7 results on '"Christopher H. Heath"'
Search Results
2. Diagnosis, management and prevention ofCandida aurisin hospitals: position statement of the Australasian Society for Infectious Diseases
- Author
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Rita Roy, Chong W. Ong, Catriona Halliday, Christopher H. Heath, Andrew J. Stewardson, Julia E Clark, Leon J Worth, Monica A. Slavin, Caroline Marshall, Deborah Marriott, Arthur J. Morris, Sarah E. Kidd, C. Orla Morrissey, and Sharon C.-A. Chen
- Subjects
medicine.medical_specialty ,Antifungal Agents ,Antifungal drug ,Microbial Sensitivity Tests ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Drug Resistance, Fungal ,Amphotericin B ,Amphotericin B deoxycholate ,Disease Transmission, Infectious ,Internal Medicine ,Humans ,Medicine ,Infection control ,030212 general & internal medicine ,DNA, Fungal ,Intensive care medicine ,Fluconazole ,Societies, Medical ,Candida ,Cross Infection ,Infection Control ,business.industry ,Age Factors ,Australia ,Candidiasis ,Outbreak ,Candida auris ,Diagnosis management ,business ,New Zealand ,medicine.drug - Abstract
Candida auris is an emerging drug-resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). Bloodstream infections are the most frequently reported infections. Infections have crude mortality of 30-60%. Acquisition is generally healthcare-associated and risks include underlying chronic disease, immunocompromise and presence of indwelling medical devices. C. auris may be misidentified by conventional phenotypic methods. Matrix-assisted laser desorption ionisation time-of-flight mass spectrometry or sequencing of the internal transcribed spacer regions and/or the D1/D2 regions of the 28S ribosomal DNA are therefore required for definitive laboratory identification. Antifungal drug resistance, particularly to fluconazole, is common, with variable resistance to amphotericin B and echinocandins. Echinocandins are currently recommended as first-line therapy for infection in adults and children ≥2 months of age. For neonates and infants
- Published
- 2019
- Full Text
- View/download PDF
3. Consensus guidelines for the use of empiric and diagnostic-driven antifungal treatment strategies in haematological malignancy, 2014
- Author
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John Kwan, Nenad Macesic, Michelle Ananda-Rajah, Nicole Gilroy, Sharon C.-A. Chen, Suzanne W Kirsa, Monica A. Slavin, C. O. Morrissey, Peter Bardy, Andrew Grigg, Patricia Walker, Thomas Gottlieb, Meryta L.A May, and Christopher H. Heath
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medicine.medical_specialty ,medicine.drug_class ,business.industry ,medicine.medical_treatment ,Antibiotics ,Context (language use) ,Hematopoietic stem cell transplantation ,Evidence-based medicine ,Aspergillosis ,medicine.disease ,Transplantation ,Pre-exposure prophylaxis ,Internal Medicine ,medicine ,Fever of unknown origin ,Intensive care medicine ,business - Abstract
Invasive fungal disease (IFD) causes significant morbidity and mortality in patients undergoing allogeneic haemopoietic stem cell transplantation or chemotherapy for haematological malignancy. Much of these adverse outcomes are due to the limited ability of traditional diagnostic tests (i.e. culture and histology) to make an early and accurate diagnosis. As persistent or recurrent fevers of unknown origin (PFUO) in neutropenic patients despite broad-spectrum antibiotics have been associated with the development of IFD, most centres have traditionally administered empiric antifungal therapy (EAFT) to patients with PFUO. However, use of an EAFT strategy has not been shown to have an overall survival benefit and is associated with excessive antifungal therapy use. As a result, the focus has shifted to developing more sensitive and specific diagnostic tests for early and more targeted antifungal treatment. These tests, including the galactomannan enzyme-linked immunosorbent assay and Aspergillus polymerase chain reaction (PCR), have enabled the development of diagnostic-driven antifungal treatment (DDAT) strategies, which have been shown to be safe and feasible, reducing antifungal usage. In addition, the development of effective antifungal prophylactic strategies has changed the landscape in terms of the incidence and types of IFD that clinicians have encountered. In this review, we examine the current role of EAFT and provide up-to-date data on the newer diagnostic tests and algorithms available for use in EAFT and DDAT strategies, within the context of patient risk and type of antifungal prophylaxis used.
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- 2014
- Full Text
- View/download PDF
4. Consensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell transplantation, 2014
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Gabrielle M Haeusler, Jeff Szer, Monica A. Slavin, C. O. Morrissey, Robert Weinkove, Christopher H. Heath, Costas K Yannakou, Sam Milliken, S. J. van Hal, Sharon C.-A. Chen, Shaun Fleming, Andrew Grigg, Constantine S. Tam, Julia E Clark, and Ashish Bajel
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Context (language use) ,Number needed to harm ,Hematopoietic stem cell transplantation ,Transplantation ,Pre-exposure prophylaxis ,Tolerability ,Epidemiology ,Internal Medicine ,medicine ,Intensive care medicine ,Risk assessment ,business - Abstract
There is a strong argument for the use of antifungal prophylaxis in high-risk patients given the significant mortality associated with invasive fungal disease, the late identification of these infections, and the availability of safe and well-tolerated prophylactic medications. Clinical decisions about which patients should receive prophylaxis and choice of antifungal agent should be guided by risk stratification, knowledge of local fungal epidemiology, the efficacy and tolerability profile of available agents, and estimates such as number needed to treat and number needed to harm. There have been substantial changes in practice since the 2008 guidelines were published. These include the availability of new medications and/or formulations, and a focus on refining and simplifying patient risk stratification. Used in context, these guidelines aim to assist clinicians in providing optimal preventive care to this vulnerable patient demographic.
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- 2014
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5. Guidelines for the use of antifungal agents in the treatment of invasiveCandidaand mould infections
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Karin A Thursky, C. O. Morrissey, Joe Sasadeusz, Monica A. Slavin, Andrew Grigg, John F. Seymour, Jeff Szer, Christopher H. Heath, Sharon C.-A. Chen, Andrew W. Roberts, and Tania C. Sorrell
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Drug ,Antifungal ,medicine.medical_specialty ,Hematology ,medicine.drug_class ,business.industry ,media_common.quotation_subject ,medicine.disease ,Surgery ,Amphotericin B ,Intensive care ,Internal medicine ,Amphotericin B deoxycholate ,Internal Medicine ,medicine ,Intensive care medicine ,business ,Echinocandins ,Mycosis ,media_common ,medicine.drug - Abstract
Treatment of invasive fungal infections is increasingly complex. Amphotericin B deoxycholate has long been the mainstay of treatment. However, there has been increasing recognition of both the propensity for nephro-toxicity in haematology, transplant and intensive care patients as well as its adverse impact on morbidity and mortality. This has coincided with the availabilty of newer, and in certain settings, more effective antifungal agents. Although the newer agents clearly cause less nephrotoxicity than amphotericin B, drug interactions, hepatic effects and unique side-effects need to be considered. The spectrum of the newer triazoles and echinocandins varies, highlighting the importance of accurate identification of the causative organism where possible. Consensus Australian guidelines have been developed to assist clinicians with treatment choices by reviewing the current evidence for the efficacy, the toxicity and the cost of these agents.
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- 2004
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6. Neutropenia is rare in patients receiving continuous infusions of vancomycin in an Australian Hospital in the Home setting
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Laurens Manning, Katherine Norton, Christopher H. Heath, and Paul R. Ingram
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Hospital in the home ,Male ,medicine.medical_specialty ,Neutropenia ,business.industry ,Australia ,Middle Aged ,medicine.disease ,Cohort Studies ,Vancomycin ,Internal Medicine ,medicine ,Humans ,In patient ,Female ,Intensive care medicine ,business ,Infusions, Intravenous ,Home Infusion Therapy ,medicine.drug ,Aged ,Retrospective Studies - Published
- 2013
7. Antifungal prophylaxis in adult stem cell transplantation and haematological malignancy
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Monica A. Slavin, Sam Milliken, L.M. Ling, Christopher H. Heath, Andrew Grigg, Jeff Szer, C. O. Morrissey, and Karin A Thursky
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Adult ,medicine.medical_specialty ,Antifungal Agents ,Neutropenia ,Opportunistic Infections ,Internal medicine ,Internal Medicine ,medicine ,Humans ,business.industry ,Induction chemotherapy ,medicine.disease ,Transplantation ,Leukemia ,Graft-versus-host disease ,medicine.anatomical_structure ,Mycoses ,Leukemia, Myeloid ,Immunology ,Number needed to treat ,Alemtuzumab ,Bone marrow ,business ,medicine.drug ,Stem Cell Transplantation - Abstract
Antifungal prophylaxis can be recommended in patients undergoing induction chemotherapy for acute myeloid leukemia and treatment for grade 2 or greater or chronic extensive graft versus host disease. The evidence for prophylaxis is less clear in other clinical settings although certain groups such as patients with prolonged neutropenia after stem cell transplants using bone marrow or cord blood sources and with impaired cell mediated immunity secondary to treatments such as Alemtuzumab are at high risk. The decision to use prophylaxis and which agent to use will be influenced by effectiveness, number needed to treat and the likelihood of toxicity and drug interactions. The availability of rapid diagnostic tests for fungal infection and institutional epidemiology will also influence the need for and choice of prophylaxis. Whilst prophylaxis can be beneficial, it may impede the ability to make a rapid diagnosis of fungal infection by reducing the yield of diagnostic tests and change the epidemiology of fungal infection. As non-culture based diagnostic tests are refined and become more available there may be a shift from prophylaxis to early diagnosis and treatment.
- Published
- 2008
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