Infectious diseases and infection prevention research

Cancer patients are a unique population with specialised needs. There is compelling evidence that infection in cancer patients remains a leading cause of death and a significant cost to the healthcare system. Our group aims to optimise patient outcomes using a health services approach to prevent and manage the critical and growing problems of healthcare associated and community acquired infection, poor antimicrobial management, and late recognition of infection in this vulnerable population. Visit the Cancer and Infections webpage for more information and resources on Infectious diseases and infection prevention research. Funded by the NHMRC Synergy grant The National Centre for Infections in Cancer (NCIC) #2011100.

Our work focuses on:

Establishing a national infrastructure for cancer specific infection surveillance, clinical trials and clinical support
Implementation of life saving and harm minimising clinical care pathways for the management of infections in the immunocompromised individual
Introducing innovative technologies to support the detection of and improve care of infections in cancer

This group comprises experienced translational researchers with national and international profiles in the surveillance and management of infections in cancer, headed by Professor Monica Slavin MBBS, FRACP, MD, FAAHMS, FECMM.

Infectious diseases physician and clinical scientist, Professor Monica Slavin, is internationally recognised for identifying risk factors and improving early diagnosis and prevention of infection in patients whose immune systems are compromised. She is a thought leader internationally in the field and continues to drive change in how infections are diagnosed and managed. She is recognised as an outstanding mentor and sponsor and as a strong role model for women in science and medicine. She is the Director of the Infectious Diseases Department at the Peter McCallum Cancer Centre, she is the inaugural University of Melbourne Chair of Infections in cancer and Transplantation and leads the Infections in the Immuncompromised Host Service at the Royal Melbourne Hospital. As well as being the Director of the NHMRC-funded Centre of Research Excellence, the National Centre for Infections in Cancer (NCIC) and a Fellow of the Australian Academy of Health and Medical Sciences.

Infectious diseases and infection prevention research focus

Our research falls under three major themes.

Surveillance (Led by A/Prof Leon Worth)

Establishing a cancer related infection surveillance network to address areas of need regarding infrastructure requirements for effectual infection surveillance. We aim to describe the prevalence and risks for infections in cancer populations as vital companion data to pooled data concerning general hospital patients. Our current flagship project in this area is the development of an automated, integrated digital health surveillance platform fro the detection of Invasive fungal infections (IFIs) in immune compromised patients. Our team, in collaboration with the Royal Melbourne Institute of Technology (RMIT), The Guidance Group at Melbourne Health and BioGrid Australia are working together to develop a platform for automated routine surveillance of IFI, employing a combination of AI techniques to identify episodes of IFI. Our goal is to go beyond the development of an AI model by creating a web-based user interface accessible by medical professionals to support surveillance and management of IFI in clinical practice. Funding provided by MRFF app#1156426.

At any one time we run a variety of local, national and international surveillance studies for viral, bacterial, fungal infections in cancer and transplant patients through our national NCIC network. Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information on becoming a participating site.

Implementation (led by Prof Karin Thursky)

We have developed, tested and implemented a suite of clinical pathways, toolkits and guidelines for the management of infectious complications in cancer patients.

No place like home

A hospital-wide approach to the recognition and management of febrile neutropenia (FN) and sepsis for patients being treated for cancer. This includes both inpatient and outpatient programs and an NHMRC (National Health and Medical Research Council) funded national project to validate a rule to stratify children into low and high risk for complications associated with FN. This will facilitate early identification and safe treatment in the outpatient setting. Full implementation toolkit for use at your site available at https://cancerandinfections.org/kids-dashboard

Antibiotic allergy delabelling

Many antibiotic allergies reported by patients are historical in nature and can be investigated safely to determine an appropriate antibiotic plan. Our Antibiotic Allergy Service is a multidisciplinary group of clinicians who work throughout Peter Mac, Austin Health and the Parkville Precinct to challenge these antibiotic allergy labels in a variety of settings including ambulatory clinics, inpatient programs and clinical trials. More info at: https://cancerandinfections.org/antibiotic-allergy-delabelling

The sepsis pathway

Sepsis is a clinical condition, arising when the body’s own immune system damages tissues and organs in the process of trying to fight off infection and organ failure occurs. Sepsis is a time critical emergency that disproportionately adversely affects cancer patients. Developed at the Peter Mac and now implemented nationally the sepsis clinical care standard can be found here: https://www.safetyandquality.gov.au/standards/clinical-care-standards/sepsis-clinical-care-standard

Find further information on all our pathways, programs and guidelines.

Innovation (led by Prof Monica Slavin)

The Dept Id, Peter Mac has established a highly successful Clinical studies group which employs five clinical trials nurses, two clinical trials assistants and three laboratory research assistants. Current pharma and investigator initiated trials in cancer patients include:

Novel antifungals (F2G, Restore, APX001, Synergia)
Novel antivirals (RSV, paraflu)
Novel prophylaxis strategies (Flu vax, COVID vax, CSMART (NHMRC #, Posa)
Novel diagnostics (Pippin, CrispBAL, Cresct and Cresct expansion)

More information here: https://cancerandinfections.org/clinical-trials

A flagship project of the innovations stream was the PIPPIN project conducted by Dr Abby Douglas during her PhD; a multicentre, randomised clinical trial to assess the impact of positron emission tomography combined with computed tomography (PET/CT) on the management and outcomes of persistent neutropenic fever in cancer patients. Due to a lack of localising symptoms and signs, and deficiencies with current diagnostic’s the cause of neutropenic fever in patients with acute leukaemia and haematopoietic stem cell transplant recipients is frequently unknown. The risk for deterioration in these patients, while waiting to determine cause of fever, is significant, with concerns for uncontrolled bacterial sepsis and invasive fungal infection. The PIPPIN project demonstrated FDG-PET/CT to be superior to CT alone in leading to reduced broad-spectrum antimicrobial use, with implications of reduced induction of antimicrobial resistance (a global threat) and other adverse effects from prolonged antimicrobials, including organ toxicities, antibiotic-associated infections and microbiome derangement. This project will impact care of patients nationally and internationally, by transforming the diagnostic algorithm in persistent neutropenic fever with likely benefits of reducing costs of care and the risk of complications related to prolonged length of stay for cancer patients experiencing neutropenic fever.

Current ongoing work of the NCIC innovations stream include use of gut microbiome profiles to predict infection outcomes in cancer patients receiving novel immunotherapies such as CART cells (HOMISPEC), development of a rapid point of care test using CRISPR technology as an infection diagnostic tool (C-FIND NHMRC development grant #2014584 in collaboration with WEHI) and participation in the Meta-GP trial (MRFF Genomics Health Futures Mission – Flagship - Pathogen Genomics) to use genome wide sequencing for rapid detection of infections.

Contact

Prof Monica Slavin - Director, Infectious Diseases | Director, National Centre for Infections in Cancer (NCIC)

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Dr Megan Crane - General manager, Infectious Diseases