In the past Joan Faoagali has collaborated on articles with Snehal S. Chandan and Hanna E. Sidjabat. One of their most recent publications is Meet the microbiology chief examiner 2009. Which was published in journal Pathology.

More information about Joan Faoagali research including statistics on their citations can be found on their Copernicus Academic profile page.

Joan Faoagali's Articles: (8)

Meet the microbiology chief examiner 2009

I am commencing my second term as Microbiology chief examiner and the main tasks include developing a robust and sustainable examination system to meet the AMC (Australian Medical Council) requirements for RCPA registration. This involves ensuring that there is an assistant chief examiner to provide examination continuity and sustainability, working with an examination panel of microbiology experts to ensure that the examination is relevant, and tests that trainees are competent in all areas of the curriculum, as well as the introduction of modern and relevant methods of assessment.Trainees are urged to interact with the CEX especially if there are problems with supervision or training and there will be opportunities to explore training issues raised by attendees.

Molecular bacteriology and the autopsy

In 1996 the UNEX study was set up in the United States to use molecular techniques on patients who had died unexpectedly from a presumed bacterial infection.The patients selected were those with a pre-mortem clinical diagnosis of infection. Samples were aseptically collected from up to a dozen normally sterile sites at post mortem.Blood and bowel contents were not examined but abscess material, CSF and tissue were collected. The samples were examined by routine culture and 16SRNA which was sequenced. The outcomes of the US study were published in 2002 and some of the US states have continued to examine selected autopsies for bacterial causes of death driven by concerns regarding possible bioterrorism.In Queensland between 2002 and 2005 a UNEX trial was set up and two illustrative cases will be presented.Problems with this technique include the costs and the time to complete testing.A review of literature and current and possible future practices will be discussed.

Meet the chief examiner microbiology 2010

The Chief Examiner coordinates the MB1 and 2 examinations, reviews laboratory accreditation, attends the Royal College of Pathologists of Australasia (RCPA) Board of Censors meetings (2 per year), the Microbiology Advisory Meeting (~1 per year) and the Royal Australasian College of Physicians (RACP)/RCPA Joint Specialist Advisory Committee for advanced training in infectious diseases and microbiology (IDJSAC) with two face to face meetings and one teleconference annually.There are a team of accredited examiners in microbiology who assist with setting and marking the microbiology examinations each year. The Chief Examiner is heavily supported by the RCPA management staff including Colin Underwood, Wendy Pryor, Leah Bloomfield, Helen Todd and Heidi Nelson and the Quality Assurance Program (QAP) team who are responsible for organising the wet practical for the MB1 examination.The Microbiology curriculum and assessment processes are being modernised and updated to reflect modern assessment practices. This will be discussed and there will be opportunities for questions and comments.

Sensitivity of respiratory bacteria to lignocaine

SummaryAimLignocaine, a topical anaesthetic agent, is generally used in variable concentrations usually between 2% and 4% on the vocal cords prior to flexible bronchoscopy and bronchoalveolar lavage (BAL) procedures. The aim of this study was to investigate whether 2% or 1% lignocaine significantly inhibits the growth of organisms commonly found in the respiratory tract, in particular Streptococcus pneumoniae.MethodIn order to determine the antibiotic effect of lignocaine on lower respiratory tract flora, five different organisms were examined in vitro using well diffusion, disc diffusion and microbroth dilution against 1% and 2% concentrations of lignocaine.ResultsAntimicrobial activity could not be detected using the well diffusion and the disc diffusion methods, as lignocaine failed to diffuse through the media. The microbroth dilution method showed reproducible bactericidal effect of these respiratory isolates against Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae at 2% concentration. Lignocaine 2% showed no growth inhibition against Pseudomonas aeruginosa and Candida albicans. Lignocaine 1% also partially inhibited S. pneumoniae.ConclusionAs lignocaine shows significant inhibition of respiratory pathogens such as Streptococcus pneumoniae even at a concentration of 1%, the lowest concentration possible should be used for flexible bronchoscopy and BAL to maximise the chance of recovery of these organisms.

The problem of choice of disinfectant

Chemical disinfectants are the most widely used alternative agents to moist heat under pressure.The ideal disinfectant is one which is rapidly 'cidal' at all temperatures, with all degrees of hardness of water, and in the presence of organic contamination. It should also be non-sensitizing and non-irritant, cheap and aesthetically pleasing.Three disinfectants were compared in a modified 'in-use' test. They were prepared at the strongest dilution recommended for use. Their actions in distilled water, distilled water plus 1% yeast, and distilled water plus CaCO3 250 p.p.m. were assessed. The test organisms were Pseudomonas pyocyanaea, Klebsiella aerogenes, Staphyloccocus aureus and Candida albicans. A standard volume of a broth culture containing 5 × 1014 organisms/ml was added to the disinfectant and subcultures were taken at 2, 5, 10 and 20 min. The subcultures were made into tryptocase soy broth containing 3% Tween 80 and were incubated for 72 h at 37° C.The results showed that the phenolic-type disinfectant was more efficient under all conditions of test than either the quaternary ammonium compound or the combination quaternary ammonium and synthetic phenol.A policy of screening a disinfectant to ensure its advantages over those already in use would help to eliminate some of the confusion that exists about the choice of a suitable disinfectant.

Expansive spread of IncI1 plasmids carrying blaCMY-2 amongst Escherichia coli

AbstractEscherichia coli is a leading cause of urinary tract infections. One of the most common antibiotic classes used to treat such infections is the β-lactams, including cephalosporins. Resistance to the third-generation cephalosporins can be caused by production of extended-spectrum β-lactamases (ESBLs) or plasmid-mediated AmpC β-lactamases. The most commonly reported AmpC β-lactamase in E. coli is CMY-2. Plasmid-mediated CMY-2 has been frequently reported in E. coli and Salmonella sp. from food-producing animals. This study aimed to elucidate the molecular characteristics of clinical E. coli isolates carrying plasmids encoding CMY-2. A total of 67 CMY-2-producing E. coli were characterised by clonal analysis and phylogenetic typing. Characterisation of the plasmids carrying blaCMY-2 included replicon typing, plasmid profiling, plasmid transferability and sequencing of the blaCMY-2 genetic environment. As a result, E. coli producing CMY-2 was found to be highly polyclonal. The majority of CMY-2-producing E. coli belonged to phylogenetic group D. IncI1 plasmids were predominant among those carrying blaCMY-2 (96%). Restriction analysis revealed a single IncI1 plasmid carrying blaCMY-2 to be predominant and present in different clones of E. coli. IS1294–ISEcp1 complex or ISEcp1 that was truncated by IS1294 was the predominant insertion sequence upstream of blaCMY-2. The homogeneous genetic environment of blaCMY-2 observed among different strains of E. coli strongly suggests horizontal transfer of this IncI1, blaCMY-2-carrying plasmid. In summary, horizontal plasmid transfer plays a major role in the spread of blaCMY-2 in E. coli.

Shelf life of sterilized packaged items stored in acute care hospital settings: factors for consideration

AbstractIntroductionReusable medical devices are sterilized and stored before their use in hospital settings. The length of time the sterilized item can be stored (shelf life) to maintain sterility has been discussed in the literature over the last four decades, with a shift to an event rather than time-related determination of shelf life. This paper reviews the evidence and provides a summary of some key issues for consideration when adopting event-related or time-based shelf life recommendations for packaged sterile items in Australian hospitals.DiscussionAustralian and international standards provide guidelines for procedures to be used for sterilization of reusable medical devices and storage conditions following sterilization. Reusable medical devices are sterilized by commercial manufacturers or sterilizing departments located in hospitals. Commercial manufacturers allocate expiry dates on sterilized items which should be respected, unless sterility is compromised by an event. The shelf life of items sterilized in hospital is debated, with growing support for event- rather than time-related sterility. Many factors determine whether event- or time-related shelf life should be followed. Well designed experimental studies into shelf life of sterilized items are lacking, with some small studies indicating that items can remain sterile for 12 to 24 months. Factors for consideration by hospitals are outlined and an algorithm to assist in implementation of event-related or time-based shelf life for reprocessed reusable medical devices is provided.ConclusionThe method of determining shelf life in hospitals is dependent on adequacy of processes for sterilization, monitoring of sterility over time and storage conditions.

Comparison of the BD™ GeneOhm MRSA assay, broth enrichment culture and chromID™ MRSA for detection of methicillin-resistant Staphylococcus aureus from inter-hospital intensive care transfer patients

AbstractThe objective of the present study was to compare the current chromogenic methicillin-resistant Staphylococcus aureus (MRSA) agar plate culture method with broth enrichment and the BD GeneOhm MRSA assay. Another key objective was to determine whether two admission surveillance swabs collected 1 h apart would reliably detect MRSA colonisation in patients transferred to a tertiary referral intensive care unit from other hospitals compared with the current routine method of two samples collected 24 h apart. In total, 593 swabs from 102 consecutive patients transferred from another hospital to the Princess Alexandra Hospital ICU were screened for the MRSA using nose and groin swabs collected on admission, 1 h and 24 h after admission. The non-selective broth enrichment step produced results in complete concordance with the existing method without an increase in sensitivity. The GeneOhm MRSA assay demonstrated 100% sensitivity, 97% specificity and 100% negative predictive values. The initial positive predictive value of this assay, however, was only 28%, largely due to the low prevalence of MRSA. Despite this low positive predictive value and because of the demonstrated 100% negative predictive value, the use of this assay could significantly improve turn-around times of surveillance screens in our laboratory by obviating the need for culture of over 90% of MRSA screening swabs. Positive polymerase chain reaction results require confirmation by culture, given that phenotypical characterisation of isolates is required for infection prevention and control. Comparison of the two screening collection timings in determining MRSA carriage could not be answered, due to insufficient positive results in the study group.

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