MCRI researchers Amanda Gwee, Melissa Lee and Jonathan Kaufman have been named as finalists in the 2020 Victorian Premier’s Awards for Health and Medical Research.
The awards, to be announced on 23 March, recognise the exceptional contributions made by early career health and medical researchers in their PhD studies.
Dr Kaufman was recognised in the Health Services Researcher category for his research into the effective investigation of urinary tract infections (UTIs) in young children.
He said UTIs were one of the most common bacterial infections of early childhood, but hard to diagnose, and easily missed.
“If untreated UTI can cause life-threatening infection and permanent kidney scarring,” he said. “A urine sample is required to check for UTI, so guidelines recommend all young children with unexplained fever must have a urine test. This is required for many children in general practice and hospital settings.”
But Dr Kaufman said existing urine collection methods could be extremely difficult and all have limitations.
The first part of his PhD research series developed a simple way to collect the necessary samples, with the ‘Quick-Wee’ method of gently rubbing a child’s abdomen with wet gauze.
“This triggers bladder reflexes and urine voiding, so samples can be collected quickly and easily,” he said.
Dr Kaufman said a large randomised trial showed the method was three times more effective than standard care, and more acceptable to parents and clinicians. A health economic analysis also showed the method was cost-effective.
The findings, published in The BMJ, are changing practice internationally and have been adopted into guidelines in Australia, the UK, Canada, and Europe.
Dr Gwee and Dr Lee were both shortlisted in the Clinical Researcher Category.
Dr Gwee was recognised for her research into determining the best dose of the antibiotic vancomycin for babies, to improve the treatment of bloodstream infections.
“Bloodstream infections are the leading cause of death in babies worldwide,” she said. “The key to effective treatment is giving the right antibiotic at the right dose. The most common antibiotic used to treat these infections is vancomycin.”
Dr Gwee’s research, published in Pediatrics, found that giving the drug continuously by intravenous drip worked better. Dr Gwee said this dosing method is now used in 10 paediatric hospitals and has led to changes to local, national and international antibiotic guidelines.
By using computer modelling, she also discovered how much vancomycin is needed to treat blood stream infections for each individual baby (published in JAMA Pediatrics).
“I have developed a web application, so with a simple click of a button a health worker can personalise the vancomycin dose not only for the baby but the infection we are trying to treat,” Dr Gwee said. “We are piloting this app in four hospitals so we can improve treatment of newborn infections and hopefully save lives.”
Dr Lee was recognised for improving outcomes after surgery for patients with a common congenital heart disease condition.
“One of the most common heart defect babies can be born with is called coarctation of the aorta, where the main blood vessel from the heart has a narrow area so less blood is pumped round the body than normal,” she said. “This means the heart must work harder to pump the blood around the body and is often unable to keep up.”
“It is often treated with surgery but over time people can develop high blood pressure. The cause of the high blood pressure is unknown as it can still develop in people who have no sign of any ongoing narrowing in the main blood vessel.”
Dr Lee’s research following up patients after this heart surgery is the largest and longest study in the world. She worked in collaboration with the Royal Brompton Hospital in London.
Dr Lee said her research found that these patients had three times the risk of early death due to the side effects of having higher blood pressure than the average person.
Dr Lee’s research has led to a change in how this heart surgery is performed and improvement in the long term follow up of these patients leading to better outcomes. Her research findings have been incorporated into international guidelines for the diagnosis and management of hypertension.