Bacterial Respiratory Infectious Disease Group (BRIDG)

The aim of the Bacterial Respiratory Infectious Disease Group (BRIDG) is to deliver strategies to prevent, diagnose and treat bacterial ear and lung infections to reduce the global burden of disease.

BRIDG are a research team of microbiologists and immunologists who work with paediatricians, ENT surgeons, research nurses, epidemiologists, vaccine developers, policy makers, consumers and community representatives working together to deliver an evidence-based approach to preventing ear and lung infections.

Ear Infections

Otitis media, also known as middle ear infection or OM, is the main reason for GP visits, antibiotic prescriptions and surgery in preschool children. OM affects almost every child by their third birthday, and one third of children will suffer from repeat or chronic OM - leading to hearing loss and surgical intervention. Almost 5000 children undergo grommet surgery for OM in Western Australia each year. The wait time for grommet surgery at public hospitals in Australia is long (up to two years), leading to hearing loss issues at a critical stage of language and speech development.

OM treatment alone costs the Australian government ~$400 million per annum, and this does not include costs to the wider community including lost productivity from parental time off work and the increasing cost of managing antibiotic resistance within the community.

The hearing loss that is associated with OM can have a devastating impact on a child’s social and emotional wellbeing. The impact is most apparent in Aboriginal and Torres Strait Islander children, who have the highest rates of chronic OM and associated hearing loss in the world. The World Health Organisation has declared these high rates of OM as “a public health emergency requiring urgent attention”.

The BRIDG team, in association with the Ear Health team and Vaccine Trials Group at the Wesfarmers Centre for Vaccines and Infectious Diseases, are committed to preventing OM and associated hearing loss in all children so that they can start school ready to learn. We have a program of research that spans across improving healthcare service delivery, improving OM detection, and developing better treatments and preventative therapies

Through studying fluid from the middle ears of children undergoing surgery for OM, our team has identified the bacterium nontypeable Haemophilus influenzae as the major OM pathogen in Western Australian children. Through follow-up of WA children undergoing surgery for OM, we have found that the children with this bacterium in their ear at first gommet surgery were three times more likely to return for repeat ENT surgery. We are now developing ways to prevent this bacterium from being able to cause disease through a ‘probiotic-like’ nasal spray therapy and repurposing a cystic fibrosis drug called Dornase alfa to dissolve ‘glue’ in the ear and prevent repeat ear infections. This is being investigated in the ATOMIC Ears clinical study, where researchers hope to find out if using Dornase alfa ear drops during and after grommet surgery can help reduce the number of children requiring repeat surgery.

Pneumonia

Pneumonia is an infection of the lungs and is the leading cause of death in children worldwide. Papua New Guinea (PNG) has one of the highest global rates of childhood mortality from pneumonia, accounting for 23 per cent of all deaths in <5 year olds.

Our team is involved in a vaccine trial of pneumonia vaccines in PNG children to identify the best vaccines to use for kids who are at very high risk of dying from pneumonia. By understanding immune responses to these vaccines, we are informing vaccine providers and vaccine developers on the best strategies to protect children from this deadly disease. The BRIDG team is proud to work in partnership with the PNG Institute of Medical Research in Goroka on this project.

Team Highlights

• Proof of concept of our novel bacteriotherapy in prevention of otitis media in preclinical models
• Identification of a modifiable microbiological risk factor to prevent repeat grommet surgery 
• Launch of the ATOMIC Ears Study
• Dr Lea-Ann Kirkham receiving the Robert Austrian Award global pneumococcal vaccinology prize in 2018 to further our understanding of pneumococcal vaccine impact in Papua New Guinean infants.