Utilising organs from hepatitis C virus PCR-positive donors in Western Australia.

We transplanted six solid organs from three hepatitis C virus (HCV) polymerase chain reaction (PCR)-positive donors during 2018-2023. Recipients were treated with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir for 4-12 weeks, with all six achieving sustained virological response without significant adverse events. As occurs in other jurisdictions, solid organ transplants from HCR PCR-positive donors can be safely utilised in Australia.

Human Clostridium difficile infection caused by a livestock-associated PCR ribotype 237 strain in Western Australia.

INTRODUCTION: Clostridium difficile infection (CDI) is a significant gastrointestinal disease in the developed world and increasingly recognised as a zoonotic infection. In North America and Europe, the PCR ribotype (RT) 078 strain of C. difficile is commonly found in production animals and as a cause of disease in humans although proof of transmission from animals is lacking. This strain is absent in Australian livestock. We report a case of human CDI caused by a strain of C. difficile belonging to known Australian livestock-associated RT 237. CASE PRESENTATION: A young male was admitted for multiple trauma following a motor vehicle accident and placed on piperacillin/tazobactam for pneumonia. After 4 days of treatment, he developed symptoms of CDI, which was confirmed in the laboratory. His symptoms resolved after 6 days of intravenous metronidazole. The strain of C. difficile isolated was identified as RT 237, an unusual RT previously found in with several Western Australia piggeries. CONCLUSION: This case of CDI caused by an unusual livestock-associated C. difficile RT 237 supports the hypothesis of zoonotic transmission. The case highlights the potential of livestock to act as reservoir for C. difficile and the need for continued surveillance of CDI in both human and animal populations.

Real-time PCR assay for detection of blaZ genes in Staphylococcus aureus clinical isolates.

The Clinical and Laboratory Standards Institute recommends consideration of blaZ gene testing for cases of serious Staphylococcus aureus infection. Conventional PCR methods have demonstrated superior sensitivity and specificity to phenotypic tests. To our knowledge, this is the first description of real-time PCR detection of the blaZ gene.

Pseudo-outbreak of Rhizobium radiobacter infection resulting from laboratory contamination of saline solution.

We report a pseudo-outbreak of Rhizobium radiobacter infections resulting from contamination by a saline dispenser in the microbiology laboratory. Isolates from clinical specimens had identical antimicrobial susceptibilities and electrophoretic fingerprints. The episode resolved with autoclaving of the dispenser. This demonstrates the importance of timely, thorough investigation of unusual organisms, particularly when they appear as a cluster.

Methicillin-resistant Staphylococcus aureus control in Singapore: moving forward.

Singapore has a sophisticated healthcare system and is an important referral centre for Asia. Like much of the world, methicillin-resistant Staphylococcus aureus (MRSA) is now endemic across its health system. MRSA infection has been associated with considerable attributable mortality, morbidity plus personal and public cost. Nosocomial infections are potentially preventable and need to be considered an unacceptable complication rather than a tolerable byproduct of healthcare. Failure to introduce long-term sustainable infection control initiatives is not an option for responsible clinical leaders and managers. Control of MRSA transmission in Singapore is achievable but we need to accept the challenge and acknowledge that it will take perhaps a decade. It requires implementation of many varied infection control measures to be rolled out sequentially and across all health services. Our ambition, in Singapore, should be for hospitals to achieve an inpatient prevalence of <1% MRSA colonised patients. Identified transmission of MRSA should be regarded as a serious breech. Successful control will require extraordinary collaboration, support, resources, accountability and consistency of effort. Currently, efforts are evolving significantly and today, we have a good opportunity to embark on this difficult journey. Implementing infection control initiatives successfully over the next few years will save lives in the future.