Head, Skin Health
BA MBBS DCH FRACP PhD
Areas of expertise: Skin infections, Streptococcus pyogenes, Staphylococcus aureus, Aboriginal children, central line associated blood stream infections, osteomyelitis, paediatric infections including HIV, bacteraemia, TB and congenital CMV.
Associate Professor Asha Bowen is a clinician scientist working at Perth Children’s Hospital as a paediatric infectious disease specialist and Head of Skin Health at the Telethon Kids Institute. Dr Bowen's clinical role informs her research as a National Health and Medical Research Council (NHMRC) funded Fellow.
Dr Bowen was awarded her PhD at the Menzies School of Health Research in Darwin in 2015 for a large randomized controlled trial on the treatment of impetigo in remote Indigenous children. She is the lead investigator for the SToP trial to “see, treat and prevent” skin infections, a large cluster randomised trial with a stepped wedge design recruiting from 2019-2021 throughout the Kimberley region in Western Australia. Community engagement over several years formed the foundation of the SToP Trial and ensured the study was guided by the Aboriginal co-investigators and community members.
Dr Bowen and her team launched the inaugural National Healthy Skin Guideline to guide clinicians in the recognition and evidence-based treatment of skin infection. She is also the Chair of the Australian and New Zealand Paediatric Infectious Diseases committee and Deputy Chair of the Australasian Society of Infectious Diseases clinical research network.
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Projects
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Publications
July 2020
Predicting the causative pathogen among children with osteomyelitis using Bayesian networks – improving antibiotic selection in clinical practice
We have demonstrated the potential use of Bayesian Networks in improving antibiotic selection for children with osteomyelitis
Published research Infectious Diseases Infectious Disease Implementation Research Infectious Diseases Epidemiology Skin HealthJune 2020Progress towards a coordinated, national paediatric antimicrobial resistance surveillance programme
These data support that children are not just 'little adults' in the AMR era, and analyses by age group are important to detect differences in antibiotic susceptibility
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Infectious Diseases Epidemiology Skin HealthJune 2020Complicated skin and soft tissue infections in remote indigenous communities
The burden and consequences of skin infections for remote living indigenous people are high
Published research Skin Infections Infectious Diseases Skin HealthMarch 2020Skin infections in Australian Aboriginal children: a narrative review
The Australian National Healthy Skin Guideline summarises evidence-based treatment of impetigo, scabies and fungal infections in high burden settings
Published research Skin Infections Skin HealthMarch 2020Spotting sporotrichosis skin infection: The first Australian paediatric case series
These data highlight the importance of recognising Sporotrichosis in children outside an outbreak setting
Published research Skin Infections Infectious Diseases Infectious Diseases Epidemiology Skin HealthJanuary 2020Barriers and enablers of health service utilisation for childhood skin infections in remote aboriginal communities of Western Australia
Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Skin HealthJanuary 2020Prevalence of Group A β-hemolytic Streptococcal Throat Carriage and Prospective Pilot Surveillance of Streptococcal Sore Throat in Ugandan School Children
The Group A β-hemolytic Streptococcus pharyngeal carriage rates seen in Uganda (15.9%) are higher than the most recent pooled results globally, at 12%
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Skin HealthOctober 2019A Survey of Infectious Diseases and Microbiology Clinicians in Australia and New Zealand About the Management of Staphylococcus aureus Bacteremia
Significant variation in practice, particularly for patients with a severe disease phenotype and antibiotic-resistant profile
Published research Infectious Diseases Skin HealthSeptember 2019SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
Skin infection burden in remote Aboriginal communities can be reduced by the See, Treat, Prevent (SToP skin sores and scabies) trial
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Skin HealthSeptember 2019Talking skin: Attitudes and practices around skin infections, treatment options, and their clinical management in a remote region in Western Australia
Documenting carer, service provider and healthcare practitioner perspectives on skin infections provides more understanding of the context of treatment decisions
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Aboriginal Maternal Health & Child Development Skin HealthSeptember 2019Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children
We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children
Published research Academic Biostatistics Skin Infections Aboriginal Health Group A Streptococcal & Rheumatic Heart Disease Infectious Diseases Epidemiology Skin HealthJuly 2019An urgent need for antimicrobial stewardship in Indigenous rural and remote primary health care
We write this perspective to raise awareness of antimicrobial resistance as an issue in Indigenous primary health care
Published research Infectious Diseases Skin HealthJuly 2019A population pharmacokinetic study of benzathine benzylpenicillin G administration in children and adolescents with rheumatic heart disease
Few children and adolescents receiving BPG as secondary prophylaxis will achieve concentrations >0.02 mg/L for the majority of the time between injections
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart Disease Skin HealthJune 2019Infectious diseases clinician's variation in the management of pediatric Staphylococcus aureus bacteraemia and equipoise for clinical trials
Large variation in antibiotic prescribing amongst clinicians is demonstrated and increased, corresponding with escalating case complexity and persisting MRSA bacteraemia
Published research Infectious Diseases Skin HealthJune 2019CASSETTE-clindamycin adjunctive therapy for severe Staphylococcus aureus treatment evaluation: Study protocol for a randomised controlled trial
This study will assess the effect of adjunctive clindamycin on patient-centred outcomes in severe, toxin-mediated S. aureus infections
Published research Infectious Diseases Skin HealthApril 2019Pre-exposure prophylaxis for HIV prevention during pregnancy and lactation: forget not the women and children
The framework for appropriately identifying and managing at-risk pregnant and lactating women requiring PrEP is poorly defined
Published research Skin HealthMarch 2019Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review
Systematic review of the treatment, prevention and public health control of skin infections in resource-limited settings where skin infections are endemic
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Skin HealthMarch 2019Burden of skin disease in two remote primary healthcare centres in northern and central Australia
Skin infections are an under-appreciated and dominant reason for presentation to primary healthcare centres in these indigenous communities
Published research Skin Infections Skin HealthFebruary 2019Potential for molecular testing for group a streptococcus to improve diagnosis and management in a high-risk population: A prospective study
Implementation of molecular testing could improve antibiotic use in this high-burden setting
Published research Skin HealthJanuary 2019Adjunctive protein synthesis inhibitor antibiotics for toxin suppression in Staphylococcus aureus infections: a systematic appraisal
A summary of the literature regarding the use of adjunctive protein synthesis inhibitors for toxin suppression in the setting of S. aureus infections is presented
Published research Infectious Diseases Skin HealthJanuary 2019The fall and rise of Group A Streptococcus diseases
We overview the changing epidemiology of Group A Streptococcus infections and the genetic alterations that accompany the emergence of Group A Streptococcus strains
Published research Group A Streptococcal & Rheumatic Heart Disease Skin HealthSeptember 2018Ascertaining infectious disease burden through primary care clinic attendance among young Aboriginal children living in four remote communities in Western Australia
Improved public health measures targeting bacterial skin infections are needed to reduce this high burden of skin infections in Western Australia
Published research Skin Infections Infectious Diseases Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart Disease Aboriginal Maternal Health & Child DevelopmentSeptember 2018Investigation of trimethoprim/sulfamethoxazole resistance in an emerging sequence type 5 methicillin-resistant Staphylococcus aureus clone reveals discrepant resistance reporting
Our findings are crucial in demonstrating that the Northern Territory STS clone is not STX resistant
Published researchAugust 2018Infection characteristics and treatment of Staphylococcus aureus bacteraemia at a tertiary children's hospital
There is a wide spectrum of disease severity in paediatric Staphylococcus aureus bacteraemia
Published research Infectious Diseases Vaccine Trials Group Skin HealthMay 2018Scabies and impetigo in Timor-Leste: A school screening study in two districts
Scabies and impetigo are common in Timor-Leste, with very high prevalence of scabies in the rural district of Ermera
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Skin HealthFebruary 2018Dedicated paediatric Outpatient Parenteral Antimicrobial Therapy medical support: a pre-post observational study
We examined the impact of introducing a dedicated team to OPAT, to define the role of increased medical oversight in improving patient outcomes in this cohort.
Published research Group A Streptococcal & Rheumatic Heart Disease Skin HealthNovember 2017Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012
Skin infections are a significant cause of severe disease, requiring hospitalization in Western Australian children, particularly with Aboriginal children
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Infectious Diseases Epidemiology Aboriginal Maternal Health & Child Development Skin HealthNovember 2017Sulfamethoxazole-Trimethoprim (Cotrimoxazole) for Skin and Soft Tissue Infections Including Impetigo, Cellulitis, and Abscess
We conducted a systematic review of clinical trials and observational studies that address the utility of SXT for SSTI treatment, caused by either GAS or MRSA
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Skin HealthNovember 2017Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012
The objective of this study was to describe the occurrence of skin infection associated hospitalizations in children born in Western Australia (WA).
Published research Group A Streptococcal & Rheumatic Heart Disease Infectious Diseases Epidemiology Vaccine Trials Group Aboriginal Maternal Health & Child Development Skin HealthOctober 2017A 15-Year Old Burmese Girl With Hemoptysis: A Case Report
A 15 year old girl, born in Hakha, Myanmar, presented with 2 months of intermittent hemoptysis 3 years after immigrating to Australia, via Malaysia.
Published research Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart Disease Skin HealthSeptember 2017Immuno-nephelometric determination of group streptococcal anti-streptolysin O titres (ASOT) from dried blood spots: Method for validating a new assay
This study was designed to determine the sensitivity and reproducibility of recovering anti-streptolysin O titres (ASOT) from dried blood spot (DBS) samples
Published research Rheumatic Heart Disease Group A Streptococcal & Rheumatic Heart Disease Skin HealthAugust 2017Dedicated paediatric Outpatient Parenteral Antimicrobial Therapy medical support: a pre-post observational study
The introduction of a formal medical team to Hospital in the Home (HiTH) demonstrated a positive clinical impact on Parenteral Antimicrobial Therapy (OPAT) patients' outcomes.
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Vaccine Trials Group Skin HealthJuly 2017Are scabies and impetigo “normalised”? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition
Scabies and impetigo infections are under-recognised and hence under-treated by clinicians
Published research Skin Infections Group A Streptococcal & Rheumatic Heart Disease Skin HealthOctober 2016Epidemiology and mortality of staphylococcus aureus Bacteremia in Australian and New Zealand children
Describe the epidemiology of Staphylococcus aureus bacteremia in children and adolescents younger than 18 years from Australia and New Zealand
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Vaccine Trials GroupAugust 2016Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines
Systematic review of antibiotic duration and timing of intravenous to oral switch for paediatric infectious diseases and evidence-graded recommendations
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease Vaccine Trials GroupJuly 2016Impetigo and scabies - Disease burden and modern treatment strategies
Recent data on the epidemiology of impetigo and scabies and describe the current evidence around approaches to individual and community based treatment
Published research Skin Infections Group A Streptococcal & Rheumatic Heart DiseaseApril 2016The Importance of Scabies Co-Infection in the Treatment Considerations for Impetigo
Treatment success for scabies co-infection was lower than for impetigo overall, with a higher success seen in the co-trimoxazole group than benzylpenicillin
Published research Aboriginal Health Group A Streptococcal & Rheumatic Heart DiseaseFebruary 2016A Retrospective case-series of children with bone and joint infection from northern Australia
We report osteomyelitis incidence in indigenous children of northern Australia is amongst the highest reported in the world
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart DiseaseFebruary 2016Whole genome sequencing reveals extensive community-level transmission of group A Streptococcus in remote communities
There was evidence of extensive transmission of group A Streptococcus both within households and across the community
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart DiseaseJanuary 2016The inequitable burden of group A streptococcal diseases in Indigenous Australians
Given the ongoing mortality and morbidity from GAS infections, we must address more effectively the treatment and prevention of GAS impetigo and pharyngitis
Published research Skin Infections Group A Streptococcal & Rheumatic Heart DiseaseDecember 2014The microbiology of impetigo in Indigenous children
Prevalence and antimicrobial resistance of impetigo pathogens in a randomised, controlled trial of impetigo treatment conducted in remote Indigenous communities
Published research Skin Infections Infectious Diseases Group A Streptococcal & Rheumatic Heart DiseaseNovember 2014Standardising and assessing digital images for use in clinical trials: A practical, reproducible method that blinds the assessor to treatment allocation
We describe the development and evaluation of a protocol for digital image collection by the non-professional photographer in a remote setting research trial
Published research Group A Streptococcal & Rheumatic Heart DiseaseAugust 2014Short-course oral co-trimoxazole versus intramuscular benzathine benzylpenicillin for impetigo in a highly endemic region
The major burden of disease is in developing and tropical settings where topical antibiotics are impractical and lead to rapid emergence of antimicrobial...
Published research Aboriginal Health Group A Streptococcal & Rheumatic Heart DiseaseJune 2014Nitazoxanide for the treatment of infectious diarrhoea in the Northern Territory, Australia 2007-2012
This paper examines the use of a new antibiotic to treat diarrhoea cause by Cryptosporidium infection in Australian Indigenous children.
Published research Aboriginal Health Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart DiseaseApril 2013Comparison of three methods for the recovery of skin pathogens from impetigo swabs collected in a remote community of Northern Territory, Australia
Immediate plating of impetigo swabs is the gold standard for bacterial recovery but is rarely feasible in remote regions.
Published research Infectious Diseases Group A Streptococcal & Rheumatic Heart Disease