Researchers acknowledge the need to share study results with the patients and their communities, but this is not done consistently due to a plethora of barriers, including a paucity of data to guide best practice approaches in different populations.This study was nested within a large multi-center randomized controlled trial of antimalaria treatment. Data on dissemination preferences were collected at the third-month follow-up visit using a short questionnaire. Data were analyzed using descriptive statistics and subsequently fed into an iterative process with key stakeholders, to develop suitable strategies for result dissemination.A total of 960 patients were enrolled in the trial, of whom 84.0% participated in the nested survey. A total of 601 (74.6%) participants indicated interest in receiving trial results. There was significant heterogeneity by study country, with 33.3% (58/174) of patients indicating being interested in Cambodia, 100% (334/334) in Ethiopia, 97.7% (209/214) in Pakistan, but none (0/85) in Indonesia. The preferred method of dissemination varied by site, with community meetings, favored in Ethiopia (79.0%, 264/334) and individualized communication such as a letter (27.6%, 16/58) or phone calls (37.9%, 22/58) in Cambodia. Dissemination strategies were designed with key stakeholders and based on patient preferences but required adaptation to accommodate local logistical challenges.The varying preferences observed across different sites underscore that a one-size-fits-all approach is inadequate. Strategies can be tailored to patient preference but require adaptation to accommodate logistical challenges.

The HOTspots surveillance and response program monitors antimicrobial resistance (AMR) in selected bacterial pathogens across three jurisdictions in northern Australia. In 2022, the program collected data from 164 community healthcare clinics and 50 hospitals to assess AMR trends and geographic variations.Data on resistance rates for methicillin-resistant (MRSA) and for () were analysed. Geographic regions were compared to identify variations in AMR across the Northern Territory, northern Western Australia and northern Queensland. Resistance rates were compared between community clinics and hospitals.In 2022, there were 56,003 clinical isolates submitted to HOTspots. Geographic variation was evident in methicillin resistance, with MRSA accounting for 14.4% of isolates in the east, 53.1% in central northern Australia and 46.3% in western northern Australia. Clindamycin-resistant MRSA was highest in the Northern Territory (21.7%) compared to Western Australia (16.1%) and Queensland (5.9%), limiting treatment options for community-acquired MRSA. Ceftriaxone-resistant also varied geographically, with resistance rates ranging from 3.9% in the east to 23.4% in central and 10.1% in the west. High rates of ceftriaxone resistance were observed in both community clinics (10.6%) and hospitals (16.3%). Nitrofurantoin-resistant remained low (0.2%) and stable over the past five years.HOTspots data are critical for informing local antibiotic guidelines and aiding clinical decision-making. This detailed surveillance captures geographic and healthcare-setting-specific variations in AMR, which can improve regional treatment strategies across northern Australia, with a focus on the Northern Territory, which had previously lacked comprehensive surveillance.

In high-burden settings, guidelines recommend antibiotic treatment for all suspected group A (GAS) infections to prevent rheumatic fever and poststreptococcal glomerulonephritis. Highly sensitive rapid GAS tests could reduce unnecessary antibiotic use in these settings.This was a prospective study of the Xpert Xpress Strep A (Cepheid) molecular test compared with culture of throat swab samples collected at a referral hospital in northern Australia. Demographic and clinical data and results of streptococcal serology and culture were collected.Of 164 throat swab samples, 145 (88%) were eligible for inclusion; 49 (34%) were molecular test positive and 24 (17%) were culture positive for GAS. The sensitivity, specificity, and positive and negative predictive values for the molecular test versus culture were 100.0%, 79.3%, 48.8%, and 100.0%, respectively. Among 25 samples testing positive with the molecular test and negative with culture, group C or G streptococci were cultured in 2, and a plausible clinical explanation, such as pharyngotonsillitis, or rheumatic fever with positive results of streptococcal serology, was apparent in 19 instances. In 25 patients with rheumatic fever or poststreptococcal glomerulonephritis diagnoses, molecular testing nearly trebled the detection of GAS in throat swab samples, from 3 (12%) detected with culture to 8 (32%) detected with molecular testing. Reasons for "false-positive" molecular test results could include the presence of GAS below the threshold of culture detection or persistence of nonviable organisms after infection.Implementation of molecular testing could improve antibiotic use in this high-burden setting. The incremental yield in poststreptococcal syndromes, by which time cultures are negative, has high potential in the diagnostic workup of autoimmune poststreptococcal syndromes and warrants further investigation.

Melioidosis is caused by the environmental pathogen Burkholderia pseudomallei. Among 1,331 patients with melioidosis during 1989-2023 in the Darwin Prospective Melioidosis Study in Australia, we identified 6 locally acquired cases caused by B. pseudomallei sequence type 46. Because of global transmission and expansion of endemicity, clinicians should increase awareness of melioidosis.

PS5 Standard for Pharmacy Based Immunisation Programs

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