Conjoint Professor Josh Davis

Conjoint Professor Josh Davis

Conjoint Professor

School of Medicine and Public Health

Career Summary

Biography

C/Prof Joshua S Davis, Infectious Diseases Physician and NHMRC Career Development Fellow

MBBS (Hons), DTM&H, FRACP, Grad Cert PopHealth, PhD

I am an established and highly productive early career clinical researcher, as evidenced by my outputs since being awarded my PhD in 2011: over 80 peer-reviewed published papers, which have been collectively cited over 2,000 times, giving me a 5-year h-index of 23, and research presentations at over 20 national and international scientific conferences. I have also attracted continuous people support funding from the NH&MRC from 2007 onwards (PhD Scholarship, ECF and CDF) and am currently a chief investigator on 4 NH&MRC project grants worth over $7 million and 5 current other competitive grants worth over $260,000.  I have achieved this whilst having an approximate half-time commitment as a senior clinician, and developing leadership roles in the Australian infectious diseases (ID) community. These include being elected as president of the Australasian Society for Infectious Diseases (ASID), playing a key role in establishing the ASID clinical research network (CRN) and being selected for the expert writing group of Therapeutic Guidelines: Antibiotic, Australia’s national antibiotic policy.

My key areas of research interest are clinical trials in severe infectious diseases, aiming to address the many evidence gaps in clinical management of Staph aureus blood stream infection, bone and joint infections, and severe sepsis. I also have ongoing clinical and research interests in viral hepatitis and Aboriginal Health.


Keywords

  • Aboriginal Health
  • Clinical Trials
  • Infectious Diseases
  • Severe sepsis
  • Viral Hepatitis

Fields of Research

Code Description Percentage
111706 Epidemiology 20
110309 Infectious Diseases 80
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.

Highlighted Publications

Year Citation Altmetrics Link
2015 Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG, 'Staphylococcus aureus infections: Epidemiology, pathophysiology, clinical manifestations, and management', Clinical Microbiology Reviews, 28 603-661 (2015) [C1]

© 2015, American Society for Microbiology. All Rights Reserved. Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading ca... [more]

© 2015, American Society for Microbiology. All Rights Reserved. Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to ß-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

DOI 10.1128/CMR.00134-14
Citations Scopus - 779Web of Science - 749
2016 Davis JS, Sud A, O'Sullivan MVN, Robinson JO, Ferguson PE, Foo H, et al., 'Combination of Vancomycin and ß-Lactam Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Pilot Multicenter Randomized Controlled Trial', Clinical Infectious Diseases, 62 173-180 (2016) [C1]

© 2015 The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.... [more]

© 2015 The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com. Background. In vitro laboratory and animal studies demonstrate a synergistic role for the combination of vancomycin and antistaphylococcal ß-lactams for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Prospective clinical data are lacking. Methods. In this open-label, multicenter, clinical trial, adults with MRSA bacteremia received vancomycin 1.5 g intravenously twice daily and were randomly assigned (1:1) to receive intravenous flucloxacillin 2 g every 6 hours for 7 days (combination group) or no additional therapy (standard therapy group). Participants were stratified by hospital and randomized in permuted blocks of variable size. Randomization codes were kept in sealed, sequentially numbered, opaque envelopes. The primary outcome was the duration of MRSA bacteremia in days. Results. We randomly assigned 60 patients to receive vancomycin (n = 29), or vancomycin plus flucloxacillin (n = 31). The mean duration of bacteremia was 3.00 days in the standard therapy group and 1.94 days in the combination group. According to a negative binomial model, the mean time to resolution of bacteremia in the combination group was 65% (95% confidence interval, 41%-102%; P =. 06) that in the standard therapy group. There was no difference in the secondary end points of 28- and 90-day mortality, metastatic infection, nephrotoxicity, or hepatotoxicity. Conclusions. Combining an antistaphylococcal ß-lactam with vancomycin may shorten the duration of MRSA bacteremia. Further trials with a larger sample size and objective clinically relevant end points are warranted. Australian New Zealand Clinical Trials Registry: ACTRN12610000940077 (www.anzctr.org.au).

DOI 10.1093/cid/civ808
Citations Scopus - 53Web of Science - 53

Journal article (118 outputs)

Year Citation Altmetrics Link
2019 Davis JS, Magin PJ, van Driel ML, 'The false dichotomy of viral versus bacterial aetiology in upper respiratory tract infections', MEDICAL JOURNAL OF AUSTRALIA, 211 108-+ (2019)
DOI 10.5694/mja2.50250
Co-authors Parker Magin
2019 Hughes CM, Lennon D, Davis JS, 'CRyptOcoccosis in Newcastle and the hUnTer (CRONUT) - An epidemiological study.', Infect Dis Health, (2019)
DOI 10.1016/j.idh.2019.08.003
2019 Dotel R, Tong SYC, Bowen A, Nelson JN, O'Sullivan MVN, Campbell AJ, et al., 'CASSETTEclindamycin adjunctive therapy for severe Staphylococcus aureus treatment evaluation: study protocol for a randomised controlled trial', TRIALS, 20 (2019)
DOI 10.1186/s13063-019-3452-y
2019 Weis S, Kesselmeier M, Davis JS, Morris AM, Lee S, Scherag A, et al., 'Cefazolin versus anti-staphylococcal penicillins for the treatment of patients with Staphylococcus aureus bacteraemia.', Clin Microbiol Infect, 25 818-827 (2019)
DOI 10.1016/j.cmi.2019.03.010
Citations Scopus - 4Web of Science - 2
2019 Meumann EM, Anstey NM, Currie BJ, Piera KA, Baird R, Sarovich DS, Davis JS, 'Whole-genome sequencing to differentiate relapse from reinfection in community-onset bacteremic acinetobacter baumannii pneumonia', Open Forum Infectious Diseases, 6 1-4 (2019)
DOI 10.1093/ofid/ofz263
2019 Tong SYC, Campbell A, Bowen AC, Davis JS, 'A Survey of Infectious Diseases and Microbiology Clinicians in Australia and New Zealand About the Management of Staphylococcus aureus Bacteremia.', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 69 1835-1836 (2019)
DOI 10.1093/cid/ciz275
2019 Doernberg SB, Thuy TTT, Tong SYC, Paul M, Yahav D, Davis JS, et al., 'Good Studies Evaluate the Disease While Great Studies Evaluate the Patient: Development and Application of a Desirability of Outcome Ranking Endpoint for Staphylococcus aureus Bloodstream Infection', CLINICAL INFECTIOUS DISEASES, 68 1691-1698 (2019)
DOI 10.1093/cid/ciy766
Citations Scopus - 3Web of Science - 3
2019 Lipman J, Brett SJ, De Waele JJ, Cotta MO, Davis JS, Finfer S, et al., 'A protocol for a phase 3 multicentre randomised controlled trial of continuous versus intermittent beta-lactam antibiotic infusion in critically ill patients with sepsis: BLING III', CRITICAL CARE AND RESUSCITATION, 21 63-68 (2019)
Citations Scopus - 4Web of Science - 1
2019 Yuen LKW, Littlejohn M, Duchene S, Edwards R, Bukulatjpi S, Binks P, et al., 'Tracing Ancient Human Migrations into Sahul Using Hepatitis B Virus Genomes', MOLECULAR BIOLOGY AND EVOLUTION, 36 942-954 (2019)
DOI 10.1093/molbev/msz021
2019 Dotel R, O'Sullivan MVN, Davis JS, Newton PJ, Gilbert GL, 'Molecular epidemiology of methicillin-resistant Staphylococcus aureus isolates in New South Wales, Australia, 2012 2017', Infection, Disease and Health, 24 134-140 (2019) [C1]

© 2019 Australasian College for Infection Prevention and Control Background: To better understand the molecular epidemiology of MRSA and to assess the utility of 19-target binary ... [more]

© 2019 Australasian College for Infection Prevention and Control Background: To better understand the molecular epidemiology of MRSA and to assess the utility of 19-target binary typing we undertook large-scale epidemiological surveillance of MRSA from invasive and non-invasive clinical specimens, and screening swabs. Methods: Binary typing was performed on clinical MRSA isolates collected in New South Wales (NSW), Australia between 01/01/2012 - 31/12/2017. Binary type (BT) predicted multilocus sequence type (ST) and spa types based on results from isolates which had been characterised by both methods. Results: 7624 MRSA isolates were analysed of which 3581 (47%) were wounds or skin & softtissue isolates (W/SSTI), 2436 (32%) screening swabs, 469 (6%) blood cultures (BC), 780 (10%) others, and 358 (5%) unknown. We identified 731 BTs, 54 spa types, and 31 STs. ST239 was the commonest MRSA clone in 2012 (30%), but it decreased to 7% in 2017 (p <0.001). In contrast, <0.5% of MRSA were ST45 in 2012 compared to 14% in 2017 (p<0.001). An emergence of PVL-positive ST22 was also noted. Of all isolates, 28% (2122/7624) were lukS/PVL positive; the proportion, among prospectively collected isolates increased from 24% (1406/5858) to 33% (1933/5858) between 2012 and 2017 (p <0.0001). 43% (1534/3581) W/SSTI, 20% (95/469) BC and 10% (239/2436) screening swabs were PVL-positive. Conclusions: A major change in the epidemiology of MRSA was noted with a decline of ST239, an emergence of ST45 and PVL-positive ST22, and a significant increase in PVL-positive isolates. Binary typing can be a useful routine laboratory test for prospective molecular surveillance of MRSA colonisation and infection.

DOI 10.1016/j.idh.2019.04.002
2019 Davis JS, Jones CA, Cheng AC, Howden BP, 'Australia's response to the global threat of antimicrobial resistance: past, present and future', MEDICAL JOURNAL OF AUSTRALIA, 211 106-+ (2019)
DOI 10.5694/mja2.50264
2019 Alwan M, Davis JS, Daneman N, Fowler R, Shehabi Y, Rogers B, 'Duration of therapy recommended for bacteraemic illness varies widely amongst clinicians', INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 54 184-188 (2019)
DOI 10.1016/j.ijantimicag.2019.05.011
2019 Henderson A, Harris P, Hartel G, Paterson D, Turnidge J, Davis JS, Tong SYC, 'Benzylpenicillin versus flucloxacillin for penicillin-susceptible Staphylococcus aureus bloodstream infections from a large retrospective cohort study.', Int J Antimicrob Agents, 54 491-495 (2019)
DOI 10.1016/j.ijantimicag.2019.05.020
2019 Meumann EM, Anstey NM, Currie BJ, Piera KA, Kenyon JJ, Hall RM, et al., 'Genomic epidemiology of severe community-onset Acinetobacter baumannii infection', MICROBIAL GENOMICS, 5 (2019) [C1]
DOI 10.1099/mgen.0.000258
Citations Scopus - 3Web of Science - 2
2019 Campbell AJ, Dotel R, Blyth CC, Davis JS, Tong SYC, Bowen AC, 'Adjunctive protein synthesis inhibitor antibiotics for toxin suppression in Staphylococcus aureus infections: a systematic appraisal', JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 74 1-5 (2019)
DOI 10.1093/jac/dky387
Citations Scopus - 2Web of Science - 2
2019 Campbell AJ, Tong SYC, Davis JS, Munro APS, Blyth CC, Bowen AC, 'Infectious Diseases Clinician's Variation in the Management of Pediatric Staphylococcus aureus Bacteraemia and Equipoise for Clinical Trials', FRONTIERS IN PEDIATRICS, 7 (2019)
DOI 10.3389/fped.2019.00249
2019 Holland TL, Davis JS, 'Combination Therapy for MRSA Bacteremia: To ß or Not to ß?', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, (2019)
DOI 10.1093/cid/ciz750
2018 Magin P, Tapley A, Morgan S, Davis JS, McElduff P, Yardley L, et al., 'Reducing early career general practitioners' antibiotic prescribing for respiratory tract infections: a pragmatic prospective non-randomised controlled trial.', Family practice, 35 53-60 (2018) [C1]
DOI 10.1093/fampra/cmx070
Citations Scopus - 5Web of Science - 5
Co-authors Patrick Mcelduff, Parker Magin
2018 Brereton CJ, Lennon D, Browning S, Dunn E, Ferguson JK, Davis JS, 'Is gentamicin safe and effective for severe community-acquired pneumonia? An 8-year retrospective cohort study', International Journal of Antimicrobial Agents, 51 862-866 (2018) [C1]

© 2018 Gram-negative bacilli are the causative organisms in a significant proportion of patients with severe community-acquired pneumonia (CAP) admitted to the intensive care unit... [more]

© 2018 Gram-negative bacilli are the causative organisms in a significant proportion of patients with severe community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU). Clinical guidelines recommend broad-spectrum antimicrobials for empirical treatment despite alarming global trends in antimicrobial resistance. In this study, we aimed to assess the safety and efficacy of gentamicin, an aminoglycoside with potent bactericidal activity, for empirical Gram-negative coverage of severe CAP in patients admitted to the ICU. A retrospective cohort study was performed at a university teaching hospital where the severe CAP guideline recommends penicillin, azithromycin and gentamicin as empirical cover. Ceftriaxone plus azithromycin is used as an alternative. Adults with radiologically-confirmed severe CAP were included, comparing those who received gentamicin in the first 72 h of admission with those who did not. Participants were identified using ICD-10 codes for bacterial pneumonia and data manually extracted from electronic medical records. Of 148 patients admitted with severe pneumonia, 117 were given at least one dose of gentamicin whereas the remaining 31 were not. The two groups were well matched in terms of demographics, co-morbidities and disease severity. There were no significant differences between the gentamicin and no-gentamicin groups in the incidence of acute kidney injury [60/117 (51%) vs. 16/31 (52%), respectively], hospital mortality [20/117 (17%) vs. 7/31 (23%)] and secondary outcomes including relapse and length of hospital stay. In conclusion, gentamicin is safe and has similar outcomes to alternative Gram-negative antimicrobial regimens for empirical coverage in severe CAP patients admitted to the ICU.

DOI 10.1016/j.ijantimicag.2018.01.018
Co-authors John Ferguson
2018 Davies J, Boutlis CS, Marshall CS, Tong SYC, Davis JS, 'The unique aspects of chronic hepatitis B infection in Aboriginal and Torres Strait Islander people', INTERNAL MEDICINE JOURNAL, 48 484-485 (2018)
DOI 10.1111/imj.13759
Citations Scopus - 1Web of Science - 1
2018 Cheah BC, Davies J, Singh GR, Wood N, Jackson K, Littlejohn M, et al., 'Sub-optimal protection against past hepatitis B virus infection where subtype mismatch exists between vaccine and circulating viral genotype in northern Australia', VACCINE, 36 3533-3540 (2018)
DOI 10.1016/j.vaccine.2018.01.062
Citations Scopus - 1Web of Science - 1
2018 Lwin N, Boyle M, Davis JS, 'Adalimumab for Corticosteroid and Infliximab-Resistant Immune Reconstitution Inflammatory Syndrome in the Setting of TB/HIV Coinfection', OPEN FORUM INFECTIOUS DISEASES, 5 (2018)
DOI 10.1093/ofid/ofy027
Citations Scopus - 2Web of Science - 3
2018 Davis JS, Young M, Lennox S, Jones T, Piera K, Pickles R, Oakley S, 'The effect of curing hepatitis C with direct-acting antiviral treatment on endothelial function', Antiviral Therapy, 23 687-694 (2018) [C1]

©2018 International Medical Press. Background: Epidemiological data suggest that chronic HCV infection (CHC) is associated with increased cardiovascular risk, but it is unknown if... [more]

©2018 International Medical Press. Background: Epidemiological data suggest that chronic HCV infection (CHC) is associated with increased cardiovascular risk, but it is unknown if it is associated with endothelial dysfunction. We aimed to assess the effect of antiviral treatment on endothelial function in non-cirrhotic adults with CHC. Methods: Self-controlled before and after study. All patients had genotype-1 CHC and were treated with 12 weeks of paritaprevir/ritonavir, ombitasvir and dasabuvir (PrOD), with ribavirin added for those with genotype-1a infection. Endothelial function was assessed at three time points before antiviral treatment, at treatment weeks 1, 4, 8 and 12, and 12 weeks after the end of treatment. The main assessment tools were reactive hyperaemia peripheral arterial tonometry (RHPAT) and serum concentrations of angiopoietin-2 (Ang-2) and E-selectin. Results: A total of 16 patients were enrolled. Mean (SD) age was 51.4 (6.9) years and 11 participants (69%) were male. All 16 patients achieved a sustained virological response. The mean (SD) baseline RHPAT index was 2.05 (0.48), and there was no significant change during treatment (mean within-patient change from baseline to end of treatment =-0.23 [0.45]; P= not significant). There was a significant improvement in both mean Ang-2 (baseline 2.44 [0.79] ng/ml, within-patient change -0.60 [0.44]; P<0.001) and E-selectin (baseline 48.7 [21.5] ng/ml, within-patient change -14.4 [13.0]; P<0.001). Conclusions: Removing HCV viraemia is associated with a significant improvement in endothelial function as measured by serum markers, but not in bedside microvascular reactivity. Chronic HCV viraemia may be associated with endothelial cell dysfunction and therefore long-term cardiovascular risk.

DOI 10.3851/IMP3257
Citations Scopus - 1
Co-authors Stephen Oakley
2018 Chong BSW, Brereton CJ, Gordon A, Davis JS, 'Epidemiology, Microbiological Diagnosis, and Clinical Outcomes in Pyogenic Vertebral Osteomyelitis: A 10-year Retrospective Cohort Study.', Open forum infectious diseases, 5 1-6 (2018) [C1]
DOI 10.1093/ofid/ofy037
Citations Scopus - 8Web of Science - 6
2018 Saeed K, Esposito S, Gould I, Ascione T, Bassetti M, Bonnet E, et al., 'Hot topics in necrotising skin and soft tissue infections', INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 52 1-10 (2018)
DOI 10.1016/j.ijantimicag.2018.02.012
Citations Scopus - 3Web of Science - 4
2018 Davis JS, Turnidge J, Tong SYC, 'A large retrospective cohort study of cefazolin compared with flucloxacillin for methicillin-susceptible Staphylococcus aureus bacteraemia', INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 52 297-300 (2018)
DOI 10.1016/j.ijantimicag.2018.02.013
Citations Scopus - 4Web of Science - 4
2017 Saeed K, Dryden M, Bassetti M, Bonnet E, Bouza E, Chan M, et al., 'Prosthetic joints: shining lights on challenging blind spots', INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 49 153-161 (2017)
DOI 10.1016/j.ijantimicag.2016.10.015
Citations Scopus - 6Web of Science - 6
2017 Harris PNA, McNamara JF, Lye DC, Davis JS, Bernard L, Cheng AC, et al., 'Proposed primary endpoints for use in clinical trials that compare treatment options for bloodstream infection in adults: a consensus definition', CLINICAL MICROBIOLOGY AND INFECTION, 23 533-541 (2017)
DOI 10.1016/j.cmi.2016.10.023
Citations Scopus - 17Web of Science - 16
2017 Chaves NJ, Paxton GA, Biggs B-A, Thambiran A, Gardiner J, Williams J, et al., 'The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline', MEDICAL JOURNAL OF AUSTRALIA, 206 310-315 (2017)
DOI 10.5694/mja16.00826
Citations Scopus - 5Web of Science - 5
2017 Lora-Tamayo J, Senneville E, Ribera A, Bernard L, Dupon M, Zeller V, et al., 'The Not-So-Good Prognosis of Streptococcal Periprosthetic Joint Infection Managed by Implant Retention: The Results of a Large Multicenter Study', CLINICAL INFECTIOUS DISEASES, 64 1742-1752 (2017)
DOI 10.1093/cid/cix227
Citations Scopus - 24Web of Science - 21
2017 Davis JS, Barrett T, Harris L, 'Knowledge of proprietary and generic drug names among hospital prescribers: time to mandate generic prescribing?', Internal Medicine Journal, 47 959-962 (2017) [C1]
DOI 10.1111/imj.13506
Citations Scopus - 1Web of Science - 1
2017 Davies J, Li SQ, Tong SY, Baird RW, Beaman M, Higgins G, et al., 'Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population', PLOS ONE, 12 (2017)
DOI 10.1371/journal.pone.0184082
Citations Scopus - 3Web of Science - 3
2017 Davis JS, Mackrow C, Binks P, Fletcher W, Dettwiller P, Marshall C, et al., 'A double-blind randomized controlled trial of ibuprofen compared to placebo for uncomplicated cellulitis of the upper or lower limb', Clinical Microbiology and Infection, 23 242-246 (2017) [C1]

© 2017 European Society of Clinical Microbiology and Infectious Diseases Objectives Cellulitis is a common skin infection resulting in inflammation that may take weeks to resolve ... [more]

© 2017 European Society of Clinical Microbiology and Infectious Diseases Objectives Cellulitis is a common skin infection resulting in inflammation that may take weeks to resolve despite appropriate antibiotics. It is unclear whether the adjunctive use of nonsteroidal anti-inflammatory drugs hastens the resolution of inflammation in patients with cellulitis. Methods We conducted a double-blind, randomized controlled trial comparing ibuprofen 400¿mg three times daily for 5¿days with identical placebo in adults with uncomplicated cellulitis of the upper or lower limb who were treated with intravenous cefazolin via an outpatient parenteral antibiotic treatment service at one of two Australian hospitals. Participants were assessed twice daily by a study nurse. The primary outcome measure was the proportion of patients with regression of inflammation 48¿hours after the first effective dose of parenteral antibiotics (trial registration ANZCTR 12611000515998). Results Fifty-one patients were enrolled; 48 had sufficient data available to be included in the modified intention-to-treat analysis. Inflammation had begun to regress at 48¿hours in 20 participants (80%) in the ibuprofen group compared to 15 (65%) in the placebo group (absolute risk difference¿+15%; 95% confidence interval¿-10 to¿+40; p >0.05). There was no significant difference in any secondary outcome. Ibuprofen appeared safe, with no patients developing renal impairment or necrotizing fasciitis. Conclusions This trial demonstrated no significant benefit of adjunctive ibuprofen in adults with uncomplicated cellulitis. The trial was powered to detect a large effect, and hence it is unclear whether the 15% absolute increase in the primary end point in the ibuprofen group was attributable to chance.

DOI 10.1016/j.cmi.2017.02.036
Citations Scopus - 4Web of Science - 2
2017 Dallas A, van Driel M, Morgan S, Tapley A, Henderson K, Oldmeadow C, et al., 'Antibiotic prescribing for acute otitis media and acute sinusitis: A cross-sectional analysis of the ReCEnT study exploring the habits of early career doctors in family practice', Family Practice, 34 180-187 (2017) [C1]

© The Author 2017. Published by Oxford University Press. All rights reserved. Background. Antibiotic resistance is a public health concern, and is linked to over-prescribing. In s... [more]

© The Author 2017. Published by Oxford University Press. All rights reserved. Background. Antibiotic resistance is a public health concern, and is linked to over-prescribing. In self-limiting infections such as acute otitis media (AOM) and acute sinusitis, prescribing remains high despite strong guideline recommendations against the routine use of antibiotics. Early career General Practitioners may find evidence-based prescribing challenging. Aim. To establish the prevalence and associations of antibiotic prescribing for AOM and acute sinusitis by Australian vocational trainees in General Practice. Method. A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. This ongoing, multicentre prospective cohort study documents trainees' consultation-based clinical experiences. Univariate and logistic regression analyses were conducted on data recorded in consultations for AOM or acute sinusitis in nine collection periods during 2010-2014. Results. Data from 856 individual trainees (response rate 95.2%) were analysed. AOM was managed in 0.9% of encounters. Antibiotics were prescribed in 78.8% of cases. Prescribing was significantly associated with longer consultation time and first presentation for this problem. There was no significant association with patient age group. Acute sinusitis was managed in 0.9% of encounters. Antibiotics were prescribed in 71.2% of cases. Later-stage trainees and trainees who did not receive their primary medical qualification in Australia were more likely to prescribe an antibiotic for acute sinusitis. Conclusion. Early career GPs are not prescribing in an evidence-based manner. The complexity of guidelines for AOM and acute sinusitis may be confusing for prescribers, especially early career doctors struggling with inexperience and diagnostic uncertainty. Educational interventions are necessary to bring prescribing rates closer to quality benchmarks.

DOI 10.1093/fampra/cmw144
Citations Scopus - 1Web of Science - 1
Co-authors Parker Magin, Christopher Oldmeadow
2017 Jones CA, Davis JS, Looke DFM, 'Death from an untreatable infection may signal the start of the post-antibiotic era', MEDICAL JOURNAL OF AUSTRALIA, 206 292-+ (2017)
DOI 10.5694/mja17.00077
Citations Scopus - 3Web of Science - 3
2017 Udy AA, Dulhunty JM, Roberts JA, Davis JS, Webb SAR, Bellomo R, et al., 'Association between augmented renal clearance and clinical outcomes in patients receiving beta-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial', INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 49 624-630 (2017)
DOI 10.1016/j.ijantimicag.2016.12.022
Citations Scopus - 20Web of Science - 18
2017 Davis JS, Tapley A, Morgan S, van Driel ML, Magin PJ, 'Clinical experience of patients with hepatitis C virus infection among Australian GP trainees', MEDICAL JOURNAL OF AUSTRALIA, 206 309-309 (2017)
DOI 10.5694/mja16.01106
Citations Scopus - 1Web of Science - 1
Co-authors Parker Magin
2016 Dallas A, van Driel M, Morgan S, Tapley A, Henderson K, Ball J, et al., 'Antibiotic prescribing for sore throat: A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice', Family Practice, 33 302-308 (2016) [C1]

© The Author 2016. Published by Oxford University Press. All rights reserved. Background: Acute sore throat is a common condition presenting to family practitioners. It is usually... [more]

© The Author 2016. Published by Oxford University Press. All rights reserved. Background: Acute sore throat is a common condition presenting to family practitioners. It is usually self-limiting, with antibiotic treatment recommended only for high-risk presentations. Overprescribing of antibiotics contributes to individual and community resistance. Learning to prescribe in the context of diagnostic uncertainty and patient pressures is a challenge for early-career doctors. Prescribing habits develop early and tend not to change with time. Objective: To establish the prevalence and associations of antibiotic prescribing for acute sore throat by Australian vocational trainees in family practice. Method: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. This ongoing, multicentre prospective cohort study documents the nature of trainees' consultation-based clinical experiences. Univariate and logistic regression analyses were conducted on data recorded in consultations for sore throat in nine collection periods during 2010-14. Results: Data from 856 individual trainees (response rate 95.2%) were analysed. Sore throat was managed in 2.3% encounters. Antibiotics were prescribed for 71.5% of sore throat diagnoses. The variables associated with prescribing were inner-regional location and higher socio-economic area. There was no significant association with younger age of patient or greater trainee experience. If an antibiotic was prescribed, the trainee was more likely to seek information from guidelines or a supervisor. Conclusions: The high frequency of antibiotic prescribing and the lack of attenuation in prescribing with increased experience suggest current educational interventions and the apprenticeship model of training is not fostering appropriate practice in this important clinical area. Targeted educational interventions, for supervisors as well as trainees, are indicated.

DOI 10.1093/fampra/cmw014
Citations Scopus - 5Web of Science - 7
Co-authors Christopher Oldmeadow, Parker Magin
2016 Tong SYC, Nelson J, Paterson DL, Fowler VG, Howden BP, Cheng AC, et al., 'CAMERA2-combination antibiotic therapy for methicillin-resistant Staphylococcus aureus infection: study protocol for a randomised controlled trial', TRIALS, 17 (2016)
DOI 10.1186/s13063-016-1295-3
Citations Scopus - 30Web of Science - 30
2016 Magin PJ, Morgan S, Tapley A, Henderson KM, Holliday EG, Ball J, et al., 'Changes in early-career family physicians' antibiotic prescribing for upper respiratory tract infection and acute bronchitis: A multicentre longitudinal study', Family Practice, 33 360-367 (2016) [C1]

© The Author 2016. Published by Oxford University Press. All rights reserved. Background. Inappropriate antibiotic prescription and subsequent antibacterial resistance are major t... [more]

© The Author 2016. Published by Oxford University Press. All rights reserved. Background. Inappropriate antibiotic prescription and subsequent antibacterial resistance are major threats to health worldwide. Objectives. We aimed to establish whether early-career 'apprenticeship-model' experience in family practice influences antibiotic prescribing for respiratory tract infections and to also establish other associations of antibiotic prescribing changes during this early-career experience. Methods. A longitudinal analysis (2010-2014) of a cohort study of Australian GP registrars' (vocational trainees') consultations. Registrars from five regional training programs recorded data from 60 consecutive consultations, once each 6-month training Term, including the diagnoses managed and medications prescribed. The outcomes were whether an antibiotic was prescribed for the diagnoses 'upper respiratory tract infection (URTI)' and 'acute bronchitis/bronchiolitis'. Generalized linear mixed modelling was used to account for repeated measures on registrars and to include the time component: 'Term'. Results. A total of 856 registrars recorded 108759 consultations, including 8715 'URTI' diagnoses (5.15% of diagnoses) and 2110 'acute bronchitis/bronchiolitis' diagnoses (1.25%). Antibiotics were prescribed in 16.3% [95% confidence interval (CI) 14.9-17.8] of URTI and 72.2% (95% CI 69.6-74.6) of acute bronchitis/bronchiolitis diagnoses. Moving from an earlier to later term did not significantly influence registrars' antibiotic prescribing for URTI [adjusted odds ratio (OR) 0.95; 95% CI 0.87, 1.04, P = 0.27] or acute bronchitis/bronchiolitis [OR 1.01 (95% CI 0.90-1.14), P = 0.86]. Significant associations of antibiotic prescribing for URTIs were the registrar being non-Australian educated, greater patient age, practices not privately billing patients, pathology being ordered, longer consultation duration and the registrar seeking in-consultation information or advice (including from their supervisor). Conclusions. Early-career experience/training failed to produce rational antibiotic prescribing for URTI and acute bronchitis/bronchiolitis. Our findings suggest that prescribing interventions could target the registrar-supervisor dyad.

DOI 10.1093/fampra/cmw025
Citations Scopus - 4Web of Science - 4
Co-authors Liz Holliday, Parker Magin
2016 van Driel ML, Morgan S, Tapley A, McArthur L, McElduff P, Yardley L, et al., 'Changing the Antibiotic Prescribing of general practice registrars: the ChAP study protocol for a prospective controlled study of a multimodal educational intervention', BMC FAMILY PRACTICE, 17 (2016)
DOI 10.1186/s12875-016-0470-7
Citations Scopus - 5Web of Science - 4
Co-authors Patrick Mcelduff, Parker Magin
2016 McGuinness SL, Whiting SE, Baird R, Currie BJ, Ralph AP, Anstey NM, et al., 'Nocardiosis in the tropical northern territory of Australia, 1997-2014', Open Forum Infectious Diseases, 3 1-25 (2016)

© 2016 The Author. Background: Nocardia is an opportunistic pathogen that can cause life-threatening disease. We aimed to characterise the epidemiological, microbiological and cli... [more]

© 2016 The Author. Background: Nocardia is an opportunistic pathogen that can cause life-threatening disease. We aimed to characterise the epidemiological, microbiological and clinical features of nocardiosis in the tropical north of Australia. Methods: We conducted a retrospective cohort study of nocardiosis diagnosed between 1997 and 2014. Population-based incidences were calculated using district population data. Results: Clinically significant nocardiosis was identified in sixty-one patients. The unadjusted population-based annual incidence of nocardiosis was 2.02 (95% confidence interval [CI] 1.55-2.60) per 100,000 people and was 1.7 (95% CI 0.96-2.90) fold higher in Indigenous compared with non-Indigenous persons (p=0.027). Of 61 patients, 47 (77%) had chronic lung disease, diabetes and/or hazardous alcohol consumption; 22 (36%) were immunocompromised; and 8 (13%) had no identified comorbidities. Disease presentations included pulmonary (69%; 42/61), cutaneous (13%, 8/61) and disseminated nocardiosis (15%, 9/61). The most commonly identified species were N. asteroides and N. cyriacigeorgica (each 11%). Linezolid was the only antimicrobial to which isolates were universally susceptible; 89% (48/54), 60% (32/53) and 48% (26/54) of isolates were susceptible to trimethoprim-sulfamethoxazole, ceftriaxone and imipenem, respectively. 18 patients (30%) required intensive care unit (ICU) admission and one-year mortality was 31%. Conclusions: The incidence of nocardiosis in tropical Australia is amongst the highest reported globally. Nocardiosis occurs in both immunocompromised and immunocompetent hosts, and is associated with high rates of ICU-admission, 1-year mortality and resistance to commonly-recommended antimicrobials. Diagnosis should be considered in patients with consistent clinical features, particularly if they are Indigenous or have chronic lung disease.

Citations Scopus - 8
2016 Magin PJ, Morgan S, Tapley A, Davis JS, McArthur L, Henderson KM, et al., 'Reducing general practice trainees' antibiotic prescribing for respiratory tract infections: An evaluation of a combined face-To-face workshop and online educational intervention', Education for Primary Care, 27 98-105 (2016) [C1]

© 2016 Taylor &amp; Francis. Over-prescription of antibiotics for non-pneumonia respiratory tract infections (RTIs) is a major concern in general practice. Australian general pr... [more]

© 2016 Taylor & Francis. Over-prescription of antibiotics for non-pneumonia respiratory tract infections (RTIs) is a major concern in general practice. Australian general practice registrars (trainees) have inappropriately high rates of prescription of antibiotics for RTIs. The 'apprenticeship' educational model and the trainee- trainer relationship are drivers of this inappropriate prescribing. We aimed to reduce registrars' non-pneumonia RTI antibiotic prescribing via an educational intervention (a 90-min face-To-face workshop supported by online modules), complemented by delivery of the same intervention, separately, to their trainers. We conducted a pre-and post-intervention comparison of the registrars' intention to prescribe antibiotics for common RTIs using McNemar's test. We similarly tested changes in supervisors' intended prescribing. Prescribing intentions were elicited by responses to six written clinical vignettes (upper respiratory tract infection, otitis media, sore throat and three acute bronchitis vignettes). We found that, for registrars, there were statistically significant reductions in antibiotic prescribing for the sore throat (24.0% absolute reduction), otitis media (17.5% absolute reduction) and two of the three acute bronchitis (12.0% and 18.0% absolute reduction) vignettes. There were significant reductions in supervisors' antibiotic prescribing intentions for the same four vignettes. We conclude that our intervention produced a significant change in registrars' intention to prescribe antibiotics for non-pneumonia RTIs.

DOI 10.1080/14739879.2015.1106085
Citations Scopus - 5Web of Science - 6
Co-authors Parker Magin
2016 Jones CA, Davis JS, Looke DFM, 'The ASID test The Australasian Society for Infectious Diseases view on infectious diseases challenges in 2016 and beyond', MEDICAL JOURNAL OF AUSTRALIA, 204 250-+ (2016)
DOI 10.5694/mja16.00284
2016 McGuinness SL, Whiting SE, Baird R, Currie BJ, Ralph AP, Anstey NM, et al., 'Nocardiosis in the Tropical Northern Territory of Australia, 1997-2014.', Open Forum Infect Dis, 3 (2016) [C1]
DOI 10.1093/ofid/ofw208
2016 Roberts JA, Abdul-Aziz MH, Davis JS, Dulhunty JM, Cotta MO, Myburgh J, et al., 'Continuous versus intermittent ß-lactam infusion in severe sepsis: A meta-analysis of individual patient data from randomized trials', American Journal of Respiratory and Critical Care Medicine, 194 681-691 (2016) [C1]

© Copyright 2016 by the American Thoracic Society. Rationale: Optimization of ß-lactam antibiotic dosing for critically ill patients is an intervention that may improve outcomes i... [more]

© Copyright 2016 by the American Thoracic Society. Rationale: Optimization of ß-lactam antibiotic dosing for critically ill patients is an intervention that may improve outcomes in severe sepsis. Objectives: In this individual patient data meta-analysis of critically ill patients with severe sepsis, we aimed to compare clinical outcomes of those treated with continuous versus intermittent infusion of ß-lactam antibiotics. Methods: We identified relevant randomized controlled trials comparing continuous versus intermittent infusion of ß-lactam antibiotics in critically ill patients with severe sepsis. We assessed the quality of the studies according to four criteria. We combined individual patient data from studies and assessed data integrity for common baseline demographics and study endpoints, including hospital mortality censored at 30 days and clinical cure. We then determined the pooled estimates of effect and investigated factors associated with hospital mortality in multivariable analysis. Measurements and Main Results: We identified three randomized controlled trials in which researchers recruited a total of 632 patients with severe sepsis. The two groups were well balanced in terms of age, sex, and illness severity. The rates of hospital mortality and clinical cure for the continuous versus intermittent infusion groups were 19.6% versus 26.3% (relative risk, 0.74; 95% confidence interval, 0.56-1.00; P = 0.045) and 55.4% versus 46.3% (relative risk, 1.20; 95% confidence interval, 1.03-1.40; P = 0.021), respectively. In a multivariable model, intermittent ß-lactam administration, higher Acute Physiology and Chronic Health Evaluation II score, use of renal replacement therapy, and infection by nonfermenting gram-negative bacilli were significantly associated with hospital mortality. Continuous ß-lactam administration was not independently associated with clinical cure. Conclusions: Compared with intermittent dosing, administration of ß-lactamantibioticsby continuous infusionincritically ill patientswith severe sepsis is associated with decreased hospital mortality.

DOI 10.1164/rccm.201601-0024OC
Citations Scopus - 102Web of Science - 97
2016 Davis JS, Sud A, O'Sullivan MVN, Robinson JO, Ferguson PE, Foo H, et al., 'Combination of Vancomycin and ß-Lactam Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Pilot Multicenter Randomized Controlled Trial', Clinical Infectious Diseases, 62 173-180 (2016) [C1]

© 2015 The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.... [more]

© 2015 The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com. Background. In vitro laboratory and animal studies demonstrate a synergistic role for the combination of vancomycin and antistaphylococcal ß-lactams for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Prospective clinical data are lacking. Methods. In this open-label, multicenter, clinical trial, adults with MRSA bacteremia received vancomycin 1.5 g intravenously twice daily and were randomly assigned (1:1) to receive intravenous flucloxacillin 2 g every 6 hours for 7 days (combination group) or no additional therapy (standard therapy group). Participants were stratified by hospital and randomized in permuted blocks of variable size. Randomization codes were kept in sealed, sequentially numbered, opaque envelopes. The primary outcome was the duration of MRSA bacteremia in days. Results. We randomly assigned 60 patients to receive vancomycin (n = 29), or vancomycin plus flucloxacillin (n = 31). The mean duration of bacteremia was 3.00 days in the standard therapy group and 1.94 days in the combination group. According to a negative binomial model, the mean time to resolution of bacteremia in the combination group was 65% (95% confidence interval, 41%-102%; P =. 06) that in the standard therapy group. There was no difference in the secondary end points of 28- and 90-day mortality, metastatic infection, nephrotoxicity, or hepatotoxicity. Conclusions. Combining an antistaphylococcal ß-lactam with vancomycin may shorten the duration of MRSA bacteremia. Further trials with a larger sample size and objective clinically relevant end points are warranted. Australian New Zealand Clinical Trials Registry: ACTRN12610000940077 (www.anzctr.org.au).

DOI 10.1093/cid/civ808
Citations Scopus - 53Web of Science - 53
2016 Jones CA, Davis JS, Looke DFM, 'The ASID test', MEDICAL JOURNAL OF AUSTRALIA, 204 250-251 (2016)
DOI 10.5694/mja16.00284
2016 McAuliffe GN, Baird RW, Hennessy J, Anstey NM, Davis JS, 'MALDI-TOF MS for identification of community-acquired Acinetobacter baumannii complex infections', PATHOLOGY, 48 100-102 (2016)
DOI 10.1016/j.pathol.2015.11.016
2015 Silva C, Ianna E, Jones T, Davis JS, 'Should patients with hepatitis C genotype 2/3 infection who are slow responders to pegylated interferon/ribavirin have treatment duration extended?', Hepatology, 62 660-661 (2015) [C3]
DOI 10.1002/hep.27601
2015 Dulhunty JM, Roberts JA, Davis JS, Webb SAR, Bellomo R, Gomersall C, et al., 'A Multicenter Randomized Trial of Continuous versus Intermittent ß-Lactam Infusion in Severe Sepsis.', American journal of respiratory and critical care medicine, 192 1298-1305 (2015) [C1]
DOI 10.1164/rccm.201505-0857oc
Citations Scopus - 90Web of Science - 91
2015 Davis JS, Van Hal S, Tong SYC, 'Combination Antibiotic Treatment of Serious Methicillin-Resistant Staphylococcus aureus Infections', SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE, 36 3-16 (2015) [C1]
DOI 10.1055/s-0034-1396906
Citations Scopus - 17Web of Science - 18
2015 Holmes NE, Tong SYC, Davis JS, van Hal SJ, 'Treatment of Methicillin-Resistant Staphylococcus aureus: Vancomycin and Beyond', SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE, 36 17-30 (2015) [C1]
DOI 10.1055/s-0034-1397040
Citations Scopus - 23Web of Science - 21
2015 Gear RJ, Carter JC, Carapetis JR, Baird R, Davis JS, 'Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia's Northern Territory', TROPICAL MEDICINE & INTERNATIONAL HEALTH, 20 40-47 (2015) [C1]
DOI 10.1111/tmi.12405
Citations Scopus - 11Web of Science - 7
2015 Blyth CC, Walls T, Cheng AC, Murray RJ, Fisher DA, Ingram PR, Davis JS, 'A comparison of paediatric and adult infectious diseases consultations in Australia and New Zealand', European Journal of Clinical Microbiology and Infectious Diseases, (2015) [C1]

The objective of this paper is to describe paediatric infectious diseases consultations across Australia and New Zealand. We surveyed infectious diseases physicians at 51 hospital... [more]

The objective of this paper is to describe paediatric infectious diseases consultations across Australia and New Zealand. We surveyed infectious diseases physicians at 51 hospitals over a period of 2 weeks in 2012. Compared with adult consults, paediatric consults were more frequently received from general paediatricians/physicians and intensive care, yet less frequently from surgeons and emergency. Respiratory, skin/soft tissue and bone/joint infections were the most frequent consultations in children. These data demonstrate the breadth of formal infectious diseases consults in children. Differences between paediatric and infectious diseases consultations need to be considered when planning both paediatric and adult physician training and future curriculum development.

DOI 10.1007/s10096-015-2391-0
Citations Scopus - 1Web of Science - 1
2015 Tsai D, Jamal JA, Davis JS, Lipman J, Roberts JA, 'Interethnic Differences in Pharmacokinetics of Antibacterials', Clinical Pharmacokinetics, 54 243-260 (2015) [C1]

© 2014, Springer International Publishing Switzerland. Background: Optimal antibacterial dosing is imperative for maximising clinical outcome. Many factors can contribute to chang... [more]

© 2014, Springer International Publishing Switzerland. Background: Optimal antibacterial dosing is imperative for maximising clinical outcome. Many factors can contribute to changes in the pharmacokinetics of antibacterials to the extent where dose adjustment may be needed. In acute illness, substantial changes in important pharmacokinetic parameters such as volume of distribution and clearance can occur for certain antibacterials. The possibility of interethnic pharmacokinetic differences can further complicate attempts to design an appropriate dosing regimen. Factors of ethnicity, such as genetics, body size and fat distribution, contribute to differences in absorption, distribution, metabolism and elimination of drugs. Despite extensive previous work on the altered pharmacokinetics of antibacterials in some patient groups such as the critically ill, knowledge of interethnic pharmacokinetic differences for antibacterials is limited. Objectives: This systematic review aims to describe any pharmacokinetic differences in antibacterials between different ethnic groups, and discuss their probable mechanisms as well as any clinical implications. Methods: We performed a structured literature review to identify and describe available data of the interethnic differences in the pharmacokinetics of antibacterials. Results: We found 50 articles that met our inclusion criteria and only six of these compared antibacterial pharmacokinetics between different ethnicities within the same study. Overall, there was limited evidence available. We found that interethnic pharmacokinetic differences are negligible for carbapenems, most ß-lactams, aminoglycosides, glycopeptides, most fluoroquinolones, linezolid and daptomycin, whereas significant difference is likely for ciprofloxacin, macrolides, clindamycin, tinidazole and some cephalosporins. In general, subjects of Asian ethnicity achieve drug exposures up to two to threefold greater than Caucasian counterparts for these antibacterials. This difference is caused by a comparatively lower volume of distribution and/or drug clearance. Conclusion: Interethnic pharmacokinetic differences of antibacterials are likely; however, the clinical relevance of these differences is unknown and warrants further research.

DOI 10.1007/s40262-014-0209-3
Citations Scopus - 10Web of Science - 11
2015 Commons RJ, Robinson CH, Gawler D, Davis JS, Price RN, 'High burden of diabetic foot infections in the top end of Australia: An emerging health crisis (DEFINE study)', DIABETES RESEARCH AND CLINICAL PRACTICE, 110 147-157 (2015) [C1]
DOI 10.1016/j.diabres.2015.09.016
Citations Scopus - 11Web of Science - 11
2015 Davies J, Bukulatjpi S, Sharma S, Caldwell L, Johnston V, Davis JS, 'Development of a Culturally Appropriate Bilingual Electronic App About Hepatitis B for Indigenous Australians: Towards Shared Understandings.', JMIR Research Protocols, 4 (2015) [C1]
DOI 10.2196/resprot.4216
Citations Web of Science - 6
2015 Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG, 'Staphylococcus aureus infections: Epidemiology, pathophysiology, clinical manifestations, and management', Clinical Microbiology Reviews, 28 603-661 (2015) [C1]

© 2015, American Society for Microbiology. All Rights Reserved. Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading ca... [more]

© 2015, American Society for Microbiology. All Rights Reserved. Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to ß-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

DOI 10.1128/CMR.00134-14
Citations Scopus - 779Web of Science - 749
2014 Davis JS, McMillan M, Swaminathan A, Kelly JA, Piera KE, Baird RW, et al., 'A 16-Year Prospective Study of Community-Onset Bacteremic Acinetobacter Pneumonia Low Mortality With Appropriate Initial Empirical Antibiotic Protocols', CHEST, 146 1038-1045 (2014) [C1]
DOI 10.1378/chest.13-3065
Citations Scopus - 23Web of Science - 23
2014 Davis JS, He V, Anstey NM, Condon JR, 'Long Term Outcomes Following Hospital Admission for Sepsis Using Relative Survival Analysis: A Prospective Cohort Study of 1,092 Patients with 5 Year Follow Up', PLOS ONE, 9 (2014) [C1]
DOI 10.1371/journal.pone.0112224
Citations Scopus - 21Web of Science - 20
2014 Engelman D, Hofer A, Davis JS, Carapetis JR, Baird RW, Giffard PM, et al., 'Invasive Staphylococcus aureus infections in children in tropical northern Australia', Journal of the Pediatric Infectious Diseases Society, 3 304-311 (2014)

© The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. Background. Despite a high burden of staphylococcal skin disease in... [more]

© The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. Background. Despite a high burden of staphylococcal skin disease in children and high incidence of Staphylococcus aureus bacteremia in adult Indigenous populations in northern Australia, there are few studies describing incidence or clinical information of invasive S aureus (ISA) infections in children. Methods. We conducted a retrospective review for all cases of S aureus bacteremia and sterile site infections, for children under 15 years, in northern Australia over a 4-year period (2007-2010). Cases were categorized as neonatal (<28 days) and pediatric (=28 days). Results. Forty-four cases (9 neonatal, 35 pediatric)were identified.The annual incidence of ISAwas 27.9 cases per 100 000 population. Among pediatric cases, the annual incidencewas significantly higher in the Indigenous (46.6) compared with the non-Indigenous (4.4) population (IRR: 10.6 [95%confidence interval, 3.8-41.4]). Pediatric infectionswere predominantly community-associated (86%).Clinical infection sites included osteoarticular (66%), pleuropulmonary (29%), and endocarditis (9%), and multifocal diseasewas common (20%). Eighty-three percent of pediatric cases presented with sepsis; 34%resulted in intensive care admission. Neonatal cases were all born prematurely; 89%were late-onset infections. Overall, 27%of infections were due to methicillin-resistant S aureus (MRSA).Comparedwithmethicillin-sensitive S aureus(MSSA), therewasnodifference in severityorpresentation in pediatricMRSA cases, but a higher proportion ofMRSA cases were readmitted. Conclusions. The annual incidence of ISA infection in this study is among the highest described, largely due to a disproportionate burden in Indigenous children. Infections are frequently severe and infection with MRSA is common. Children presenting with suspected ISA in this region should be treated empirically for MRSA.

DOI 10.1093/jpids/piu013
Citations Scopus - 11Web of Science - 3
2014 Littlejohn M, Davies J, Yuen L, Edwards R, Sozzi T, Jackson K, et al., 'Molecular virology of hepatitis B virus, sub-genotype C4 in northern Australian Indigenous populations', Journal of Medical Virology, 86 695-706 (2014)

Indigenous Australians experience a significant health burden from chronic hepatitis B infection; however, the strain of hepatitis B virus (HBV) found among Indigenous Australians... [more]

Indigenous Australians experience a significant health burden from chronic hepatitis B infection; however, the strain of hepatitis B virus (HBV) found among Indigenous Australians has not been well characterized. Blood samples were collected from 65 Indigenous Australians with chronic HBV infection from across the Top End of Australia's Northern Territory. Phylogenetic analysis of HBV from these samples revealed that 100% of the isolates were genotype C, sub-genotype C4, expressing the serotype ayw3. This strain is a divergent group within the HBV/C genotype, and has only been described in Indigenous Australians. Evidence of recombination was suggested by discordant phylogenetic clustering of the C4 sequences when comparing the full genome to the surface region and confirmed by recombination analysis which showed the surface gene region to be most closely related to genotype J, while the remaining regions of the genome were most similar to genotype C sequences. Mutational analysis revealed the presence of multiple mutations that have been linked with more rapid liver disease progression and an increased risk of hepatocellular carcinoma. These mutations were detected in the majority of sequences examined. Variants associated with vaccine failure were detected as the predominant viral quasi-species in 3/35 samples. In summary, the HBV C4 variant found in this population has a high potential to cause advanced liver disease and to escape vaccination programs. Further in vitro functional and natural history studies are warranted in order to determine the clinical and public health consequences of infection with the HBV C4 variant in these communities. © 2014 Wiley Periodicals, Inc.

DOI 10.1002/jmv.23888
Citations Scopus - 19Web of Science - 18
2014 Hewagama S, Krishnaswamy S, King L, Davis J, Baird R, 'Human T-cell lymphotropic virus type 1 exposures following blood-borne virus incidents in Central Australia, 2002-2012', Clinical Infectious Diseases, 59 85-87 (2014)

We retrospectively audited hospital occupational exposure events over a 10-year period, in a human T-cell lymphotropic virus type 1 (HTLV-1)-endemic area of Central Australia, and... [more]

We retrospectively audited hospital occupational exposure events over a 10-year period, in a human T-cell lymphotropic virus type 1 (HTLV-1)-endemic area of Central Australia, and report on 53 individuals exposed to HTLV-1 with no transmissions documented (95% confidence interval, 0%-1.5%). This has important implications for the management of exposures including the role of postexposure prophylaxis. © The Author 2014.

DOI 10.1093/cid/ciu227
Citations Scopus - 3Web of Science - 2
2014 Davies J, Bukulatjpi S, Sharma S, Davis J, Johnston V, '"Only your blood can tell the story" - A qualitative research study using semi-structured interviews to explore the hepatitis B related knowledge, perceptions and experiences of remote dwelling Indigenous Australians and their health care providers in northern Australia', BMC Public Health, 14 (2014)

© 2014 Davies et al.; licensee BioMed Central Ltd. Background: Hepatitis B is endemic in the Indigenous communities of the Northern Territory of Australia and significantly contri... [more]

© 2014 Davies et al.; licensee BioMed Central Ltd. Background: Hepatitis B is endemic in the Indigenous communities of the Northern Territory of Australia and significantly contributes to liver-related morbidity and mortality. It is recognised that low health literacy levels, different worldviews and English as a second language all contribute to the difficulties health workers often have in explaining biomedical health concepts, relevant to hepatitis B infection, to patients. The aim of this research project was to explore the knowledge, perceptions and experiences of remote dwelling Indigenous adults and their health care providers relating to hepatitis B infection with a view to using this as the evidence base to develop a culturally appropriate educational tool. Methods: The impetus for this project came from health clinic staff at a remote community in Arnhem Land in the Northern Territory, in partnership with a visiting specialist liver clinic from the Royal Darwin Hospital. Participants were clinic patients with hepatitis B (n = 12), community members (n = 9) and key informants (n = 13); 25 were Indigenous individuals. A participatory action research project design was used with purposive sampling to identify participants. Semi-structured interviews were undertaken to explore: current understanding of hepatitis B, desire for knowledge, and perspectives on how people could acquire the information needed. All individuals were offered the use of an interpreter. The data were examined using deductive and inductive thematic analysis. Results: Low levels of biomedical knowledge about Hepatitis B, negative perceptions of Hepatitis B, communication (particularly language) and culture were the major themes that emerged from the data. Accurate concepts grounded in Indigenous culture such as "only your blood can tell the story" were present but accompanied by a feeling of disempowerment due to perceived lack of "medical" understanding, and informed partnerships between caregiver and patient. Culturally appropriate discussions in a patient's first language using visual aids were identified as vital to improving communication. Conclusions: Having an educational tool in Indigenous patient's first language is crucial in developing treatment partnerships for Indigenous patients with hepatitis B. Using a culturally appropriate worldview as the foundation for development should help to reduce disempowerment and improve health literacy.

DOI 10.1186/1471-2458-14-1233
Citations Scopus - 15Web of Science - 14
2014 Darcy CJ, Minigo G, Piera KA, Davis JS, McNeil YR, Chen Y, et al., 'Neutrophils with myeloid derived suppressor function deplete arginine and constrain T cell function in septic shock patients', CRITICAL CARE, 18 (2014) [C1]
DOI 10.1186/cc14003
Citations Scopus - 58Web of Science - 61
2014 Parker C, Tong SYC, Dempsey K, Condon J, Sharma SK, Chen JWC, et al., 'Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome', MEDICAL JOURNAL OF AUSTRALIA, 201 470-474 (2014) [C1]
DOI 10.5694/mja13.11117
Citations Scopus - 12Web of Science - 12
2014 Ingram PR, Cheng AC, Murray RJ, Blyth CC, Walls T, Fisher DA, Davis JS, 'What do infectious diseases physicians do? A 2-week snapshot of inpatient consultative activities across Australia, New Zealand and Singapore', CLINICAL MICROBIOLOGY AND INFECTION, 20 O737-O744 (2014) [C1]
DOI 10.1111/1469-0691.12581
Citations Scopus - 13Web of Science - 11
2014 Jeremiah CJ, Wills C, Bayly A, Perry GJ, Davis JS, Tong SY, Currie BJ, 'VANCOMYCIN DOSING NOMOGRAM FOR HAEMODIALYSIS PATIENTS', NEPHROLOGY, 19 513-514 (2014) [C3]
DOI 10.1111/nep.12270
Citations Scopus - 7Web of Science - 6
2014 Darcy CJ, Woodberry T, Davis JS, Piera KA, McNeil YR, Chen Y, et al., 'Increased plasma arginase activity in human sepsis: association with increased circulating neutrophils', CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 52 573-581 (2014) [C1]
DOI 10.1515/cclm-2013-0698
Citations Scopus - 8Web of Science - 7
2013 Davis JS, Kulatunga AC, Hajkowicz K, 'Outcomes for Indigenous and non-Indigenous patients who access treatment for hepatitis C in the Top End of the Northern Territory', MEDICAL JOURNAL OF AUSTRALIA, 199 23-23 (2013)
DOI 10.5694/mja13.10083
Citations Scopus - 2Web of Science - 2
2013 Deans AK, Boerma CJ, Fordyce J, De Souza M, Palmer DJ, Davis JS, 'Use of Royal Darwin Hospital emergency department by immigration detainees in 2011', MEDICAL JOURNAL OF AUSTRALIA, 199 776-778 (2013) [C1]
DOI 10.5694/mja13.10447
Citations Scopus - 7Web of Science - 6
2013 Pitman MC, Anstey NM, Davis JS, 'Eosinophils in Severe Sepsis in Northern Australia: Do the Usual Rules Apply in the Tropics?', CRITICAL CARE MEDICINE, 41 E286-E288 (2013) [C1]
DOI 10.1097/CCM.0b013e3182923755
Citations Scopus - 4Web of Science - 5
2013 Davies J, Littlejohn M, Locarnini SA, Whiting S, Hajkowicz K, Cowie BC, et al., 'The molecular epidemiology of hepatitis B in the Indigenous people of northern Australia', JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 28 1234-1241 (2013)
DOI 10.1111/jgh.12177
Citations Scopus - 27Web of Science - 25
2013 Dulhunty JM, Roberts JA, Davis JS, Webb SAR, Bellomo R, Gomersall C, et al., 'Continuous Infusion of Beta-Lactam Antibiotics in Severe Sepsis: A Multicenter Double-Blind, Randomized Controlled Trial', CLINICAL INFECTIOUS DISEASES, 56 236-244 (2013) [C1]
DOI 10.1093/cid/cis856
Citations Scopus - 198Web of Science - 194
2013 Dulhunty JM, Roberts JA, Davis JS, Webb SAR, Bellomo R, Gomersall C, et al., 'Reply to Soman et al', CLINICAL INFECTIOUS DISEASES, 57 323-+ (2013)
DOI 10.1093/cid/cit201
2013 Davies J, Tong SYC, Davis JS, 'Hepatitis D is rare or non-existent in hepatitis B virus-infected Indigenous Australians in the Northern Territory', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 37 188-189 (2013)
DOI 10.1111/1753-6405.12040
Citations Scopus - 1Web of Science - 1
2013 Dulhunty JM, Roberts JA, Davis JS, Webb SAR, Bellomo R, Gomersall C, et al., 'A protocol for a multicentre randomised controlled trial of continuous beta-lactam infusion compared with intermittent beta-lactam dosing in critically ill patients with severe sepsis: the BLING II study', CRITICAL CARE AND RESUSCITATION, 15 179-185 (2013)
Citations Scopus - 18Web of Science - 17
2013 Davis JS, McGloughlin S, Tong SYC, Walton SF, Currie BJ, 'A Novel Clinical Grading Scale to Guide the Management of Crusted Scabies', PLOS NEGLECTED TROPICAL DISEASES, 7 (2013)
DOI 10.1371/journal.pntd.0002387
Citations Scopus - 27Web of Science - 23
2012 Harding DJ, Subramaniam K, MacQuillan G, Davis J, Nolan D, 'Severe drug-induced hypersensitivity syndrome with a shared HLA-B allele', MEDICAL JOURNAL OF AUSTRALIA, 197 411-413 (2012)
DOI 10.5694/mja12.10477
Citations Scopus - 13Web of Science - 11
2012 Davis JS, 'Assessing fever in the returned traveller', AUSTRALIAN PRESCRIBER, 35 142-142 (2012)
2012 Whelan P, Huy N, Hajkowicz K, Davis J, Smith D, Pyke A, et al., 'Evidence in Australia for a Case of Airport Dengue', PLOS NEGLECTED TROPICAL DISEASES, 6 (2012)
DOI 10.1371/journal.pntd.0001619
Citations Scopus - 9Web of Science - 13
2012 Gordon CL, Whiting S, Haran G, Ward A, Coleman M, Baird R, et al., 'Entomophthoromycosis caused by Basidiobolus ranarum in tropical northern Australia', PATHOLOGY, 44 375-379 (2012)
DOI 10.1097/PAT.0b013e328353e912
Citations Scopus - 2Web of Science - 1
2012 Davies J, Gordon CL, Tong SYC, Baird RW, Davis JS, 'Impact of Results of a Rapid Staphylococcus aureus Diagnostic Test on Prescribing of Antibiotics for Patients with Clustered Gram-Positive Cocci in Blood Cultures', JOURNAL OF CLINICAL MICROBIOLOGY, 50 2056-2058 (2012)
DOI 10.1128/JCM.06773-11
Citations Scopus - 33Web of Science - 32
2012 Robins-Browne KL, Cheng AC, Thomas KAS, Palmer DJ, Currie BJ, Davis JS, 'The SMART-COP score performs well for pneumonia risk stratification in Australia's Tropical Northern Territory: a prospective cohort study', TROPICAL MEDICINE & INTERNATIONAL HEALTH, 17 914-919 (2012)
DOI 10.1111/j.1365-3156.2012.03006.x
Citations Scopus - 6Web of Science - 6
2011 Davis JS, Cheng AC, McMillan M, Humphrey AB, Stephens DP, Anstey NM, 'Sepsis in the tropical Top End of Australia's Northern Territory: disease burden and impact on Indigenous Australians', MEDICAL JOURNAL OF AUSTRALIA, 194 519-524 (2011)
DOI 10.5694/j.1326-5377.2011.tb03088.x
Citations Scopus - 36Web of Science - 34
2011 Davis JS, Anstey NM, 'Is plasma arginine concentration decreased in patients with sepsis? A systematic review and meta-analysis', CRITICAL CARE MEDICINE, 39 380-385 (2011)
DOI 10.1097/CCM.0b013e3181ffd9f7
Citations Scopus - 37Web of Science - 39
2011 White HA, Davis JS, Kittler P, Currie BJ, 'Outpatient parenteral antimicrobial therapy-treated bone and joint infections in a tropical setting', INTERNAL MEDICINE JOURNAL, 41 668-673 (2011)
DOI 10.1111/j.1445-5994.2009.02136.x
Citations Scopus - 15Web of Science - 13
2011 Davis JS, Darcy CJ, Yeo TW, Jones C, McNeil YR, Stephens DP, et al., 'Asymmetric Dimethylarginine, Endothelial Nitric Oxide Bioavailability and Mortality in Sepsis', PLOS ONE, 6 (2011)
DOI 10.1371/journal.pone.0017260
Citations Scopus - 47Web of Science - 46
2011 Darcy CJ, Davis JS, Woodberry T, McNeil YR, Stephens DP, Yeo TW, Anstey NM, 'An Observational Cohort Study of the Kynurenine to Tryptophan Ratio in Sepsis: Association with Impaired Immune and Microvascular Function', PLOS ONE, 6 (2011)
DOI 10.1371/journal.pone.0021185
Citations Scopus - 31Web of Science - 27
2010 Bilgrami I, Roberts JA, Wallis SC, Thomas J, Davis J, Fowler S, et al., 'Meropenem Dosing in Critically Ill Patients with Sepsis Receiving High-Volume Continuous Venovenous Hemofiltration', ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 54 2974-2978 (2010)
DOI 10.1128/AAC.01582-09
Citations Scopus - 52Web of Science - 47
2010 Dent E, Selvey CE, Bell A, Davis J, McDonald MI, 'Incomplete protection against hepatitis B among remote Aboriginal adolescents despite full vaccination in infancy.', Communicable diseases intelligence, 34 435-439 (2010)

The objective of this study was to determine long-term immunity to hepatitis B virus (HBV) in a cohort of adolescents who received plasma-derived HBV vaccine in 1989 and 1990 in a... [more]

The objective of this study was to determine long-term immunity to hepatitis B virus (HBV) in a cohort of adolescents who received plasma-derived HBV vaccine in 1989 and 1990 in a remote Australian Aboriginal community. This was done using a serological survey; primary outcome measures were cut-off titres of HBsAb, and the presence of HBcAb and/or HBsAg. Of 37 adolescents in the cohort, 4 (11%) had evidence of active infection, one with abnormal liver enzymes, 7 (19%) had evidence of past infection, 15 (41%) were HBsAb positive in low titre and 11 (30%) were classed as immune. It was concluded that there was relatively poor long-term serological immunity to HBV vaccination in this group; a finding which is in keeping with similar studies in Indigenous and remote populations elsewhere. This finding raises the concern that a significant proportion of Aboriginal adolescents in other remote communities (vaccinated in 1989 and 1990) were not adequately protected by the vaccine. If so, there will be an unexpected burden of chronic HBV infection in these settings and a substantial group who are non-immune, despite having received complete HBV vaccination courses as infants. The authors recommend followup serosurveys in remote Aboriginal communities to identify people with low HBsAb titres, especially those without an adequate anamnestic response to another dose of HBV vaccine. In addition, community-based active surveillance programs will be required to detect people with chronic HBV infection and provide access to monitoring and appropriate treatment.

Citations Scopus - 20
2010 Markey PG, Davis JS, Harnett GB, Williams SH, Speers DJ, 'Meningitis and a Febrile Vomiting Illness Caused by Echovirus Type 4, Northern Territory, Australia', EMERGING INFECTIOUS DISEASES, 16 63-68 (2010)
DOI 10.3201/eid1601.081519
Citations Scopus - 9Web of Science - 8
2010 McMillan M, Davis JS, 'Acute hospital admission for sepsis: an important but under-utilised opportunity for smoking cessation interventions', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 34 432-433 (2010)
DOI 10.1111/j.1753-6405.2009.00580.x
Citations Scopus - 1Web of Science - 1
2010 Davis JS, Cross GB, Charles PGP, Currie BJ, Anstey NM, Cheng AC, 'Pneumonia risk stratification in tropical Australia: does the SMART-COP score apply?', MEDICAL JOURNAL OF AUSTRALIA, 192 133-136 (2010)
DOI 10.5694/j.1326-5377.2010.tb03450.x
Citations Scopus - 13Web of Science - 14
2010 Davis JS, Cheng AC, Currie BJ, Anstey NM, 'Pneumonia risk stratification in tropical Australia: does the SMART-COP score apply? Reply', MEDICAL JOURNAL OF AUSTRALIA, 192 543-543 (2010)
2010 Flint SM, Davis JS, Su J-Y, Oliver-Landry EP, Rogers BA, Goldstein A, et al., 'Disproportionate impact of pandemic (H1N1) 2009 influenza on Indigenous people in the Top End of Australia's Northern Territory', MEDICAL JOURNAL OF AUSTRALIA, 192 617-622 (2010)
DOI 10.5694/j.1326-5377.2010.tb03654.x
Citations Scopus - 35Web of Science - 44
2010 Davis JS, Cheng AC, Currie BJ, Anstey NM, 'In reply', Medical Journal of Australia, 192 543 (2010)
2010 Winter S, Thomas JH, Stephens DP, Davis JS, 'Particulate face masks for protection against airborne pathogens - one size does not fit all: an observational study', CRITICAL CARE AND RESUSCITATION, 12 24-27 (2010)
Citations Scopus - 10Web of Science - 7
2010 Carroll E, Page W, Davis JS, 'Screening for hepatitis B in East Arnhem Land: a high prevalence of chronic infection despite incomplete screening', INTERNAL MEDICINE JOURNAL, 40 784-787 (2010)
DOI 10.1111/j.1445-5994.2010.02316.x
Citations Scopus - 9Web of Science - 11
2010 Davis JS, Yeo TW, Piera KA, Woodberry T, Celermajer DS, Stephens DP, Anstey NM, 'Angiopoietin-2 is increased in sepsis and inversely associated with nitric oxide-dependent microvascular reactivity', CRITICAL CARE, 14 (2010)
DOI 10.1186/cc9020
Citations Scopus - 52Web of Science - 48
2009 Davis JS, Darcy CJ, Piera K, McNeil YR, Woodberry T, Anstey NM, 'Ex-vivo changes in amino acid concentrations from blood stored at room temperature or on ice: implications for arginine and taurine measurements', BMC CLINICAL PATHOLOGY, 9 (2009)
DOI 10.1186/1472-6890-9-10
Citations Scopus - 24Web of Science - 12
2009 Murray RJ, Davis JS, Burgner DP, 'The Australasian Society for Infectious Diseases guidelines for the diagnosis, management and prevention of infections in recently arrived refugees: an abridged outline', MEDICAL JOURNAL OF AUSTRALIA, 190 421-425 (2009)
DOI 10.5694/j.1326-5377.2009.tb02489.x
Citations Scopus - 34Web of Science - 33
2009 Charles PGP, Davis JS, Grayson ML, 'Rocket Science and the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) Guidelines for Severe Community-Acquired Pneumonia', CLINICAL INFECTIOUS DISEASES, 48 1796-1796 (2009)
DOI 10.1086/599227
Citations Scopus - 8Web of Science - 9
2009 Davis JS, Yeo TW, Thomas JH, McMillan M, Darcy CJ, McNeil YR, et al., 'Sepsis-associated microvascular dysfunction measured by peripheral arterial tonometry: an observational study', CRITICAL CARE, 13 (2009)
DOI 10.1186/cc8055
Citations Scopus - 36Web of Science - 35
2008 Davis J, 'Preventing hepatitis B virus reactivation following immunosuppressive therapy', INTERNAL MEDICINE JOURNAL, 38 617-617 (2008)
DOI 10.1111/j.1445-5994.2008.01652.x
Citations Scopus - 1Web of Science - 1
2008 Kaufman J, Davis J, Krause V, 'Influenza immunisation of doctors at an Australian tertiary hospital: immunisation rate and factors contributing to uptake.', Communicable diseases intelligence, 32 443-448 (2008)

Immunisation of health care workers against influenza reduces influenza-related morbidity and mortality of hospital inpatients and staff absenteeism. Uptake of influenza vaccinati... [more]

Immunisation of health care workers against influenza reduces influenza-related morbidity and mortality of hospital inpatients and staff absenteeism. Uptake of influenza vaccination amongst hospital doctors is generally inadequate, and factors contributing to influenza vaccine uptake among doctors have not been well defined. We performed an audit of doctors at an Australian hospital to establish the rate of and the factors contributing to influenza immunisation uptake. The audit was conducted by delivering a survey to doctors for self-completion at major departmental meetings. Of 243 doctors employed at the hospital, 150 completed the survey (response rate 62%), of whom only 28% received influenza immunisation in 2007 and 44% in any prior year. Doctors immunised in 2007 were of an older age (39.1 vs. 34.7 years, P = 0.01) and level of seniority (odds ratio for consultant vs. more junior staff = 2.9, P = 0.02) than those not immunised. Doctors who had ever been immunised had a better knowledge about influenza than those never immunised (odds ratio for high knowledge score 4.2, P < 0.001). The most common reasons cited for not being immunised in 2007 were being too busy, immunisation not being offered conveniently and not being aware how to access the vaccine. Immunisation rates among doctors in this study are inadequate. A perceived lack of convenience of the immunisation service and poor knowledge about influenza vaccination are the major contributing factors. Efforts to improve influenza immunisation uptake amongst hospital doctors should focus on education, and on innovative strategies to make immunisation more convenient and accessible specifically for doctors.

Citations Scopus - 11
2007 Benson J, Davis J, 'Malaria in the Australian refugee population', AUSTRALIAN FAMILY PHYSICIAN, 36 639-+ (2007)
Citations Scopus - 4Web of Science - 4
2005 Davis JS, 'Management of bone and joint infections due to Staphylococcus aureus', INTERNAL MEDICINE JOURNAL, 35 S79-S96 (2005)
DOI 10.1111/j.1444-0903.2005.00982.x
Citations Scopus - 77Web of Science - 67
2004 Davis JS, Bourke P, 'Rhabdomyolysis associated with dengue virus infection', CLINICAL INFECTIOUS DISEASES, 38 E109-E111 (2004)
DOI 10.1086/392510
Citations Scopus - 64Web of Science - 56
2004 Davis JS, 'High-dose riboflavin for the prevention of migraine: can we afford to ignore it?', INTERNAL MEDICINE JOURNAL, 34 372-372 (2004)
DOI 10.1111/j.1445-5994.2004.00620.x
2003 Cheng AC, Hanna JN, Norton R, Hills SL, Davis J, Krause VL, et al., 'Melioidosis in northern Australia, 2001-02.', Communicable diseases intelligence, 27 272-277 (2003)

Melioidosis, caused by the gram negative bacterium Burkholderia pseudomallei, is endemic in northern Australia. Using data collated from centres in Western Australia, the Northern... [more]

Melioidosis, caused by the gram negative bacterium Burkholderia pseudomallei, is endemic in northern Australia. Using data collated from centres in Western Australia, the Northern Territory and Queensland, this report describes the epidemiology of this disease between 1 November, 2001 and 31 October, 2002. There were 47 cases seen during this period with an average annual incidence of 5.8 cases per 100,000 population. In Indigenous Australians, an incidence of 25.5 cases per 100,000 population was seen. The timing and location of cases was generally correlated with rainfall across northern Australia. A case-cluster in a Queensland community was associated with post-cyclonic flooding. Risk factors included diabetes, alcohol-related problems and renal disease. Pneumonia (51%) was the most common clinical diagnosis. The mortality rate attributable to melioidosis was 21 per cent, although a number of other patients died of underlying disease. Despite improvements in recognition and treatment, melioidosis is still associated with a high morbidity and mortality, particularly in Indigenous Australians.

Citations Scopus - 36
2003 Davis JS, Currie BJ, Fisher DA, Huffam SE, Anstey NM, Price RN, et al., 'Prevention of opportunistic infections in immunosuppressed patients in the tropical top end of the Northern Territory.', Communicable diseases intelligence, 27 526-532 (2003)

The population of the Top End of the Northern Territory has a high incidence of several infections of particular significance in the immunosuppressed. The following protocol for e... [more]

The population of the Top End of the Northern Territory has a high incidence of several infections of particular significance in the immunosuppressed. The following protocol for evaluation and treatment of patients prior to immunosuppression was developed in order to reduce the incidence of serious opportunistic infections. The infections discussed are Strongyloides stercoralis, tuberculosis, scabies, chronic hepatitis B, melioidosis and other bacterial infections. We recommend that all patients planned to receive more than 0.5 mg/kg/day of prednisolone for >14 days, or any more potent immunosuppressive drug, be evaluated and treated according to this protocol. Details of the rationale, evidence base, and proposed investigations and therapy for such patients are discussed.

Citations Scopus - 25
2001 Davis JS, Boyle MJ, Hannaford R, Watson A, 'Bupropion and serum sickness-like reaction', MEDICAL JOURNAL OF AUSTRALIA, 174 479-480 (2001)
DOI 10.5694/j.1326-5377.2001.tb143381.x
Citations Scopus - 17Web of Science - 10
1997 Howard D, Davis JS, Pugsley D, Seymour T, Hoy W, 'Morphologic correlates of renal disease in a high risk Aboriginal community.', KIDNEY INTERNATIONAL, 51 1318-1318 (1997)
Citations Web of Science - 8
1992 Davies J, Davis J, 'Where naming cuts confusion.', Nursing times, 88 43-44 (1992)
1992 Davis J, 'Expanding horizons.', Nursing times, 88 37-39 (1992)
Citations Scopus - 7
1984 SMITH JB, SMITH L, BROWN ER, BARNES D, SABIR MA, DAVIS JS, FARESE RV, 'ANGIOTENSIN-II RAPIDLY INCREASES PHOSPHATIDATE-PHOSPHOINOSITIDE SYNTHESIS AND PHOSPHOINOSITIDE HYDROLYSIS AND MOBILIZES INTRACELLULAR CALCIUM IN CULTURED ARTERIAL MUSCLE-CELLS', PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA-BIOLOGICAL SCIENCES, 81 7812-7816 (1984)
DOI 10.1073/pnas.81.24.7812
Citations Scopus - 128Web of Science - 216
Show 115 more journal articles

Conference (2 outputs)

Year Citation Altmetrics Link
2017 Davis JS, Young MS, Lennox S, Jones T, Piera K, Oakley S, 'CHESS - curing hepatitis C: effect on the endothelium and cardiovascular risk', JOURNAL OF HEPATOLOGY, Amsterdam, NETHERLANDS (2017)
DOI 10.1016/S0168-8278(17)31378-8
2015 Chaves NJ, Paxton GP, Smith M, Gardiner J, Biggs BA, Davis JS, 'REVISING THE 2009 AUSTRALASIAN SOCIETY OF INFECTIOUS DISEASES GUIDELINES FOR DIAGNOSIS, MANAGEMENT AND PREVENTION OF INFECTIONS IN NEWLY ARRIVED REFUGEES - NOT ONLY INFECTIONS AND NOT ONLY REFUGEES', INTERNAL MEDICINE JOURNAL (2015) [E3]
Citations Web of Science - 1
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Grants and Funding

Summary

Number of grants 8
Total funding $8,782,734

Click on a grant title below to expand the full details for that specific grant.


20183 grants / $4,270,000

HBV PAST - Eliminating HBV from the Northern Territory$2,300,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Scheme Partnership Projects
Role Investigator
Funding Start 2018
Funding Finish 2023
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Combination antibiotic therapy for MRSA blood stream infection$1,100,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Scheme Project
Role Lead
Funding Start 2018
Funding Finish 2019
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Host pathogen interactions in community acquired Acinetobacter infection$870,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Scheme Project Grant
Role Investigator
Funding Start 2018
Funding Finish 2020
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

20171 grants / $20,000

Plasma Torque Teno Virus load as a novel tool to monitor intensity of immunosuppression in renal transplant recipients$20,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Josh Davis, Associate Professor Nathan Bartlett, Dr Peter Choi
Scheme Project Grant
Role Lead
Funding Start 2017
Funding Finish 2017
GNo G1701566
Type Of Funding C3120 - Aust Philanthropy
Category 3120
UON Y

20153 grants / $4,465,222

Selective Digestive Tract Decontamination in Intensive Care Units$4,200,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Scheme Project
Role Investigator
Funding Start 2015
Funding Finish 2019
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Adressing evidence gaps in severe infectious diseases$240,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Scheme Career Development Fellowships
Role Lead
Funding Start 2015
Funding Finish 2018
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

MERINO2 - A randomised controlled trial comparing two different antibiotics for blood stream infections caused by the 'ESCaPM' group of antibiotic resistant Gram negative bacteria$25,222

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Josh Davis, Professor Andrew Boyle, Patrick Harris, David Paterson
Scheme Project Grant
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1500781
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y

20141 grants / $27,512

PIANO - Prosthetic Joint Infection in Australia and New Zealand Observational Study$27,512

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Josh Davis, Doctor Mark Loewenthal
Scheme Project Grant
Role Lead
Funding Start 2014
Funding Finish 2018
GNo G1400545
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y
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Research Supervision

Number of supervisions

Completed3
Current5

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2018 PhD Septic Arthritis in Orthopaedics - Optimising Management and Outcomes PhD (Surgical Science), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2017 PhD The epidemiology of MRSA in NSW Microbiology, Sydney University Medical Foundation Co-Supervisor
2016 Honours T cell responses to Salmonella Typhi in a human challenge model Medical Science, University of Newcastle Co-Supervisor
2016 PhD The molecular epidemiology of Gram negative environmental pathogens in Tropical Australia Microbiology, Menzies School of Health Research and Charles Darwin University Co-Supervisor
2014 PhD Relative Survival Analysis as a tool to understand disease outcomes in Australia's Northern Territory Statistics, Menzies School of Health Research and Charles Darwin University Co-Supervisor

Past Supervision

Year Level of Study Research Title Program Supervisor Type
2016 PhD ECHOCARDIOGRAPHIC SCREENING FOR RHEUMATIC HEART DISEASE IN NORTHERN AUSTRALIAN CHILDREN Epidemiology, Menzies School of Health Research and Charles Darwin University Co-Supervisor
2016 PhD Hepatitis B in Australia's Northern Territory: Understanding the True Story Epidemiology, Menzies School of Health Research and Charles Darwin University Principal Supervisor
2012 Honours The epidemiology of hepatocellular carcinoma in Australia's Northern Territory Epidemiology, The University of Melbourne Sole Supervisor
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Research Projects

NETA - Neutrophil Extracellular Traps in Autoimmunity 2015 -

Neutrophil Extracellular Traps are a recently described mechanism of innate immunity. The Trauma group led by Prof Zsolt Balogh at HNE Health have recently demonstrated that a different type of NETosis involving mitochondrial DNA rather than cellular nuclear DNA occurs in the sterile inflammation occurring in the Systemic Inflammatory Response Syndrome. It seems plausible that the same process may occur in other forms of sterile inflammation such as the autoimmune diseases encountered in clinical Rheumatology. NETA is a preliminary observational study to determine whether NETosis is occurring in a range of inflammatory diseases and the type of NETosis that is occurring. The range of conditions includes rheumatoid arthritis, psoriatic arthritis, giant cell arteritis, gout, bacterial sepsis. The collaborators include A/Prof Stephen Oakley, Prof Zsolt Balogh, Prof Phil Hansbro and Dr Joshua Davis.

Collaborators

Name Organisation
Conjoint Professor Josh S Davis
Professor Zsolt Janos Balogh University of Newcastle

CHESS 2015 - 2016


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Conjoint Professor Josh Davis

Position

Conjoint Professor
School of Medicine and Public Health
Faculty of Health and Medicine

Contact Details

Email josh.davis@newcastle.edu.au
Link Personal webpage
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