Conjoint Associate Professor John Ferguson

Conjoint Associate Professor John Ferguson

Conjoint Associate Professor

School of Biomedical Sciences and Pharmacy (Immunology and Microbiology)

Career Summary

Biography

John Ferguson is a Microbiologist with Pathology North, NSW and Infectious Diseases Physician with Hunter New England Health and a conjoint academic with the Universities of Newcastle and New England. 

His interests include healthcare-associated infection and antibiotic resistance and stewardship.  He was on the Writing Group for the National Antibiotic Guidelines for 12 years and formerly Chair of the Healthcare-associated Infection Advisory Committee at the Australian Commission on Safety and Quality in Healthcare for 5 years.  

He is currently Director of the Infection Prevention Service for Hunter New England Health and a senior staff specialist in microbiology  and infectious diseases (Division of Medicine, John Hunter Hospital, Newcastle). He also provides support for undergraduate and postgraduate teaching at the University of Papua New Guinea and the National Academy of Medical Sciences in Nepal.  

Topic areas for current research projects include:

    • Otitis media and the role of Alloiococcus otitidis
    • healthcare-associated urinary tract infection- surveillance and morbidity impact
    • vancomycin-resistant enterococcus (VRE) epidemiology in healthcare
    • antibiotic use and resistance – time series analysis
    • methicillin-resistant Staphylococcus aureus epidemiology – community and healthcare
    • neonatal infections- early and late onset sepsis, antibiotic management, Staphylococcus capitis infections and VRE epidemiology
    • Group B streptococcus infections in neonates and the role of prophylaxis (co-supervising of a PhD candidate)

He has published over 75 articles including book chapters and reviews. 


Qualifications

  • Bachelor of Medicine, Bachelor of Surgery (Hons), University of Sydney
  • Diploma in Tropical Medicine & Hygiene, Liverpool School of Tropical Medicine - UK

Fields of Research

Code Description Percentage
110299 Cardiorespiratory Medicine and Haematology not elsewhere classified 20
111799 Public Health and Health Services not elsewhere classified 60
119999 Medical and Health Sciences not elsewhere classified 20

Professional Experience

Academic appointment

Dates Title Organisation / Department
1/01/1997 -  Senior Staff Specialist Microbiology and Infectious Diseases Hunter New England Health
Australia
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (2 outputs)

Year Citation Altmetrics Link
2015 Giles M, Watts W, Berringer S, Paul M, O'Brien AP, Ferguson J, 'Preventing Catheter Associated Urinary Tract Infection', Quality Initiatives ¿ Entries in the 18th Annual ACHS Quality Improvement Awards 2015. The Australian Council on Health Care Standards, The Australian Council on Healthcare Standards (ACHS), Sydney 5-12 (2015) [B2]
Co-authors John Ferguson, Tony Obrien
2011 Ferguson JK, 'The role of the clinical microbiology service', Antimicrobial Stewardship in Australian Hospitals 2011, Australian Commission on Safety and Quality in Health Care, Sydney 80-91 (2011) [B2]
Co-authors John Ferguson

Journal article (70 outputs)

Year Citation Altmetrics Link
2017 Ellem JA, Ginn AN, Chen SCA, Ferguson J, Partridge SR, Iredell JR, 'Locally acquired mcr-1 in Escherichia coli, Australia, 2011 and 2013', Emerging Infectious Diseases, 23 1160-1163 (2017) [C1]

© 2017, Centers for Disease Control and Prevention (CDC). All rights reserved. We identified discrete importation events of the mcr-1 gene on incompatibility group IncI2 plasmids... [more]

© 2017, Centers for Disease Control and Prevention (CDC). All rights reserved. We identified discrete importation events of the mcr-1 gene on incompatibility group IncI2 plasmids in Escherichia coli isolated from patients in New South Wales, Australia, in 2011 and 2013. mcr-1 is present in a small minority of colistin-resistant Enterobacteriaceae and appears not to be established locally.

DOI 10.3201/eid2307.161638
Co-authors John Ferguson
2017 Mitchell BG, Anderson M, Ferguson JK, 'A predictive model of days from infection to discharge in patients with healthcare-associated urinary tract infections: a structural equation modelling approach.', The Journal of hospital infection, 97 282-287 (2017) [C1]
DOI 10.1016/j.jhin.2017.08.006
Co-authors John Ferguson
2017 Agostino JW, Ferguson JK, Eastwood K, Kirk MD, 'The increasing importance of community-acquired methicillin-resistant <em>Staphylococcus aureus</em> infections', The Medical journal of Australia, 207 388-393 (2017) [C1]

MAIN OUTCOME MEASURES: Proportion of MRSA infections among people with S. aureus isolates; antimicrobial susceptibility of MRSA isolates; origin of MRSA infections (community- or ... [more]

MAIN OUTCOME MEASURES: Proportion of MRSA infections among people with S. aureus isolates; antimicrobial susceptibility of MRSA isolates; origin of MRSA infections (community- or health care-associated); demographic factors associated with community-associated MRSA infections. OBJECTIVES: To identify groups at risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, patterns of antimicrobial resistance, and the proportion of patients with MRSA infections but no history of recent hospitalisation. DESIGN, SETTING AND PARTICIPANTS: Case series of 39 231 patients with S. aureus isolates from specimens processed by the Hunter New England Local Health District (HNELHD) public pathology provider during 2008-2014. RESULTS: There were 71 736 S. aureus-positive specimens during the study period and MRSA was isolated from 19.3% of first positive specimens. Most patients (56.9%) from whom MRSA was isolated had not been admitted to a public hospital in the past year. Multiple regression identified that patients with community-associated MRSA were more likely to be younger (under 40), Indigenous Australians (odds ratio [OR], 2.6; 95% CI, 2.3-2.8), or a resident of an aged care facility (OR, 4.7; 95% CI, 3.8-5.8). The proportion of MRSA isolates that included the dominant multi-resistant strain (AUS-2/3-like) declined from 29.6% to 3.4% during the study period (P < 0.001), as did the rates of hospital origin MRSA in two of the major hospitals in the region. CONCLUSIONS: The prevalence of MRSA in the HNELHD region decreased during the study period, and was predominantly acquired in the community, particularly by young people, Indigenous Australians, and residents of aged care facilities. While the dominance of the multi-resistant strain decreased, new strategies for controlling infections in the community are needed to reduce the prevalence of non-multi-resistant strains.

Citations Scopus - 1
Co-authors John Ferguson
2017 Richards Chair M, Cruickshank M, Cheng A, Gandossi S, Quoyle C, Stuart R, et al., 'Recommendations for the control of carbapenemase-producing Enterobacteriaceae (CPE): A guide for acute care health facilities: Australian Commission on Safety and Quality in Health Care', Infection, Disease and Health, 22 159-186 (2017) [C1]

© 2017 Australian Commission on Safety and Quality in Health Care Gram-negative bacteria that are resistant to antimicrobials, including carbapenems, have emerged as a significan... [more]

© 2017 Australian Commission on Safety and Quality in Health Care Gram-negative bacteria that are resistant to antimicrobials, including carbapenems, have emerged as a significant global public health threat. Multidrug-resistant gram-negative bacteria, including carbapenemase-producing Enterobacteriaceae (CPE), place patients at risk of potentially untreatable infection. Australia has not reported a large number of CPE cases compared to Europe, North America, and the Middle East, creating an opportunity to prevent CPE from becoming established in Australia. An outbreak of Klebsiella pneumoniae carbapenemase in 2014 demonstrated there was variable testing, reporting, response to and communication of CPE. In response, the Australian Commission on Safety and Quality in Health Care formed a taskforce to assist health facilities to respond to the threat of CPE. Recommendations for state and territory health departments include coordinating a risk assessment, undertaking epidemiological and microbiological investigations, determining the requirement for control measures, and coordinating risk-communication activities. The response should take advice from experts in infectious diseases, microbiology, public health, infection prevention and control and epidemiologists. The guide aims to: ¿ Alert healthcare professionals, health departments and hospital executives to the emerging threat of CPE in Australia¿ Recommend strategies to prevent, detect and contain CPE¿ Provide information and resources for hospital executives, healthcare professionals and consumers¿ Recommend laboratory screening and confirmation methods.The recommendations with rationale and commentary have been structured into sections depending on the burden of CPE in the health facility. The sections include: planning, preparing and prevention; CPE screening and surveillance; strategies to reduce CPE transmission; outbreak management; laboratory screening and confirmation methods.

DOI 10.1016/j.idh.2017.09.001
Co-authors John Ferguson
2017 Hughes C, Ferguson J, 'Phenotypic chlorhexidine and triclosan susceptibility in clinical Staphylococcus aureus isolates in Australia', Pathology, 49 633-637 (2017) [C1]

© 2017 Royal College of Pathologists of Australasia Antiseptics such as chlorhexidine gluconate and triclosan are widely used in healthcare settings for both skin antisepsis and ... [more]

© 2017 Royal College of Pathologists of Australasia Antiseptics such as chlorhexidine gluconate and triclosan are widely used in healthcare settings for both skin antisepsis and decolonisation of Staphylococcus aureus. We determined the minimum inhibitory concentration (MIC) of 198 methicillin susceptible and resistant Staphylococcus aureus clinical isolates to both chlorhexidine and triclosan using an agar dilution method. Of these, 10% (19/198) showed a raised MIC to chlorhexidine and 3% (6/198) showed an elevated MIC to triclosan. The multilocus sequence type (MLST) of each isolate was predicted using a binary method, and although ST93-MRSA-IV was the most common, ST22-MRSA-IV was shown to have statistically higher chlorhexidine MIC values compared with non ST22-MRSA-IV isolates (z = -8.7, p < 0.01). Additionally, isolates from patients known to have failed decolonisation were included and did not demonstrate elevated MIC to the decolonisation antiseptic. Monitoring for non-susceptibility of clinical isolates to biocides is important to determine trends, and may have clinical implications in terms of sub-lethal concentration in residues and concomitant antibiotic resistance.

DOI 10.1016/j.pathol.2017.05.008
Co-authors John Ferguson
2017 Braye K, Ferguson J, Davis D, Catling C, Monk A, Foureur M, 'Effectiveness of intrapartum antibiotic prophylaxis for early-onset group B Streptococcal infection: An integrative review.', Women Birth, (2017)
DOI 10.1016/j.wombi.2017.10.012
Co-authors John Ferguson
2017 Harris PNA, Peri AM, Pelecanos AM, Hughes CM, Paterson DL, Ferguson JK, 'Risk factors for relapse or persistence of bacteraemia caused by Enterobacter spp.: A case-control study', Antimicrobial Resistance and Infection Control, 6 1-8 (2017) [C1]
DOI 10.1186/s13756-017-0177-0
Citations Scopus - 3Web of Science - 3
Co-authors John Ferguson
2017 Agostino JW, Ferguson JK, Eastwood K, Kirk MD, 'The increasing importance of community-acquired methicillin-resistant Staphylococcus aureus infections', Medical Journal of Australia, 207 1-6 (2017)

© 2017, Australasian Medical Publishing Co. Ltd. All rights reserved. Objectives: To identify groups at risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, patt... [more]

© 2017, Australasian Medical Publishing Co. Ltd. All rights reserved. Objectives: To identify groups at risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, patterns of antimicrobial resistance, and the proportion of patients with MRSA infections but no history of recent hospitalisation. Design, setting and participants: Case series of 39 231 patients with S. aureus isolates from specimens processed by the Hunter New England Local Health District (HNELHD) public pathology provider during 2008-2014. Main outcome measures: Proportion of MRSA infections among people with S. aureus isolates; antimicrobial susceptibility of MRSA isolates; origin of MRSA infections (community- or health care-associated); demographic factors associated with community-associated MRSA infections. Results: There were 71 736 S. aureus-positive specimens during the study period and MRSA was isolated from 19.3% of first positive specimens. Most patients (56.9%) from whom MRSA was isolated had not been admitted to a public hospital in the past year. Multiple regression identified that patients with community-associated MRSA were more likely to be younger (under 40), Indigenous Australians (odds ratio [OR], 2.6; 95% CI, 2.3-2.8), or a resident of an aged care facility (OR, 4.7; 95% CI, 3.8-5.8). The proportion of MRSA isolates that included the dominant multi-resistant strain (AUS-2/3-like) declined from 29.6% to 3.4% during the study period (P < 0.001), as did the rates of hospital origin MRSA in two of the major hospitals in the region. Conclusions: The prevalence of MRSA in the HNELHD region decreased during the study period, and was predominantly acquired in the community, particularly by young people, Indigenous Australians, and residents of aged care facilities. While the dominance of the multi-resistant strain decreased, new strategies for controlling infections in the community are needed to reduce the prevalence of non-multi-resistant strains.

DOI 10.5694/mja17.00089
Co-authors John Ferguson
2016 Trubiano JA, Cheng AC, Korman TM, Roder C, Campbell A, May MLA, et al., 'Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand', Internal Medicine Journal, 46 479-493 (2016) [C1]

© 2016 Royal Australasian College of Physicians. The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, ... [more]

© 2016 Royal Australasian College of Physicians. The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children.

DOI 10.1111/imj.13027
Citations Scopus - 11Web of Science - 9
Co-authors John Ferguson
2016 Cheng AC, Collins DA, Elliott B, Ferguson JK, Paterson DL, Thean S, Riley TV, 'Laboratory-based surveillance of Clostridium difficile circulating in Australia, September - November 2010', Pathology, 48 257-260 (2016) [C1]

© 2016 Royal College of Pathologists of Australasia. Clostridium difficile rose in prominence in the early 2000s with large-scale outbreaks of a particular binary toxin-positive ... [more]

© 2016 Royal College of Pathologists of Australasia. Clostridium difficile rose in prominence in the early 2000s with large-scale outbreaks of a particular binary toxin-positive strain, ribotype 027, in North America and Europe. In Australia outbreaks of the same scale had not and have not been seen. A survey of C. difficile across Australia was performed for 1 month in 2010. A collection of 330 C. difficile isolates from all States and Territories except Victoria and the Northern Territory was amassed. PCR ribotypi ng revealed a diverse array of strains. Ribotypes 014/020 (30.0%) and 002 (11.8%) were most common, followed by 054 (4.2%), 056 (3.9%), 070 (3.6%) and 005 (3.3%). The collection also contained few binary toxin positive strains, namely 027 (0.9%), 078 (0.3%), 244 (0.3%), 251 (0.3%) and 127 (0.3%). The survey highlights the need for vigilance for emerging strains in Australia, and gives an overview of the molecular epidemiology of C. difficile in Australia prior to an increase in incidence noted from mid-2011.

DOI 10.1016/j.pathol.2016.02.005
Citations Scopus - 6Web of Science - 2
Co-authors John Ferguson
2016 Flint J, Dalton CB, Merritt TD, Graves S, Ferguson JK, Osbourn M, et al., 'Q FEVER AND CONTACT WITH KANGAROOS IN NEW SOUTH WALES', COMMUNICABLE DISEASES INTELLIGENCE, 40 E202-E203 (2016)
Citations Scopus - 1
Co-authors John Ferguson, D Durrheim, Craig Dalton
2016 Carter GP, Buultjens AH, Ballard SA, Baines SL, Tomita T, Strachan J, et al., 'Emergence of endemic MLST non-typeable vancomycin-resistant Enterococcus faecium', JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 71 3367-3371 (2016) [C1]
DOI 10.1093/jac/dkw314
Citations Scopus - 3Web of Science - 3
Co-authors John Ferguson
2016 Mitchell BG, Ferguson JK, Anderson M, Sear J, Barnett A, 'Length of stay and mortality associated with healthcare-associated urinary tract infections: A multi-state model', Journal of Hospital Infection, 93 92-99 (2016) [C1]

© 2016 The Authors. Background: The emergence of antimicrobial resistance is of particular concern with respect to urinary tract infections, since the majority of causative agent... [more]

© 2016 The Authors. Background: The emergence of antimicrobial resistance is of particular concern with respect to urinary tract infections, since the majority of causative agents are Gram-negative bacteria. Healthcare-associated urinary tract infections (HAUTIs) are frequently associated with instrumentation of the urinary tract, specifically with indwelling catheters. Aim: To evaluate the current incidence, mortality, and length of hospital stay associated with HAUTIs. Methods: A non-concurrent cohort study design was used, conducted between January 1st, 2010 and June 30th, 2014. All patients admitted to one of the eight participating Australian hospitals and who were hospitalized for more than two days were included. The primary outcome measures were the incidence, mortality, and excess length of stay associated with HAUTIs. Findings: From 162,503 patient admissions, 1.73% [95% confidence interval (CI): 1.67-1.80] of admitted patients acquired a HAUTI. Using a multi-state model, the expected extra length of stay due to HAUTI was four days (95% CI: 3.1-5.0 days). Using a Cox regression model, infection significantly reduced the rate of discharge (hazard ratio: 0.78; 95% CI: 0.73-0.83). Women were less likely to die (0.71; 0.66-0.75), whereas older patients were more likely to die (1.40; 1.38-1.43). Death was rarer in a tertiary referral hospital compared to other hospitals, after adjusting for age and sex (0.74; 0.69-0.78). Conclusion: This study is the first to explore the burden of HAUTIs in hospitals using appropriate statistical methods in a developed country. Our study indicates that the incidence of HAUTI, in addition to its associated extra length of stay in hospital, presents a burden to the hospital system. With increasing incidence of UTI due to antimicrobial-resistant organisms, surveillance and interventions to reduce the incidence of HAUTI are required.

DOI 10.1016/j.jhin.2016.01.012
Citations Scopus - 13Web of Science - 9
Co-authors John Ferguson
2016 Mitchell BG, Ferguson JK, 'The use of clinical coding data for the surveillance of healthcare-associated urinary tract infections in Australia', Infection, Disease and Health, 21 32-35 (2016) [C1]

© 2016 Australasian College for Infection Prevention and Control Introduction Given the trends in antimicrobial resistance, particularly for Gram-negative organisms, the surveill... [more]

© 2016 Australasian College for Infection Prevention and Control Introduction Given the trends in antimicrobial resistance, particularly for Gram-negative organisms, the surveillance of urinary tract infections (UTIs) has the potential to become increasingly important in the future. Whilst considering accuracy and efficiency, we undertook a cohort study in a large Australian health district to inform future discussions around surveillance approaches to healthcare-associated UTIs (HAUTI). Methods A retrospective cohort study in eight hospitals was conducted to examine the clinical coding data of all patients hospitalised for more than two days over a four-and-half-year period. These data were compared to a conservative laboratory-based HAUTI definition. Results The data from 162,503 patient admissions were examined. During the study period, 2821 of the admitted patients acquired a HAUTI. Of those patients identified as having a laboratory-diagnosed HAUTI, 29.3% had a clinical code relating to a UTI. Conclusion The clinical coding data used to identify cases of HAUTI is very unreliable as a significant proportion of cases were not identified. To ensure the efficient and effective use of resources, a range of approaches should be considered in the event of HAUTI surveillance being required.

DOI 10.1016/j.idh.2016.03.002
Citations Scopus - 1
Co-authors John Ferguson
2015 Asigau V, Lavu EK, McBride WJH, Biloh E, Naroi F, Koana E, et al., 'Short Report: Prevalence of patients with acute febrile illnesses and positive dengue NS1 tests in a tertiary hospital in papua new guinea', American Journal of Tropical Medicine and Hygiene, 92 72-74 (2015) [C1]

Copyright © 2015 by The American Society of Tropical Medicine and Hygiene. Because the prevalence of dengue fever in urban settings in Papua New Guinea is unknown, we investigate... [more]

Copyright © 2015 by The American Society of Tropical Medicine and Hygiene. Because the prevalence of dengue fever in urban settings in Papua New Guinea is unknown, we investigated the presence of dengue using the NS1 antigen test in an outpatient-based prospective observational study at Port Moresby General Hospital. Of 140 patients with acute febrile illnesses, dengue fever was diagnosed in 14.9% (20 of 134; 95% confidence interval [95% CI] = 9.6-22.4). Malaria (2 of 137; 1.5%; 95% CI = 0.3-5.7), chikungunya (3 of 140; 2.1%; 95% CI = 0.6-6.6), and bacterial bloodstream infections (0 of 80; 0%; 95% CI = 0-5.7) were uncommon. Dengue fever should no longer be considered rare in Papua New Guinea.

DOI 10.4269/ajtmh.14-0373
Co-authors John Ferguson
2015 Stuart RL, Marshall C, Orr E, Bennett N, Athan E, Friedman D, et al., 'Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities', Internal Medicine Journal, 45 576-580 (2015)

© 2015 Royal Australasian College of Physicians. This study assessed infection prevention and antimicrobial stewardship (AMS) practices in Australian residential aged-care facili... [more]

© 2015 Royal Australasian College of Physicians. This study assessed infection prevention and antimicrobial stewardship (AMS) practices in Australian residential aged-care facilities (RACF). Two hundred and sixty-five surveys (15.6%) were completed with all states represented and the majority (177 (67.3%)) privately run. Only 30.6% RACF had infection control trained staff on site. Few facilities had AMS policies, only 14% had antimicrobial prescribing restrictions. Most facilities offered vaccination to residents (influenza vaccination rates > 75% in 73% of facilities), but pneumococcal vaccination was poor.

DOI 10.1111/imj.12740
Citations Scopus - 3
Co-authors John Ferguson
2015 Mirmilstein G, Ferguson J, 'Stable post-TRUS biopsy sepsis rates and antibiotic resistance over 5 years in patients from Newcastle, New South Wales', MEDICAL JOURNAL OF AUSTRALIA, 202 237-237 (2015) [C1]
DOI 10.5694/mja14.01571
Co-authors John Ferguson
2014 Chean R, Ferguson JK, Stuart RL, 'Mandatory seasonal influenza vaccination of health care workers: A way forward to improving influenza vaccination rates', Healthcare Infection, 19 42-44 (2014) [C3]

Vaccine-preventable diseases cause significant mortality and morbidity. Immunisation of healthcare workers (HCW) plays a significant role in preventing nosocomial transmission in ... [more]

Vaccine-preventable diseases cause significant mortality and morbidity. Immunisation of healthcare workers (HCW) plays a significant role in preventing nosocomial transmission in healthcare settings. Non-immune HCW put themselves, their contacts and patients at risk of preventable diseases. Achieving 100% protection for HCW and patients should be an achievable target; however, voluntary vaccination programs fail to achieve this rate of protection. This is true in the case of influenza, which contributes to the highest mortality and morbidity of any vaccine-preventable disease. Despite available safe, effective vaccines for seasonal influenza and recommendations by local and international authoritative bodies, the annual influenza vaccination rates amongst HCW remain disappointingly low despite recommendations by local and international authoritative bodies. Voluntary strategies of increasing access, offers of free vaccines, education, and highly visible publicity campaigns have had limited success. In the US, more innovative ideas have been proposed to complement these steps. We discuss such strategies including mandatory influenza vaccination and its possible implementation. © Australasian College for Infection Prevention and Control 2014.

DOI 10.1071/HI13041
Citations Scopus - 1
Co-authors John Ferguson
2014 Mitchell BG, Digney W, Ferguson JK, 'Prior room occupancy increases risk of methicillin-resistant Staphylococcus aureus acquisition', Healthcare Infection, 19 135-140 (2014) [C1]

© 2014 Australasian College for Infection Prevention and Control. Background In Australia, little is known about the risk of acquiring methicillin-resistant Staphylococcus aureus... [more]

© 2014 Australasian College for Infection Prevention and Control. Background In Australia, little is known about the risk of acquiring methicillin-resistant Staphylococcus aureus (MRSA) from prior room occupants. The aims of the study are to understand the risk of MRSA acquisition from prior room occupants and to further extend the existing knowledge-base on the role of discharge cleaning in hospitals. Methods A non-concurrent cohort study was undertaken in five wards at a 250-bed general hospital in Tasmania, Australia. All admitted patients were screened for MRSA. Weekly screenings for all patients who remained in hospital were undertaken. New MRSA acquisitions were identified. The exposed group were patients whose immediate prior room occupant had MRSA, while the unexposed prior room occupant did not have MRSA. Results 6228 patients were at risk of acquiring MRSA, with 237 new MRSA acquisitions equating to an acquisition rate of 3.8% for each at-risk patient admission. The unadjusted odds ratio for acquiring MRSA when the prior room occupant had MRSA was 2.9 (95% CI 2.2-3.9). Using logistic regression, exposure to a prior occupant harbouring MRSA remained a significant predictor of subsequent acquisition, after controlling for variables, OR 2.7 (95% CI 2.0-3.6). Conclusion Admission to a room previously occupied by a person with MRSA increased the odds of acquisition for the subsequent patient, independent of other risk factors. It demonstrates the necessity of having effective discharge cleaning practices in place. We believe increased attention to discharge room cleaning in hospitals is required and the reconsideration of additional recommendations for discharge cleaning.

DOI 10.1071/HI14023
Citations Scopus - 3
Co-authors John Ferguson
2012 Harris PNA, Ashhurst-Smith CIJ, Berenger SJ, Shoobert A, Ferguson JK, 'Adhesive tape in the health care setting: Another high-risk fomite?', Medical Journal of Australia, 196 34 (2012) [C3]
Citations Scopus - 8Web of Science - 6
Co-authors John Ferguson
2012 Harris PNA, Ferguson JK, 'Antibiotic therapy for inducible AmpC ß-lactamase-producing Gram-negative bacilli: What are the alternatives to carbapenems, quinolones and aminoglycosides?', International Journal of Antimicrobial Agents, 40 297-305 (2012) [C1]
DOI 10.1016/j.ijantimicag.2012.06.004
Citations Scopus - 40Web of Science - 37
Co-authors John Ferguson
2012 Ryan NM, Vertigan AE, Ferguson JK, Wark PA, Gibson PG, 'Clinical and physiological features of postinfectious chronic cough associated with H1N1 infection', Respiratory Medicine, 106 138-144 (2012) [C1]
DOI 10.1016/j.rmed.2011.10.007
Citations Scopus - 9Web of Science - 9
Co-authors Nicole Ryan, Peter Wark, Peter Gibson, John Ferguson
2012 Ferguson JK, 'Preventive strategies for recurrent staphylococcal skin infection', Medicine Today, 13 65-70 (2012) [C3]
Co-authors John Ferguson
2011 Stuart RL, Marshall C, McLaws M-L, Boardman C, Russo PL, Harrington G, Ferguson JK, 'ASID/AICA position statement - Infection control guidelines for patients with Clostridium difficile infection in healthcare settings', Healthcare Infection, 16 33-39 (2011) [C3]
DOI 10.1071/hi11011
Citations Scopus - 17
Co-authors John Ferguson
2011 Islam A, Ferguson JK, Givney R, Graves S, 'Short report: Seroprevalence to Coxiella Burnetii among residents of the Hunter New England Region of New South Wales, Australia', American Journal of Tropical Medicine and Hygiene, 84 318-320 (2011) [C1]
DOI 10.4269/ajtmh.2011.10-0268
Citations Scopus - 12Web of Science - 11
Co-authors John Ferguson
2011 Cheng AC, Ferguson JK, Richards MJ, Robson JM, Gilbert GL, McGregor A, et al., 'Australasian Society for Infectious Diseases guidelines for the diagnosis and treatment of clostridium difficile infection', Medical Journal of Australia, 194 353-358 (2011) [C2]
Citations Scopus - 55Web of Science - 45
Co-authors John Ferguson
2011 Ferguson JK, Cheng AC, Gilbert GL, Gottlieb T, Korman T, McGregor A, et al., 'Clostridium difficile laboratory testing in Australia and New Zealand: National survey results and Australasian Society for Infectious Diseases recommendations for best practice', Pathology, 43 482-487 (2011) [C1]
Citations Scopus - 26Web of Science - 20
Co-authors John Ferguson
2011 Thomas R, Ferguson JK, Coombs G, Gibson PG, 'Community-acquired methicillin-resistant Staphylococcus aureus pneumonia: A clinical audit', Respirology, 16 926-931 (2011) [C1]
Citations Scopus - 11Web of Science - 14
Co-authors Peter Gibson, John Ferguson
2010 Guimont C, Hullick C, Durrheim DN, Ryan N, Ferguson J, Massey P, 'Invasive meningococcal disease: Improving management through structured review of cases in the Hunter New England area, Australia', Journal of Public Health, 21 38-43 (2010) [C1]
DOI 10.1093/pubmed/fdp075
Citations Scopus - 6Web of Science - 3
Co-authors D Durrheim, John Ferguson
2009 Cruickshank M, Ferguson J, Bull A, 'Reducing harm to patients from health care associated infection: The role of surveillance. Chapter 3: Surgical site infection - An abridged version', Healthcare Infection, 14 109-114 (2009)

The following article is an abridged version of Chapter 3: &apos;Surgical site infection&apos; from the publication &apos;Reducing harm to patients from health care associated inf... [more]

The following article is an abridged version of Chapter 3: 'Surgical site infection' from the publication 'Reducing harm to patients from health care associated infection: the role of surveillance.' In: Cruickshank M, Ferguson J, editors. Sydney: Australian Commission on Safety and Quality in Health Care; 2008. The complete publication is available online at: www.safetyandquality.gov. au. © Australian Infection Control Association 2009.

DOI 10.1071/HI09912
Citations Scopus - 4
Co-authors John Ferguson
2009 Chen SCA, Marriott D, Playford EG, Nguyen Q, Ellis D, Meyer W, et al., 'Candidaemia with uncommon Candida species: Predisposing factors, outcome, antifungal susceptibility, and implications for management', Clinical Microbiology and Infection, 15 662-669 (2009)

The risk factors for and clinical features of bloodstream infection with uncommon Candida spp. (species other than C. albicans, C. glabrata, C. parapsilosis, C. tropicals and C. k... [more]

The risk factors for and clinical features of bloodstream infection with uncommon Candida spp. (species other than C. albicans, C. glabrata, C. parapsilosis, C. tropicals and C. krusei) are incompletely defined. To identify clinical variables associated with these species that might guide management, 57 cases of candidaemia resulting from uncommon Candida spp. were analysed in comparison with 517 episodes of Candida albicans candidaemia (2001-2004). Infection with uncommon Candida spp. (5.3% of candidaemia cases), as compared with C. albicans candidaemia, was significantly more likely to be outpatient-acquired than inpatient-acquired (15 of 57 vs. 65 of 517 episodes, p0.01). Prior exposure to fluconazole was uncommon (n =1). Candida dubliniensis was the commonest species (n =22, 39%), followed by Candida guilliermondii (n = 11, 19%) and Candida lusitaniae (n = 7, 12%). C. dubliniensis candidaemia was independently associated with recent intravenous drug use (p0.01) and chronic liver disease (p0.03), and infection with species other than C. dubliniensis was independently associated with age < 65 years (p0.02), male sex (p0.03) and human immunodeficiency virus infection (p0.05). Presence of sepsis at diagnosis and crude 30-day mortality rates were similar for C. dubliniensis-related, non- C. dubliniensis-related and C. albicans-related candidaemia. Haematological malignancy was the commonest predisposing factor in C. guilliermondii (n = 3, 27%) and C. lusitaniae (n = 3, 43%) candidaemia. The 30-day mortality rate of C. lusitaniae candidaemia was higher than the overall death rate for all uncommon Candida spp. (42.9% vs. 25%, not significant). All isolates were susceptible to amphotericin.B, voriconazole, posaconazole, and caspofungin; five strains (9%) had fluconazole MIC values of 16-32 mg/L. Candidaemia due to uncommon Candida spp. is emerging among hospital outpatients; certain clinical variables may assist in recognition of this entity. © 2009 The Authors Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.

DOI 10.1111/j.1469-0691.2009.02821.x
Citations Scopus - 54
Co-authors John Ferguson
2009 Marriott DJE, Geoffrey EG, Chen S, Slavin M, Nguyen Q, Ellis D, et al., 'Determinants of mortality in non-neutropenic ICU patients with candidaemia', Critical Care, 13 (2009)

Introduction: Candidaemia in critically-ill intensive care unit (ICU) patients is associated with high crude mortality. Determinants of mortality - particularly those amenable to ... [more]

Introduction: Candidaemia in critically-ill intensive care unit (ICU) patients is associated with high crude mortality. Determinants of mortality - particularly those amenable to potential modification - are incompletely defined. Methods: A nationwide prospective clinical and microbiological cohort study of all episodes of ICU-acquired candidaemia occurring in non-neutropenic adults was undertaken in Australian ICUs between 2001 and 2004. Multivariate Cox regression analyses were performed to determine independently significant variables associated with mortality. Results: 183 episodes of ICU-acquired candidaemia occurred in 183 patients during the study period. Of the 179 with microbiological data, Candida albicans accounted for 111 (62%) episodes and Candida glabrata, 32 (18%). Outcome data were available for 173: crude hospital mortality at 30 days was 56%. Host factors (older age, ICU admission diagnosis, mechanical ventilation and ICU admission diagnosis) and failure to receive systemic antifungal therapy were significantly associated with mortality on multivariate analysis. Among the subset who received initial fluconazole therapy (n = 93), the crude mortality was 52%. Host factors (increasing age and haemodialysis receipt), but not organism- (Candida species, fluconazole MIC), pharmacokinetic- (fluconazole dose, time to initiation), or pharmacodynamic-related parameters (fluconazole dose:MIC ratio) were associated with mortality. Process of care measures advocated in recent guidelines were implemented inconsistently: follow-up blood cultures were obtained in 68% of patients, central venous catheters removed within five days in 80% and ophthalmological examination performed in 36%. Conclusions: Crude mortality remains highin Australian ICU patients with candidaemia and is overwhelmingly related to host factors but not treatment variables (the time to initiation of antifungals or fluconazole pharmacokinetic and pharmacodynamic factors). The role and timing of early antifungal intervention in critically-ill ICU patients requires further investigation. © 2009 Marriott et al.; licensee BioMed Central Ltd.

DOI 10.1186/cc7964
Citations Scopus - 64
Co-authors John Ferguson
2009 Stuart RL, Cheng AC, Marshall CL, Ferguson JK, 'ASID (HICSIG) position statement: infection control guidelines for patients with influenza-like illnesses, including pandemic (H1N1) influenza 2009, in Australian health care facilities (vol 191, pg 454, 2009)', MEDICAL JOURNAL OF AUSTRALIA, 191 667-667 (2009)
Co-authors John Ferguson
2009 Stuart RL, Cheng AC, Marshall CL, Ferguson JK, 'ASID (HICSIG) position statement: infection control guidelines for patients with influenza-like illnesses, including pandemic (H1N1) influenza 2009, in Australian health care facilities', Medical Journal of Australia, 191 454-458 (2009) [C1]
Citations Scopus - 18Web of Science - 15
Co-authors John Ferguson
2009 Heath CH, Slavin MA, Sorrell TC, Handke R, Harun A, Phillips M, et al., 'Population-based surveillance for scedosporiosis in Australia: Epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection', Clinical Microbiology and Infection, 15 689-693 (2009)

Australia-wide population-based surveillance for scedosporiosis identified 180 cases, with 118 (65.6%) cases of colonization and 62 (34.4%) cases of infection. Predisposing factor... [more]

Australia-wide population-based surveillance for scedosporiosis identified 180 cases, with 118 (65.6%) cases of colonization and 62 (34.4%) cases of infection. Predisposing factors for isolation of Scedosporium spp. included chronic lung disease in 37.8% and malignancy in 21.7% of cases. Predictors of invasive disease (n = 62) included haematological stem cell transplantation (n = 7), leukaemia (n = 16) and diabetes mellitus (n = 8). Of 183 phenotypically-speciated isolates, 75 (41%) were Scedosporium prolificans (risk factors: haematologic cancer (n = 17), neutropaenia (n = 14)) and 108 (59%) had Scedosporium apiospermum/Pseudallescheria boydii phenotype [risk factor: diabetes (n = 15)]. Scedosporium prolificans (p 0.01) and leukaemia (p 0.03) independently predicted death. Epidemiological and antifungal susceptibility profiles of Scedosporium aurantiacum (prevalence =15.8%) and S. apiospermum were similar. No patient with S aurantiacum infection (n = 6) died. This is the first description of clinical features associated with S. aurantiacum. © 2009 The Authors Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.

DOI 10.1111/j.1469-0691.2009.02802.x
Citations Scopus - 56
Co-authors John Ferguson
2009 Ferguson JK, 'Preventing healthcare-associated infection: Risks, healthcare systems and behaviour', Internal Medicine Journal, 39 574-581 (2009) [C1]
DOI 10.1111/j.1445-5994.2009.02004.x
Citations Scopus - 19Web of Science - 15
Co-authors John Ferguson
2008 Delhaes L, Harun A, Chen SCA, Nguyen Q, Slavin M, Heath CH, et al., 'Molecular typing of Australian Scedosporium isolates showing genetic variability and numerous S. aurantiacum', Emerging Infectious Diseases, 14 282-290 (2008)

One hundred clinical isolates from a prospective nationwide study of scedosporiosis in Australia (2003-2005) and 46 additional isolates were genotyped by internal transcribed spac... [more]

One hundred clinical isolates from a prospective nationwide study of scedosporiosis in Australia (2003-2005) and 46 additional isolates were genotyped by internal transcribed spacer-restriction fragment length polymorphism (ITS-RFLP) analysis, ITS sequencing, and M13 PCR fingerprinting. ITS-RFLP and PCR fingerprinting identified 3 distinct genetic groups. The first group corresponded to Scedosporium prolificans (n = 83), and the other 2 comprised isolates previously identified as S. apiospermum: one of these corresponded to S. apiospermum (n = 33) and the other to the newly described species S. aurantiacum (n = 30). Intraspecies variation was highest for S. apiospermum (58%), followed by S. prolificans (45%) and S. aurantiacum (28%) as determined by PCR fingerprinting. ITS sequence variation of 2.2% was observed among S. apiospermum isolates. No correlation was found between genotype of strains and their geographic origin, body site from which they were cultured, or colonization versus invasive disease. Twelve S. prolificans isolates from 2 suspected case clusters were examined by amplified fragment length polymorphism analysis. No specific clusters were confirmed.

Citations Scopus - 21
Co-authors John Ferguson
2008 Ferguson JK, Van Gessel H, 'Methicillin-resistant Staphylococcus aureus in hospitals: Time for a culture change', The Medical Journal of Australia, 188 61-64 (2008) [C3]
Co-authors John Ferguson
2008 Unicomb LE, O'Reilly LC, Kirk MD, Stafford RJ, Smith HV, Becker NG, et al., 'Risk factors for infection with Campylobacter jejuni flaA genotypes', Epidemiology and Infection, 136 1480-1491 (2008)

We aimed to explore Campylobacter genotype-specific risk factors in Australia. Isolates collected prospectively from cases recruited into a case-control study were genotyped using... [more]

We aimed to explore Campylobacter genotype-specific risk factors in Australia. Isolates collected prospectively from cases recruited into a case-control study were genotyped using flaA restriction fragment-length polymorphism typing ( flaA genotyping). Exposure information for cases and controls was collected by telephone interview. Risk factors were examined for major flaA genotypes using logistic and multinomial regression. Five flaA genotypes accounted for 325 of 590 (55%) cases - flaA-6b (n=129), flaA-6 (n=70), flaA-10 (n=48), flaA-2 (n=43), flaA-131 (n=35). In Australia, infections due to flaA-10 and flaA-2 were found to be significantly associated with eating non-poultry meat (beef and ham, respectively) in both case-control and inter-genotype comparisons. All major genotypes apart from flaA-10 were associated with chicken consumption in the case-control comparisons. Based on several clinical criteria, infections due to flaA-2 were more severe than those due to other genotypes. Thus genotype analysis may reveal genotype-specific niches and differences in virulence and transmission routes. © 2008 Cambridge University Press.

DOI 10.1017/S0950268807000246
Citations Scopus - 5
Co-authors Craig Dalton, John Ferguson
2007 Ferguson JK, 'A call to arms', Australian Infection Control, 12 39-40 (2007) [C3]
Co-authors John Ferguson
2007 Mickan L, Doyle R, Valcanis M, Dingle KE, Unicomb L, Lanser J, et al., 'Multilocus sequence typing of Campylobacter jejuni isolates from New South Wales, Australia', Journal of Applied Microbiology, 102 144-152 (2007)

Aims: Multilocus sequence typing (MLST) was used to examine the diversity and population structure of Campylobacter jejuni isolates associated with sporadic cases of gastroenterit... [more]

Aims: Multilocus sequence typing (MLST) was used to examine the diversity and population structure of Campylobacter jejuni isolates associated with sporadic cases of gastroenteritis in Australia, and to compare these isolates with those from elsewhere. Methods and Results: A total of 153 Camp. jejuni isolates were genotyped. Forty sequence types (STs) were found, 19 of which were previously undescribed and 21 identified in other countries. The 19 newly described STs accounted for 43% of isolates, 16 of which were assigned to known clonal complexes. Eighty-eight percent of isolates were assigned to a total of 15 clonal complexes. Of these, four clonal complexes accounted for 60% of isolates. Three STs accounted for nearly 40% of all isolates and appeared to be endemic, while 21 STs were represented by more than one isolate. Seven infections were acquired during international travel, and the associated isolates all had different STs, three of which were exclusive to the travel-acquired cases. Comparison of serotypes among isolates from clonal complexes revealed further diversity. Eight serotypes were identified among isolates from more than one clonal complex, while isolates from six clonal complexes displayed serotypes not previously associated with those clonal complexes. Conclusions: Multilocus sequence typing is a useful tool for the discrimination of subtypes and examination of the population structure of Camp. jejuni associated with sporadic infections. Significance and Impact of the Study: This study highlights the genotypic diversity of Camp. jejuni in Australia, demonstrating that STs causing disease have both a global and a local distribution evident from the typing of domestically and internationally acquired Camp. jejuni isolates. © 2007 The Authors.

DOI 10.1111/j.1365-2672.2006.03049.x
Citations Scopus - 33
Co-authors Craig Dalton, John Ferguson
2007 Angstetra D, Ferguson J, Giles WB, 'Institution of universal screening for Group B streptococcus (GBS) from a risk management protocol results in reduction of early-onset GBS disease in a tertiary obstetric unit', Australian and New Zealand Journal of Obstetrics and Gynaecology, 47 378-382 (2007) [C1]
DOI 10.1111/j.1479-828X.2007.00760.x
Citations Scopus - 17Web of Science - 11
Co-authors John Ferguson
2007 Watson J, Graves SR, Ferguson JK, D'Este CA, Batey RG, 'Hepatitis C virus RNA quantitation and degradation studies in whole blood samples in vitro', Gut, 56 306-307 (2007) [C3]
Citations Scopus - 2Web of Science - 2
Co-authors Catherine Deste, John Ferguson
2007 Djordjevic SP, Unicomb LE, Adamson PJ, Mickan L, Rios R, Adamson P, et al., 'Clonal complexes of Campylobacter jejuni identified by multilocus sequence typing are reliably predicted by restriction fragment length polymorphism analyses of the flaA gene', Journal of Clinical Microbiology, 45 102-108 (2007)

Multilocus sequence typing (MLST) has provided important new insights into the population structure of Campylobacter jejuni and is rapidly becoming the gold standard for typing th... [more]

Multilocus sequence typing (MLST) has provided important new insights into the population structure of Campylobacter jejuni and is rapidly becoming the gold standard for typing this species. However, the methodology is comparatively costly and slow to perform for the routine surveillance testing of large numbers of isolates required by public health laboratories. Restriction fragment length polymorphism analysis of the flaA gene (RELP-flaA) and sequencing of the variable region in the fla locus (SVR-fla) were compared to MLST to determine if a low cost alternative could be found that reliably predicts clonal lineage (as determined by MLST). An isolate of C. jejuni from each of 153 patients from New South Wales, Australia, collected sequentially over a period of 30 months from 1999 to 2001 and comprising 40 sequence types (ST) from 15 clonal complexes (CC) was examined. Of 15 CC, 12 were represented by more than one isolate and a predominant RFLP-flaA type was found for 10 (83%). Of these, seven (70%) correctly predicted the predominant MLST CC with a probability of > 0.8. Of 40 STs detected, 19 were reported for the first time, 9 of which were represented by more than one isolate. Eight of these were represented by a single RFLP-flaA type. Only two of eight major SVR-fla types were able to predict CC with a probability of > 0.8, indicating that flaA-RFLP is a more reliable predictor of CC than SVR-fla and thus offers an alternative to MLST for use in routine surveillance. Copyright © 2007, American Society for Microbiology. All Rights Reserved.

DOI 10.1128/JCM.01012-06
Citations Scopus - 27
Co-authors Craig Dalton, John Ferguson
2006 Ng J, Gosbell IB, Kelly JA, Boyle MJ, Ferguson JK, 'Cure of multiresistant Acinetobacter baumannii central nervous system infections with intraventricular or intrathecal colistin: case series and literature review', Journal of Antimicrobial Chemotherapy, 58 1078-1081 (2006) [C1]
DOI 10.1093/jac/dkl347
Citations Scopus - 65Web of Science - 58
Co-authors John Ferguson
2006 Cameron RJ, De Wit D, Welsh TN, Ferguson JK, Grissell TV, Rye PJ, 'Virus infection in exacerbations of chronic obstructive pulmonary disease requiring ventilation', Intensive Care Medicine, 32 1022-1029 (2006) [C1]
DOI 10.1007/s00134-006-0202-x
Citations Scopus - 63Web of Science - 56
Co-authors John Ferguson
2006 O'Reilly LC, Inglis TJJ, Unicomb L, Adamson P, Cheung K, Dalton C, et al., 'Australian multicentre comparison of subtyping methods for the investigation of Campylobacter infection', Epidemiology and Infection, 134 768-779 (2006)

In order to identify subtyping methods able to contribute to the surveillance or investigation of Australian Campylobacter infection, six genotypic and three phenotypic subtyping ... [more]

In order to identify subtyping methods able to contribute to the surveillance or investigation of Australian Campylobacter infection, six genotypic and three phenotypic subtyping methods were evaluated on a collection of 84 clinical isolates collected over a 30-month period from one region in Australia. The aim was to compare the logistics of various subtyping methods and examine their ability to assist in finding outbreaks or common sources of sporadic infection. The genotypic subtyping methods used were sequencing of the short variable region of the flaA gene, two methods using restriction fragment length polymorphism (RFLP) of the flaA gene using either DdeI or EcoRI with PstI, automated ribotyping, pulsed field gel electrophoresis and multilocus sequence typing. The phenotypic methods employed included Laboratory of Enteric Pathogens serotyping, Lior biotyping and antibiotic resistotyping. The level of agreement between subtyping results was determined. Phenotypic methods showed little agreement whereas genotypic typing methods showed a high level of agreement. Using the premise that five of the six genotypic typing methods were in agreement 15 genotypic groupings were identified. Sequencing of the short variable region of the flaA gene, RFLP of the flaA gene or automated ribotyping in conjunction with multilocus sequence typing best identified genotypic groupings. An alternative combination of RFLP of the flaA gene followed by ribotyping was equally satisfactory. RFLP of the flaA gene appeared to be suitable as a preliminary typing method based on ease of operation, equipment availability and cost. © 2006 Cambridge University Press.

DOI 10.1017/S0950268805005777
Citations Scopus - 23
Co-authors Craig Dalton, John Ferguson
2006 Unicomb LE, Ferguson JK, Stafford RJ, Ashbolt R, Kirk MD, Becker NG, et al., 'Low-level fluoroquinolone resistance among Campylobacter jejuni isolates in Australia', Clinical Infectious Diseases, 42 1368-1374 (2006) [C1]
DOI 10.1086/503426
Citations Scopus - 40Web of Science - 38
Co-authors John Ferguson
2006 Chen S, Slavin M, Nguyen Q, Marriott D, Playford EG, Ellis D, et al., 'Active surveillance for candidemia, Australia', Emerging Infectious Diseases, 12 1508-1516 (2006)

Population-based surveillance for candidemia in Australia from 2001 to 2004 identified 1,095 cases. Annual overall and hospital-specific incidences were 1.81/100,000 and 0.21/1,00... [more]

Population-based surveillance for candidemia in Australia from 2001 to 2004 identified 1,095 cases. Annual overall and hospital-specific incidences were 1.81/100,000 and 0.21/1,000 separations (completed admissions), respectively. Predisposing factors included malignancy (32.1%), indwelling vascular catheters (72.6%), use of antimicrobial agents (77%), and surgery (37.1%). Of 919 episodes, 81.5% were inpatient healthcare associated (IHCA), 11.6% were outpatient healthcare associated (OHCA), and 6.9% were community acquired (CA). Concomitant illnesses and risk factors were similar in IHCA and OHCA candidemia. IHCA candidemia was associated with sepsis at diagnosis (p < 0.001), death =30 days after infection (p < 0.001), and prolonged hospital admission (p < 0.001). Non-Candida albicans species (52.7%) caused 60.5% of cases acquired outside hospitals and 49.9% of IHCA candidemia (p = 0.02). The 30-day death rate was 27.7% in those =65 years of age. Adult critical care stay, sepsis syndrome, and corticosteroid therapy were associated with the greatest risk for death. Systematic epidemiologic studies that use standardized definitions for IHCA, OHCA, and CA candidemia are indicated.

Citations Scopus - 113
Co-authors John Ferguson
2005 Wilson PA, Ferguson JK, 'Severe community-acquired pneumonia: an Australian perspective', Internal Medicine Journal, 35 699-705 (2005) [C1]
DOI 10.1111/j.1445-5994.2005.00962.x
Citations Scopus - 37Web of Science - 33
Co-authors John Ferguson
2004 Berenger SJ, Ferguson JK, 'Reuse of single-use medical devices: how often does this still occur in Australia?', MEDICAL JOURNAL OF AUSTRALIA, 180 46-46 (2004)
Citations Scopus - 3Web of Science - 1
Co-authors John Ferguson
2004 Ferguson J, 'Antibiotic prescribing: How can emergence of antibiotic resistance be delayed?', Australian Prescriber, 27 39-42+51 (2004)

The discovery of new antibiotic drugs has slowed significantly and widespread use of current antibiotics has resulted in the emergence of many multi-resistant bacterial pathogens.... [more]

The discovery of new antibiotic drugs has slowed significantly and widespread use of current antibiotics has resulted in the emergence of many multi-resistant bacterial pathogens. In order to preserve the activity of currently available antibiotics for as long as possible, care should be taken to only prescribe them when an infection is serious and is likely to respond significantly to treatment. Judicious prescribing will reduce the selective pressure on bacteria and thereby slow down the emergence of resistance. In the future, prevention through immunisation and reducing the spread of infection (infection control) will assume greater importance as a way of sidestepping the interplay of antibiotic use and bacterial resistance. It is particularly important to avoid empirical use of antibiotics for most patients with upper respiratory infections.

Citations Scopus - 8
Co-authors John Ferguson
2004 Doyle R, Watson K, Unicomb LE, Lanser JA, Wise R, Ratcliff R, et al., 'Laboratory surveillance of shiga toxin producing Escherichia coli in South Australia and the Hunter Health Area, New South Wales, Australia', Communicable Diseases Intelligence Quarterly Report, 28 390-391 (2004) [C1]
Co-authors John Ferguson
2004 Sturman N, Ferguson J, 'Antibiotic prescribing (multiple letters) [4]', Australian Prescriber, 27 140 (2004)
Co-authors John Ferguson
2003 Ferguson JK, Doherty PL, Cooper CM, Dollman CM, Looke DFM, Radford JM, 'Hospital antibiotic utilisation in three states', Australian Infection Control, 8 7-12 (2003) [C2]
Co-authors John Ferguson
2003 Tiley S, MacDonald J, Ferguson JK, 'Active promotion of antibiotic guidelines: an intensive program', Communicable Diseases Intelligence Quarterly Report, 27 S13-S18 (2003) [C1]
Co-authors John Ferguson
2003 Unicomb L, Ferguson JK, Riley TV, Collignon P, 'Fluoroquinolone resistance in Campylobacter absent from Isolates, Australia', Emerging Infectious Diseases, 9 1482-1483 (2003) [C1]
DOI 10.3201/eid0911.030336
Citations Scopus - 47Web of Science - 46
Co-authors John Ferguson
2001 Rea MD, Dalton CB, Ebeling PW, Ferguson JK, 'Pertussis death in the Hunter region of New South Wales', MEDICAL JOURNAL OF AUSTRALIA, 175 172-173 (2001)
Co-authors John Ferguson, Craig Dalton
2001 MacDonald J, Ferguson JK, 'How education influences prescribing at John Hunter Hospital', Australian Prescriber, 24 32 (2001) [C3]
Citations Scopus - 1
Co-authors John Ferguson
1999 Arestis N, Tham YJ, McIntyre PB, Isaacs D, Palasanthiran P, Ferguson JK, et al., 'A population-based study of children with cerebral tuberculosis in New South Wales', MEDICAL JOURNAL OF AUSTRALIA, 171 197-200 (1999)
Citations Scopus - 5Web of Science - 3
Co-authors John Ferguson
1999 Ferguson JK, 'Vancomycin-resistant enterococci: causes and control', MEDICAL JOURNAL OF AUSTRALIA, 171 117-118 (1999)
Citations Scopus - 6Web of Science - 6
Co-authors John Ferguson
1999 Cameron RJ, Ferguson JK, O'Brien MW, 'Pulsed-field gel electrophoresis is a useful tool in the monitoring of methicillin-resistant Staphylococcus aureus epidemic outbreaks in the intensive care unit', ANAESTHESIA AND INTENSIVE CARE, 27 447-451 (1999)
Citations Scopus - 7Web of Science - 7
Co-authors John Ferguson
1998 Ferguson J, 'Respiratory infections in the community. A concise update.', Australian family physician, 27 883-887 (1998)

BACKGROUND: The decision to institute antibiotic therapy is often empirical and based on historical precedent. As respiratory tract infections are the commonest reason for prescri... [more]

BACKGROUND: The decision to institute antibiotic therapy is often empirical and based on historical precedent. As respiratory tract infections are the commonest reason for prescribing antibiotics and bacterial resistance to many drugs is increasing, it is important to look at the evidence for using antibiotics. OBJECTIVE: This article reviews the various components of the respiratory tree addressing the indications for instituting antibiotic therapy and the most appropriate antibiotic. DISCUSSION: The information contained in this article is based on the 10th edition of the Therapeutic Guidelines: Antibiotics. It is acknowledged that the decision of when and which antibiotics to prescribe must be made on an individual basis, however, by considering the broader ramifications of antibiotic use and the evidence of outcome studies, the decision can be based on a more rational approach.

Citations Scopus - 2
Co-authors John Ferguson
1998 Ferguson JK, Hensley MJ, 'Should third-generation cephalosporins be the empirical treatment of choice for severe community-acquired pneumonia in adults?', The Medical Journal of Australia, 169 230 (1998) [C3]
Co-authors John Ferguson, Michael Hensley
1997 Kesson AM, Ferguson JK, Rawlinson WD, Cunningham AL, 'Progressive vaccinia treated with ribavirin and vaccinia immune globulin', CLINICAL INFECTIOUS DISEASES, 25 911-914 (1997)
DOI 10.1086/515534
Citations Scopus - 46Web of Science - 37
Co-authors John Ferguson
1997 Hamann ID, Gillespie RJ, Ferguson JK, 'Primary cryptococcal cellulitis caused by Cryptococcus neoformans var. gattii in an immunocompetent host', Australasian Journal of Dermatology, 38 29-32 (1997)

Primary cutaneous cryptococcal infection is uncommon. The cutaneous manifestations are most often the result of dissemination from the central nervous system or lung, usually in a... [more]

Primary cutaneous cryptococcal infection is uncommon. The cutaneous manifestations are most often the result of dissemination from the central nervous system or lung, usually in an immunocompromised host; cellulitis is regarded as the rarest cutaneous form. Primary cutaneous cryptococcosis has occasionally been reported in the immunocompetent, the causative organism being Cryptococcus neoformans var. neoformans. We present a case of cellulitis of the right arm in a 75-year-old man caused by Cryptococcus neoformans var. gattii, a fungus which is endemic in Australia and an important cause of infection in the immunocompetent. This is the first case described of a primary cutaneous infection due to Cryptococcus neoformans var. gattii. The interesting ecology of this organism is discussed.

Citations Scopus - 29
Co-authors John Ferguson
1997 Reeves GEM, Ferguson JK, Dobson P, Boyle MJ, 'Pentoxifylline to treat Mycobacterium avium complex exacerbation in late-stage HIV infection', MEDICAL JOURNAL OF AUSTRALIA, 166 446-446 (1997)
Citations Scopus - 2Web of Science - 2
Co-authors John Ferguson
1996 Ferguson JK, Gill A, 'Risk-stratified nosocomial infection surveillance in a neonatal intensive care unit: Report on 24 months of surveillance', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 32 525-531 (1996)
DOI 10.1111/j.1440-1754.1996.tb00967.x
Citations Scopus - 27Web of Science - 23
Co-authors John Ferguson
1996 Ferguson J, Butt H, Johnson C, Boyle M, 'Vancomycin-resistant Enterococcus faecium colonisations', MEDICAL JOURNAL OF AUSTRALIA, 165 292-293 (1996)
Citations Scopus - 4Web of Science - 6
Co-authors John Ferguson
1995 Ferguson JK, Jorm LR, Allen CD, Whitehead PK, Gilbert GL, 'Prospective study of diarrhoeal outbreaks in child long-daycare centres in western Sydney', Medical Journal of Australia, 163 137-140 (1995)

Objectives: To investigate outbreaks of diarrhoeal illness in children attending long-daycare centers (LDCs). To characterise parasitic, bacterial and viral isolates from children... [more]

Objectives: To investigate outbreaks of diarrhoeal illness in children attending long-daycare centers (LDCs). To characterise parasitic, bacterial and viral isolates from children's faeces and to identify individual and LDC risk factors for diarrhoea. Design: Eleven-month prospective case-control study of diarrhoeal outbreaks among children in LDCs. Subjects: 2368 children attending 35 LDCs in the western Sydney area. Main outcome measures: Frequently of diarrhoeal outbreaks, rate of attack and spread to family members; pathogens isolated from stools; and individual and LDC risk factors. Results: The overall incidence of diarrhoeal disease was low (0.28 outbreaks per center per year and 0.056 outbreak-associated cases per child-year). Attack rates during outbreaks varied widely (4% - 55%); mean, 15%), as did secondary spread rates to family members (1% - 15%; mean, 9%). Pathogens were isolated from 7% of symptomatic children and 7% of controls; no outbreak was shown to be caused by a recognised pathogen. Children with outbreak associated diarrhoeal illness were more likely to have suffered vomiting, poor appetite, lack of energy, fever and to have taken antibiotics in the previous week than other children. Hygiene practices varied widely among centers. Conclusions: We found low incidence and morbidity from diarrhoeal illness in Australian urban LDCs. Diarrhoea in children in LDCs may be caused predominantly by non-infectious factors such as diet and prevent and contain outbreaks of infectious diarrhoea.

Citations Scopus - 7
Co-authors John Ferguson
Show 67 more journal articles

Conference (4 outputs)

Year Citation Altmetrics Link
2014 Goodsall TM, Menon M, Bollipo S, Ferguson JK, 'Therapeutic abdominal paracentesis in an ambulatory setting: is routine blood culture bottle co-culture necessary?', JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2014) [E3]
Co-authors John Ferguson
2011 Ryan NM, Vertigan AE, Ferguson JK, Wark PA, Gibson PG, 'Investigation and characterization of persistent cough associated with H1N1 2009 influenza', Respirology, Perth, WA (2011) [E3]
Co-authors Peter Gibson, John Ferguson, Peter Wark, Nicole Ryan
2010 Mara SKO, Ferguson JK, Manolis M, 'Blood Transfusion Increases Hospital Acquired Septicaemia', Blood, Orlando, FL (2010) [E3]
Co-authors John Ferguson
2009 Thomas R, Ferguson JK, Gibson PG, 'Community acquired methicillin resistant staphylococcus aureus pneumonia: A clinical audit', Respirology, Darwin, NT (2009) [E3]
DOI 10.1111/j.1440-1843.2009.01502_7.x
Co-authors Peter Gibson, John Ferguson
Show 1 more conference
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Conjoint Associate Professor John Ferguson

Position

Conjoint Associate Professor
School of Biomedical Sciences and Pharmacy
Faculty of Health and Medicine

Focus area

Immunology and Microbiology

Contact Details

Email john.kferguson@newcastle.edu.au
Phone (02) 4921 4422
Fax (02) 4921 4440
Links Personal Blogs
Personal Blogs

Office

Room Level 2
Building HAPS Building
Location Other

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