The CIDM Laboratory Service (CIDMLS) is the largest department within the ICPMR. It provides comprehensive microbiology services for the Western Sydney Area Health Service and is the "hub" for microbiology services of several other health services in metropolitan Sydney and rural NSW. Scientific and medical staff of CIDMLS act as consultants for microbiological laboratories, clinicians and infection control staff in several hospitals in rural NSW. Medical staff within the CIDM Laboratory Services are infectious diseases physicians and clinical microbiologists who participate in the clinical inpatient and/or consultant infectious diseases roster for Westmead Hospital and the area Hospitals in the Western Sydney Area.
CIDMLS has a staff of approximately 100 hospital scientists, technical staff and medical microbiologists. CIDMLS provides a full range of diagnostic microbiological services and is the major centre for public health microbiology in New South Wales, along with the ICPMR Analytical Laboratories, which provides environmental (food and water) microbiological testing for NSW.
CIDMLS has an active research programme, with several current NH&MRC grants and graduate students, including several PhD and honours students and overseas visiting scholars. The Department is currently a WHO Collaborating Centre for Syphilis and Endemic Treponematoses and a WHO National Influenza Centre. It is the main NSW Public Health Laboratory and NSW representative on the National Public Health Laboratory Network.
CIDMLS is responsible for all laboratory projects of the National Centre for Immunization Research and Surveillance (NCIRS), based at the New Children's Hospital, Westmead.
Research Projects in Laboratory Services
Sections of CIDMLS
General Microbiology
Section ManagerTom Olma, BScHons, MASM, MAIMS
Provides acute diagnostic bacteriology for Westmead and district hospitals, including routine cultures of all clinical specimens except respiratory and faecal specimens.
Research in Clinical Microbiology
Enteric/Respiratory
Section ManagerGraeme O Donnell, BSc
Routine examination of faecal specimens for bacterial, viral, protozoal and helminth pathogens and respiratory specimens for nonviral pathogens including mycobacteria, legionella, Mycoplasma pneumoniae, Bordetella pertussis and Pneumocystis carinii. This section also includes the NSW Enteric, Mycobacterium and Legionella reference laboratories.
Clinical Virology
Section ManagerMala Ratnamohan, BVSc, MSc
This section undertakes routine viral and chlamydial cultures, viral identification and subtyping, antiviral susceptibility testing and electron microscopy. It is the NSW designated reference laboratory for arboviruses and emerging viral diseases (including viral haemorrhagic fevers). A full range of hepatitis and HIV diagnostic testing is available including culture, genotyping and viral load. Commercial and in-house (qualitative and quantitative) PCR testing is done for a range of viral infections (see below). The section is involved in surveillance of viral infections including arboviral diseases and influenza.
Research in Clinical Virology
Serology
Section ManagerDavid Dickeson BSc, MPH, MASM
An extensive range of viral, bacterial, rickettsial and parasite serological tests including in-house confirmatory testing by Western blot, viral neutralization, sucrose density gradient fractionation are performed. All serological tests performed are listed in the ICPMR Service Directory.
Molecular Microbiology
Section ManagerGreg James BSc, MSc, MASM
Provides a broad range of molecular diagnostic nucleic acid amplification tests for diagnosis of viral (HSV, CMV, VZV, parvovirus, HHV 6 & 7, enterovirus), protozoal (Toxoplasma gondii) and bacterial (Mycobacterium spp., Bordetella pertussis; Mycoplasma spp.; Chlamydia spp.) infections; detection of bacterial virulence factors (e.g. E.coli shiga-like toxin; C.diphtheriae toxin) and antibiotic resistance genes (mecA, rpoB), PCR/ sequencing for identification of unknown bacteria (especially mycobacteria) and molecular epidemiological typing of bacteria (M. tuberculosis; Legionella spp.; Salmonella spp. and nosocomial pathogens) and viral load testing of HIV and hepatitis B and C viruses and HIV genotyping.
Reference Laboratory in Molecular Mycology
Establishment of a facility
Centre for Infectious Diseases and Microbiology, ICPMR,Westmead Hospital, Westmead, NSW
The Reference Laboratory in Molecular Mycology was established in May 2000 in response to a need to:
- Develop a reference data-base for the identification of pathogenic fungi by molecular methods (complementing traditional identification methods offered by Associate Professor David Ellis, Women’s and Children’s Hospital, Adelaide).
- Develop molecular methods for identification of fungi in clinical samples.
Fungal identification.
PCR fingerprinting is currently being used to establish the reference data-base. We are also evaluating the use of RFLP and sequence analyses in identification. All 3 techniques have been applied to pathogenic and non-pathogenic species of the genera Candida, Cryptococcus, Penicillium, Aspergillus and Trichoderma using type strains obtained from reference culture collections.
Preliminary assessment:
- PCR-fingerpinting accurately identifies Candida spp. at species and strain level, including, for example, C. dubliniensis, C. norvegensis and C. conspicua. Similar levels of identification are possible with Cryptococcus spp., Penicillium spp. and Aspergillus spp.
- RFLP analysis of the rRNA gene cluster is suitable for identification to species level only.
- Sequence analysis of the rRNA gene cluster and the actin gene is suitable for species identification but is expensive and relatively time-consuming.
Biological samples.
We are in the early stages of developing a method for the detection of fungal DNA in fresh tissue and body fluids, or paraffin-embedded tissue.
Request for isolates
Fungal cultures. We are keen to extend the number and range of fungal species in our data-base and are particularly interested in the less common Candida spp. and moulds. We invite all interested diagnostic and research laboratories to contribute strains of interest, uncommon or problematic isolates, either identified or unidentified. A brief clinical history should be included. Receipt of isolates will be acknowledged and results will be faxed or e-mailed as appropriate. All contributors will be acknowledged in periodic updates of the status of the data-base.
Future Plans
Once the data-base is developed, we will offer a reference facility for the tests based on cost-recovery to complement classical identification methods. Details of our methods and examples of "standard" PCR fingerprints of different fungal species will be posted on our website.
Tissue or biological fluids. While developing our methods, we would like to receive samples containing microscopically visible fungal elements or from which fungi have been identified. If you have some interest please contact Greg James or Wieland Meyer.
Sending samples, technical information and results.
- Prior to sending isolates, please contact Ok Cha Lee or Greg James (Molecular Biology laboratory at the ICPMR) to expedite handling of the samples [Phone (02) 9845 6255, Fax (02) 9893 8659].
- Clinical queries to Dr. Sharon Chen [Phone (02) 9845 6255, Fax (02) 9893 8659, email sharonc@icpmr.wsahs.nsw.gov.au].
- Technical queries to Wieland Meyer, Head, Molecular Mycology [Phone 61 2 9845 6895, Fax 61 2 9891 5317, email meyer@angis.usyd.edu.au.].
- Result queries to Wieland Meyer or Ok Cha Lee.
Parasitology
HeadDr John Walker PhD
Reference service for diagnosis of malaria and other haematogenous parasites; enteric parasites and a wide range of parasite serological tests; identification of parasites in tissue sections
Medical Entomology
HeadAssociate Professor Richard Russell BSc, MSc, PhD
Laboratory Manager
Merilyn Geary Dip App Sc
Identification of insects, mites, ticks and spiders; research into distribution of arthropod vectors of human disease and arbovirus surveillance. [website: http://medent.usyd.edu.au].
Research in Medical Entomology
Infection Control
Sr. Kathy Dempsey, CNC, DipAppSc, BAS (Nursing), MNScDr David Mitchell
The infection control team for Westmead Hospital; surveillance and control of nosocomial infections, antibiotic resistant pathogens, bloodborne viral infection.
Senior staff
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Director Professor Lyn Gilbert MD, FRACP, FRCPA Laboratory Manager Raymond Mallon BAppSc, MMngt, MASM Medical Virologist Dr Dominic Dwyer, FRACP, FRCPA Medical Microbiologist Dr David Mitchell, FRACP, FRCPA, M Med Sci (Epi), Medical Microbiologist (& Infectious Diseases) Dr Sharon Chen, FRACP, FRCPA |
Dr. Dominic Dwyer - Medical Virologist |
Publications and Educational activities
CIDM publishes a bimonthly newsletter Inoculum which includes infectious diseases case reports, microbiology and public health laboratory data and updates on topics related to infectious diseases and microbiology.CIDMLS runs a Postgraduate Lecture Course in Medical Microbiology comprising 20 2-hour lecture/seminars.
For further information on the above activities contact: Jill Marmara, 9845 6238