiol Infect 2019; 25(12): 1473-8.
7. Nemes E, Geldenhuys H, Rozot V, Rutkowski KT, Ratangee F, Bilek N, Mabwe S, Makhethe L, Erasmus M, Toefy A, Mulenga H, Hanekom WA, Self SG, Bekker LG, Ryall R, Gurunathan S, DiazGranados CA, Andersen P, Kromann I, Evans T, Ellis RD, Landry B, Hokey DA, Hopkins R, Ginsberg AM, Scriba TJ, Hatherill M, Team CS. Prevention of M. tuberculosis Infection with H4:IC31 Vaccine or BCG Revaccination. N Engl J Med 2018; 379(2): 138-49.
8. Wardhana, Datau EA, Sultana A, Mandang VV, Jim E. The efficacy of Bacillus Calmette-Guerin vaccinations for the prevention of acute upper respiratory tract infection in the elderly. Acta Med Indones 2011; 43(3): 185-90.
9. Hollm-Delgado MG, Stuart EA, Black RE. Acute lower respiratory infection among Bacille Calmette-Guerin (BCG)-vaccinated children. Pediatrics 2014; 133(1): e73-81.
10. de Castro MJ, Pardo-Seco J, Martinon-Torres F. Nonspecific (Heterologous) Protection of Neonatal BCG Vaccination Against Hospitalization Due to Respiratory Infection and Sepsis. Clin Infect Dis 2015; 60(11): 1611-9.
11. Zimmermann P, Curtis N. The influence of BCG on vaccine responses - a systematic review. Expert Rev Vaccines 2018; 17(6): 547-54.
12. Messina NL, Zimmermann P, Curtis N. The impact of vaccines on heterologous adaptive immunity. Clin Microbiol Infect 2019; 25(12): 1484-93.
13. Shann F. Nonspecific effects of vaccines and the reduction of mortality in children. Clin Ther 2013; 35(2): 109-14.
14. SAGE Working Group on BCG Vaccines and WHO Secretariat. Report on BCG vaccine use for protection against mycobacterial infections including tuberculosis, leprosy, and other nontuberculous mycobacteria (NTM) infections. Geneva: World Health Organization, 2017.
15. Hatherill M, Geldenhuys H, Pienaar B, Suliman S, Chheng P, Debanne SM, Hoft DF, Boom WH, Hanekom WA, Johnson JL. Safety and reactogenicity of BCG revaccination with isoniazid pretreatment in TST positive adults. Vaccine 2014; 32(31): 3982-8.
16. World Health Organization. Recommendations to assure the quality, safety and efficacy of BCG vaccines. In: WHO Expert Committee on Biological Standardization, editor. Geneva: World Health Organization; 2011. p. 1-48.
- Centre of Research Excellence on Tuberculosis Control
- Radboud University Nijmegen Medical Centre
- University of Oxford
- University College London
- Instituto de Medicina Tropical Alexander von Humboldt Cayetano Heredia University
- University of Melbourne
- Hudson Institute of Medical Research
- Groningen University Nijmegen Medical Centre
- Microbiological Diagnostic Unit Public Health Laboratory
- Victorian Infectious Diseases Reference Laboratory
- Association between the intestinal microbiota and allergic sensitization, eczema, and asthma: A systematic review. 2019
- BCG Vaccination and All-Cause Neonatal Mortality. 2019
- Continuous Versus Intermittent Vancomycin Infusions in Infants: A Randomized Controlled Trial. 2019
- Cytokine biomarkers for the diagnosis of tuberculosis infection and disease in adults in a low prevalence setting. 2019
- Effect of a pneumococcal whole cell vaccine on influenza A-induced pneumococcal otitis media in infant mice. 2019
- Factors That Influence the Immune Response to Vaccination. 2019
- Interpretation and management of discordant tuberculin skin test and interferon-gamma release assays results in children. 2019
- Itraconazole Dosing and Drug Monitoring at a Tertiary Children's Hospital. 2019
- Mycobacteria-Specific Mono- and Polyfunctional CD4+ T Cell Profiles in Children With Latent and Active Tuberculosis: A Prospective Proof-of-Concept Study. 2019
- Overexpression of IL-11 promotes premalignant gastric epithelial hyperplasia in isolation from germline gp130-JAK-STAT driver mutations. 2019
- Pulmonary Mycobacterium abscessus complex in children with cystic fibrosis: A practical management guideline. 2019
- Review article: A primer for clinical researchers in the emergency department: Part VII. Considering a research higher degree in emergency medicine: How does it work, where to start, what to consider. 2019
- The immunomodulatory effects of measles-mumps-rubella vaccination on persistence of heterologous vaccine responses. 2019
- The incidence, aetiology, and adverse clinical consequences of less severe diarrhoeal episodes among infants and children residing in low-income and middle-income countries: a 12-month case-control study as a follow-on to the Global Enteric Multicenter Study (GEMS). 2019
- The influence of neonatal Bacille Calmette-Guérin (BCG) immunisation on heterologous vaccine responses in infants. 2019
- The role of Cutibacterium acnes in auto-inflammatory bone disorders. 2019
- Unintended consequences of a cautious approach to e-cigarette laws. 2019
- Adequate or Inadequate? The Volume of Blood Submitted for Blood Culture at a Tertiary Children's Hospital. 2018
- Adverse effects of amphotericin B in children; a retrospective comparison of conventional and liposomal formulations. 2018
- Antibacterial activity of rhodomyrtone on Clostridium difficile vegetative cells and spores in vitro. 2018
- Arterial Structure and Function Following Viral Myocarditis. 2018
- Burden of Congenital Rubella Syndrome (CRS) in Bangladesh: Systematic review of existing literature and transmission modelling of sero-prevalence studies. 2018
- Can colony-forming unit testing be used to extend the shelf life of BCG vaccines? 2018
- Cardiovascular Risk After Kawasaki Disease - Findings From an Australian Case-Control Study. 2018
- Does BCG Vaccination Protect Against Nontuberculous Mycobacterial Infection? A Systematic Review and Meta-Analysis. 2018
- Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and sub-Saharan Africa. 2018
- Factors Influencing the Intestinal Microbiome During the First Year of Life. 2018
- Health service impact of testing for respiratory pathogens using cartridge-based multiplex array versus molecular batch testing. 2018
- Hear no evil, see no evil: a careful history with judicious use of imaging in detecting brain abscess. 2018
- Innate immune responses following Kawasaki disease and toxic shock syndrome. 2018
- Interlaboratory Comparison of the Pneumococcal Multiplex Opsonophagocytic Assays and Their Level of Agreement for Determination of Antibody Function in Pediatric Sera. 2018
- Meningococcal Meningitis Complicated by Ventriculitis in an Infant. 2018
- Neonatal BCG Vaccination Influences Cytokine Responses to Toll-like Receptor Ligands and Heterologous Antigens. 2018
- Pneumococcal haemolytic uraemic syndrome in the postvaccine era. 2018
- Protocol for a randomised controlled trial of continuous infusions of vancomycin to improve the attainment of target vancomycin levels in young infants: The VANC trial. 2018
- Question 1: Is it safe to use ivermectin in children less than five years of age and weighing less than 15 kg? 2018
- Seasonal variation in the performance of QuantiFERON-TB Gold In-Tube assays used for the diagnosis of tuberculosis infection. 2018
- Tackling the worsening epidemic of Buruli ulcer in Australia in an information void: time for an urgent scientific response. 2018
- The effect of aspirin on antibiotic susceptibility. 2018
- The Immunomodulatory Effects of Macrolides-A Systematic Review of the Underlying Mechanisms. 2018
- The influence of BCG on vaccine responses - a systematic review. 2018
- The influence of probiotics on vaccine responses - A systematic review. 2018
- The influence of the intestinal microbiome on vaccine responses. 2018
- Absence of evidence: antimicrobial prescribing in neonates, elderly and pregnant women. 2017
- Antimicrobial Effects of Antipyretics. 2017
- Bell's Palsy in Children (BellPIC): protocol for a multicentre, placebo-controlled randomized trial. 2017
- Congenital Cytomegalovirus: A European Expert Consensus Statement on Diagnosis and Management. 2017
- Control of Virulence Gene Expression by the Master Regulator, CfaD, in the Prototypical Enterotoxigenic Escherichia coli Strain, H10407. 2017
- Corticosteroids and infliximab impair the performance of interferon-γ release assays used for diagnosis of latent tuberculosis. 2017
- Evidence of Microvascular Changes in the Retina following Kawasaki Disease. 2017
- External Validation of Six Pediatric Fever and Neutropenia Clinical Decision Rules. 2017
- Hospital-in-the-Home - essential to an integrated model of paediatric care. 2017
- Increased aortic intima-media thickness following Kawasaki disease. 2017
- Infographic: Consensus statement on concussion in sport. 2017
- Macro- and Microvascular Parameters Following Toxic Shock Syndrome. 2017
- Mycobacteria-specific cytokine responses as correlates of treatment response in active and latent tuberculosis. 2017
- Mycobacterium gordonae Skin Infection in an Immunocompetent Child. 2017
- Non-specific effects of vaccines: plausible and potentially important, but implications uncertain. 2017
- Nontuberculous mycobacterial disease in childhood - update on diagnostic approaches and treatment. 2017
- QUESTION 1: What is the risk of a repeat reaction to amoxicillin or a cephalosporin in children with a history of a non-immediate reaction to amoxicillin? 2017
- Teicoplanin-Should We Be Doing Routine Therapeutic Drug Monitoring in Children? 2017
- The controversial role of breast milk in GBS late-onset disease. 2017
- Toxic shock syndrome - the seven Rs of management and treatment. 2017
- What dose of aspirin should be used in the initial treatment of Kawasaki disease? 2017
- Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines. 2016
- Brachial Plexus Palsy in Young Infants Harboring Osteomyelitis of the Humerus - Case Report and Review of the Literature. 2016
- Comparable CD4 and CD8 T cell responses and cytokine release after at-birth and delayed BCG immunisation in infants born in Australia. 2016
- Congenital Tuberculosis Complicated by Hemophagocytic Lymphohistiocytosis. 2016
- Early gut colonization by Bifidobacterium breve and B. catenulatum differentially modulates eczema risk in children at high risk of developing allergic disease. 2016
- Evolution of atypical enteropathogenic E. coli by repeated acquisition of LEE pathogenicity island variants. 2016
- Harnessing the beneficial heterologous effects of vaccination. 2016
- Kawasaki disease and cardiovascular risk: a comprehensive review of subclinical vascular changes in the longer term. 2016
- Nontuberculous Mycobacterial Disease in Children - Epidemiology, Diagnosis & Management at a Tertiary Center. 2016
- QUESTION 1: Are household contacts of patients with invasive group A streptococcal disease at higher risk of secondary infection? 2016
- Structural Determinants Defining the Allosteric Inhibition of an Essential Antibiotic Target. 2016
- The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS). 2016
- Toxic shock syndrome in Australian children. 2016
- Voriconazole dosing and therapeutic drug monitoring in children: experience from a paediatric tertiary care centre. 2016
- Anti-infective use in children and pregnancy: current deficiencies and future challenges. 2015
- ASO titer or not? When to use streptococcal serology: a guide for clinicians. 2015
- Australia-wide point prevalence survey of antimicrobial prescribing in neonatal units: how much and how good? 2015
- BCG-associated heterologous immunity, a historical perspective: experimental models and immunological mechanisms. 2015
- BCG-associated heterologous immunity, a historical perspective: intervention studies in animal models of infectious diseases. 2015
- Complementary and alternative medicine use among paediatric emergency department patients. 2015
- Control of acid resistance pathways of enterohemorrhagic Escherichia coli strain EDL933 by PsrB, a prophage-encoded AraC-like regulator. 2015
- Cytokines for monitoring anti-tuberculous therapy: A systematic review. 2015
- Diagnostic Tests for Childhood Tuberculosis: Past Imperfect, Present Tense and Future Perfect? 2015
- Evolutionary adaptation of an AraC-like regulatory protein in Citrobacter rodentium and Escherichia species. 2015
- Interferon gamma release assays for monitoring the response to treatment for tuberculosis: A systematic review. 2015
- Monitoring Central Venous Catheter Resistance to Predict Imminent Occlusion: A Prospective Pilot Study. 2015
- Mycobacteria-Specific Cytokine Responses Detect Tuberculosis Infection and Distinguish Latent from Active Tuberculosis. 2015
- Plasma vascular endothelial growth factor A and placental growth factor: novel biomarkers of pulmonary hypertension in congenital diaphragmatic hernia. 2015
- Posaconazole: promising but problematic in practice in pediatric patients. 2015
- Serum IP-10 in the diagnosis of latent and active tuberculosis. 2015
- Site of fluorescent label modifies interaction of melittin with live cells and model membranes. 2015
- Streptococcal Serology: Secrets for the Specialist. 2015
- The impact of anti-tuberculous antibiotics and corticosteroids on cytokine production in QuantiFERON-TB Gold In Tube assays. 2015
- The management of non-tuberculous cervicofacial lymphadenitis in children: A systematic review and meta-analysis. 2015
- Effectiveness of clindamycin and intravenous immunoglobulin, and risk of disease in contacts, in invasive group a streptococcal infections. 2014
- Long-term persistence of immunity and B-cell memory following Haemophilus influenzae type B conjugate vaccination in early childhood and response to booster. 2014
- Novel concepts in the epidemiology, diagnosis and prevention of childhood tuberculosis. 2014
- Pristinamycin: old drug, new tricks? 2014
- Question 2: which infants with congenital cytomegalovirus infection benefit from antiviral therapy? 2014
- Streptococcal superantigens: categorization and clinical associations. 2014
- Ureaplasma--Are you sitting comfortably? 2014
- A type III effector antagonizes death receptor signalling during bacterial gut infection 2013
- Alteration of the thymic T cell repertoire by rotavirus infection is associated with delayed type 1 diabetes development in non-obese diabetic mice. 2013
- Antibiotic-resistant Gram-negative bacteremia in pediatric oncology patients--risk factors and outcomes. 2013
- Assembly of the type II secretion system such as found in Vibrio cholerae depends on the novel Pilotin AspS. 2013
- Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. 2013
- Carriage-associated Streptocccus pneumoniae serotype 1 in Brussels, Belgium. 2013
- Central line-associated bloodstream infection in children: an update on treatment. 2013
- Characterization of the ospZ Promoter in Shigella flexneri and Its Regulation by VirB and H-NS 2013
- Contribution of Secretory Antibodies to Intestinal Mucosal Immunity against Helicobacter pylori 2013
- Control of Bacterial Virulence by the RalR Regulator of the Rabbit-Specific Enteropathogenic Escherichia coli Strain E22. 2013
- Disarming bacterial virulence through chemical inhibition of the DNA binding domain of an AraC-like transcriptional activator protein. 2013
- Ethanol Lock Therapy in Pediatric Hematology and Oncology 2013
- Formal Infectious Diseases Consultations at a Tertiary Pediatric Hospital: A 14 Year Review 2013
- Heterologous ("nonspecific") and sex-differential effects of vaccines: epidemiology, clinical trials, and emerging immunologic mechanisms. 2013
- Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG? 2013
- Inhibition of Streptococcus pneumoniae adherence to human epithelial cells in vitro by the probiotic Lactobacillus rhamnosus GG. 2013
- Interferon-? release assays for the diagnosis of tuberculosis in children. 2013
- Maculatin 1.1 Disrupts Staphylococcus aureus Lipid Membranes via a Pore Mechanism 2013
- Masters, marionettes and modulators: intersection of pathogen virulence factors and mammalian death receptor signaling 2013
- Molecular markers for the study of streptococcal epidemiology. 2013
- Mycobacterium ulcerans infection in two alpacas. 2013
- Nasopharyngeal microbial interactions in the era of pneumococcal conjugate vaccination. 2013
- Neonatal Vancomycin Continuous Infusions: Still a Confusion? 2013
- Non-specific effect of Bacille Calmette-Guerin vaccine on routine immunisations 2013
- Otitis media among high-risk populations: can probiotics inhibit Streptococcus pneumoniae colonisation and the risk of disease? 2013
- Prednisolone added to intravenous immunoglobulin treatment improves outcome in children with severe Kawasaki disease. 2013
- Question 1: what are the options for treating latent TB infection in children? 2013
- RegR virulence regulon of rabbit-specific enteropathogenic Escherichia coli strain E22. 2013
- Reply: Bacille Calmette-Guérin vaccine: innate immunity and nonspecific effects. 2013
- Rotavirus acceleration of murine type 1 diabetes is associated with a T helper 1-dependent specific serum antibody response and virus effects in regional lymph nodes. 2013
- Sleep and infection: no snooze, you lose? 2013
- Successful Treatment of Refractory Immune Thrombocytopenia With Rituximab in a 10-Week-Old Infant 2013
- Susceptibility to acute rheumatic fever: differential expression of genes involved in cytotoxicity, chemotaxis and apoptosis 2013
- The contribution of non-conventional T cells and NK cells in the mycobacterial-specific IFN? response in Bacille Calmette-Guérin (BCG)-immunized infants. 2013
- To x-ray or not to x-ray? Screening asymptomatic children for pulmonary TB: a retrospective audit. 2013
- Update on Kawasaki disease: epidemiology, aetiology and pathogenesis. 2013
- Ureaplasma meningitis and subdural collections in a neonate. 2013
- A Comparative Analysis of Polyfunctional T Cells and Secreted Cytokines Induced by Bacille Calmette-Guerin Immunisation in Children and Adults 2012
- A totally synthetic lipopeptide-based self-adjuvanting vaccine induces neutralizing antibodies against heat-stable enterotoxin from enterotoxigenic Escherichia coli 2012
- Adenovirus: An Overview for Pediatric Infectious Diseases Specialists 2012
- B Cell Memory to a Serogroup C Meningococcal Conjugate Vaccine in Childhood and Response to Booster: Little Association with Serum IgG Antibody 2012
- Characterization of novel phages isolated in coagulase-negative staphylococci reveals evolutionary relationships with Staphylococcus aureus phages. 2012
- Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics--systematic review and meta-analysis. 2012
- Diagnostic Microbiologic Methods in the GEMS-1 Case/Control Study. 2012
- Discovery of an archetypal protein transport system in bacterial outer membranes 2012
- DO FEBRILE CONVULSIONS CAUSE CSF PLEOCYTOSIS? 2012
- Effect of pneumococcal vaccination on nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in Fijian children. 2012
- Factors that explain excretion of enteric pathogens by persons without diarrhea. 2012
- Genome-Wide Analysis of the Pho Regulon in a pstCA Mutant of Citrobacter rodentium 2012
- Group A Streptococcus Meningitis in Children. 2012
- Invasive group a streptococcal disease: epidemiology, pathogenesis and management. 2012
- Involvement of PatE, a Prophage-Encoded AraC-Like Regulator, in the Transcriptional Activation of Acid Resistance Pathways of Enterohemorrhagic Escherichia coli Strain EDL933. 2012
- Laboratory diagnostic challenges in case/control studies of diarrhea in developing countries. 2012
- Meningitis in children in Fiji: etiology, epidemiology, and neurological sequelae. 2012
- Protecting against Pneumococcal Disease: Critical Interactions between Probiotics and the Airway Microbiome. 2012
- Streptococcal skin infection and rheumatic heart disease. 2012
- The Role of Panton-Valentine Leukocidin in Staphylococcus aureus Musculoskeletal Infections in Children 2012
- The type II secretion system and its ubiquitous lipoprotein substrate, SslE, are required for biofilm formation and virulence of enteropathogenic Escherichia coli. 2012
- Web-Based Recruiting for Health Research Using a Social Networking Site: An Exploratory Study 2012
- Absence of interferon-gamma release assay conversion following tuberculin skin testing. 2011
- Adolescent and young adult HPV vaccination in Australia: Achievements and challenges 2011
- Antimicrobial resistance in group B streptococcus: the Australian experience 2011
- Assessment of first sexual intercourse in young women with a history of childhood sexual abuse 2011
- Autogenous Transcriptional Regulation of the regA Gene, Encoding an AraC-Like, Essential Virulence Regulator in Citrobacter rodentium 2011
- Chlamydia trachomatis Genotypes Among Men Who Have Sex With Men in Australia 2011
- Chlamydia trachomatis infection and risk of cervical intraepithelial neoplasia 2011
- Chlamydia trachomatis serovars in community-based HIV-positive and HIV-negative men who have sex with men in Sydney, Australia 2011
- Clearance of Human Papillomavirus in Women Treated for Cervical Dysplasia 2011
- Comparison of the INNO-LiPA and PapType Assays for Detection of Human Papillomavirus in Archival Vulva Dysplasia and/or Neoplasia Tissue Biopsy Specimens 2011
- Comparison of Two Mycoplasma genitalium Real-Time PCR Detection Methodologies 2011
- Control of bacterial virulence by AraC-like regulators that respond to chemical signals 2011
- Distribution of human papillomavirus genotypes in archival cervical tissue from women with cervical cancer in urban Sri Lanka 2011
- Fimbrial adhesins produced by atypical enteropathogenic Escherichia coli strains 2011
- HOW COMMON IS CO-EXISTING MENINGITIS IN INFANTS WITH URINARY TRACT INFECTION? 2011
- Human papillomavirus genotype prevalence in cervical biopsies from women diagnosed with cervical intraepithelial neoplasia or cervical cancer in Fiji 2011
- Human papillomavirus in adolescents: Lessons learned from decades of evaluation. 2011
- Human papillomavirus prevalence among indigenous and non-indigenous Australian women prior to a national HPV vaccination program 2011
- Human papillomavirus vaccination: where to now? 2011
- Laboratory-based diagnosis of pneumococcal pneumonia: state of the art and unmet needs 2011
- Low Perceived Risk and High HIV Prevalence Among a Predominantly African American Population Participating in Philadelphia's Rapid HIV Testing Program 2011
- Multilocus Sequence Typing of Streptococcus pneumoniae by Use of Mass Spectrometry. 2011
- Mycobacterium marinum infection 2011
- Oral Ivermectin for the Treatment of Pediculosis Capitis 2011
- Phasevarion Mediated Epigenetic Gene Regulation in Helicobacter pylori 2011
- Prenatal administration of Lactobacillus rhamnosus has no effect on the diversity of the early infant gut microbiota 2011
- Prevention of neonatal group B streptococcus disease in the 21st century. 2011
- Randomized control trials using a tablet formulation of hyperimmune bovine colostrum to prevent diarrhea caused by enterotoxigenic Escherichia coli in volunteers 2011
- Recurrent apnoea post immunisation: Informing re-immunisation policy 2011
- Science that "knows" and science that "asks". 2011
- Technical Variability Is Greater than Biological Variability in a Microarray Experiment but Both Are Outweighed by Changes Induced by Stimulation 2011
- The age-related risk of co-existing meningitis in children with urinary tract infection 2011
- The influence of BCG vaccine strain on the immune response against tuberculosis: a randomised trial 2011
- The placebo mystique: Implications for clinical trial methodology 2011
- The ProPrems trial: investigating the effects of probiotics on late onset sepsis in very preterm infants 2011
- The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol 2011
- To TST or not to TST: Is tuberculin skin testing necessary before BCG immunisation in children? 2011
- Tuberculous dactylitis-an easily missed diagnosis 2011
- Variation in erythromycin and clindamycin resistance patterns between New Zealand and Australian group B streptococcus isolates 2011
- What's bugging you? An update on the treatment of head lice infestation 2011
- [Discussion: dental care for the people: dentists' answer to the mounting public criticism]. 1975