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Revisiting the inoculum effect for Streptococcus pyogenes with a hollow fibre infection model

Severe, invasive Streptococcus pyogenes (Strep A) infections result in greater than 500,000 deaths annually. First line treatment for such infections is benzylpenicillin, often with the addition of clindamycin, but treatment failure can occur with this regimen. This failure has been partially attributed to the inoculum effect, which presents as reduced antibiotic susceptibility during high bacterial density and plateau-phase growth.

The measurement properties of tests and tools used in cystic fibrosis studies: a systematic review

There is no consensus on how best to measure responses to interventions among children and adults with cystic fibrosis (CF). We have systematically reviewed and summarised the characteristics and measurement properties of tests and tools that have been used to capture outcomes in studies among people with CF, including their reliability, validity and responsiveness. This review is intended to guide researchers when selecting tests or tools for measuring treatment effects in CF trials. A consensus set of these tests and tools could improve consistency in how outcomes are captured and thereby facilitate comparisons and synthesis of evidence across studies.

Understanding parental decisions to decline or delay infant RSV immunisation, nirsevimab, in Western Australia in 2024

In 2024, the government of Western Australia introduced 'nirsevimab', a monoclonal antibody offering protection from respiratory syncytial virus (RSV), for eligible infants. This study explores why parents of infants who were eligible to receive nirsevimab opted to decline or delay the immunisation.

Modelling Micro-Elimination: Third-Trimester Tenofovir Prophylaxis for Perinatal Transmission of Hepatitis B in the Remote Dolpa District of Nepal

Hepatitis B (HBV) prevalence is very high in pregnant women in the Dolpa district of Nepal, a region characterised by a remote geographic landscape and low vaccination coverage. Using mathematical modelling, we evaluated the impact of third-trimester tenofovir disoproxil fumarate (TDF) prophylaxis on HBV burden and estimated the time required to achieve HBV elimination in Dolpa. 

Safety, tolerability, and pharmacokinetics of a 2 g subcutaneous dose of ceftriaxone as an alternative to intravenous delivery

Subcutaneous delivery of antibiotics is a practical alternative to intravenous administration. Ceftriaxone is commonly used for a variety of infections with limited data on the safety and pharmacokinetics of a 2 g subcutaneous dose. This was a prospective, self-controlled cross-over study in 20 stable inpatients receiving ceftriaxone for their infection. Following an intravenous dose, participants received a single dose of 2 g subcutaneous ceftriaxone, in 50 mL normal saline via gravity feed.

Country-level and global burden of diseases caused by group A Streptococcus: protocol for a multicountry epidemiological study

Group A Streptococcus (Strep A) causes a wide spectrum of diseases, ranging from pharyngitis and impetigo to severe invasive infections and immune-mediated conditions such as acute rheumatic fever, rheumatic heart disease and acute post-streptococcal glomerulonephritis. Contemporary data on the global burden of Strep A diseases are lacking.

Socio-economic inequality underpins inequity in influenza vaccination uptake between public and private secondary schools: an Australian population-based study

Socio-economic inequality and vaccination inequity have long been critical issues. However, no studies have explored the gap in influenza vaccination uptake between public and private schools. Importantly, the extent to which socio-economic inequality translates into vaccination uptake inequity has not been quantified.

Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023

Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging.

Indigenous infants in remote Australia retain an ancestral gut microbiome despite encroaching Westernization

Studies of traditional Indigenous compared to 'Western' gut microbiomes are underrepresented, and lacking in young children, limiting knowledge of early-life microbiomes in different cultural contexts. Here we analyze the gut metagenomes of 50 Indigenous Australian infants (median age <one year) living remotely with variable access to Western foods, compared to age- and sex-matched non-Indigenous infants living in urban Australia.

Impact of Host and Bacterial Metabolism on Antibiotic Susceptibility

Antimicrobial resistance (AMR) is a global healthcare emergency, directly causing 1.3 million deaths per year and predicted to increase dramatically over the coming decades. Understanding the molecular mechanisms underpinning antibiotic resistance is central to approaches for AMR surveillance and diagnosis in a clinical laboratory.