The Department conducts research into various aspects of clinical infectious diseases and microbiology with a focus on: multidrug-resistant bacteria and healthcare-associated infections they cause; pathogen genomics; infections in immunocompromised individuals; invasive bacterial infections, such as infections in the blood stream, deep tissues, and bones or joints; and respiratory infections in hospitalised patients including COVID-19.

Multidrug-resistant bacteria, and the hospital acquired infections they cause, are one of the most significant future threats to human health both in Australia and globally. Effective antibiotics are essential for the safe provision of life-saving interventions such as solid organ and bone marrow transplantation, cancer chemotherapy and surgery. These interventions are now under threat, due to rapidly expanding antimicrobial resistance and a lack of novel antimicrobial drug classes.

A major focus of the Department's research is understanding how these multidrug-resistant bacteria spread across the community and the hospital and how they adapt to specific niches, using pathogen genomics and state-of-the-art molecular epidemiological methods. This research is accomplished by patient screening, surveillance and use of whole genome sequencing for high-consequence and high-prevalence micro-organisms. The Department participates in national surveillance programs for bacterial resistance, reporting to the Australian Group for Antimicrobial Resistance (AGAR), OrgTrx and CARalerts.

The Department has led the state in developing highly specialised and locally optimised in-house bioinformatics pipelines and automated reporting systems. This has facilitated studies which have provided important insights into the transmission dynamics of healthcare-associated pathogens, particularly vancomycin-resistant enterococcus (VRE) and carbapenem-resistant Enterobacterales (CPE), and more recently SARS-CoV-2. Research findings have been rapidly translated into the implementation of targeted measures to optimise control of these multi-drug resistant organisms as well as COVID-19.

Our research in immunocompromised individuals includes liver, renal and allogeneic transplant recipients, as well as people with HIV. The Department participates in mycology studies evaluating fungal resistance rates, which have enabled refinement of local antifungal prophylaxis strategies for the numerous immunocompromised individuals cared for at Royal Prince Alfred Hospital. Ongoing studies in transplant recipients include evaluations of surgical site infections and colonisation and invasive infections with multidrug resistant infections. HIV drug resistance surveillance is another area of interest of the Department, through involvement in the implementation of a state-wide HIV drug resistance database and participation in national surveillance reports. Additional studies planned to start in 2024 in people with HIV include an observational study on women with HIV and a randomised clinical trial evaluating an intervention to improve cardiovascular health in people with HIV. 

We have several studies that are ongoing or planned to start in 2024 in the area of invasive bacterial infections including: an ongoing randomised clinical trial evaluating the management of Staphylococcus aureus blood stream infections; an observational study evaluating outcomes in people who inject drugs and are hospitalised with invasive infections; and a randomised clinical trial evaluating the optimal management of prosthetic joint infections. An additional study planned to start in 2024 is an international randomised clinical trial evaluating different medications for the treatment of respiratory infections in hospitalised patients including COVID-19.