Microbiology & Immunology - Research Publications

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    Mosquitoes provide a transmission route between possums and humans for Buruli ulcer in southeastern Australia
    Mee, PT ; Buultjens, AH ; Oliver, J ; Brown, K ; Crowder, JC ; Porter, JL ; Hobbs, EC ; Judd, LM ; Taiaroa, G ; Puttharak, N ; Williamson, DA ; Blasdell, KR ; Tay, EL ; Feldman, R ; Muzari, MO ; Sanders, C ; Larsen, S ; Crouch, SR ; Johnson, PDR ; Wallace, JR ; Price, DJ ; Hoffmann, AA ; Gibney, KB ; Stinear, TP ; Lynch, SE (NATURE PORTFOLIO, 2024-02)
    Buruli ulcer, a chronic subcutaneous infection caused by Mycobacterium ulcerans, is increasing in prevalence in southeastern Australia. Possums are a local wildlife reservoir for M. ulcerans and, although mosquitoes have been implicated in transmission, it remains unclear how humans acquire infection. We conducted extensive field survey analyses of M. ulcerans prevalence among mosquitoes in the Mornington Peninsula region of southeastern Australia. PCR screening of trapped mosquitoes revealed a significant association between M. ulcerans and Aedes notoscriptus. Spatial scanning statistics revealed overlap between clusters of M. ulcerans-positive Ae. notoscriptus, M. ulcerans-positive possum excreta and Buruli ulcer cases, and metabarcoding analyses showed individual mosquitoes had fed on humans and possums. Bacterial genomic analysis confirmed shared single-nucleotide-polymorphism profiles for M. ulcerans detected in mosquitoes, possum excreta and humans. These findings indicate Ae. notoscriptus probably transmit M. ulcerans in southeastern Australia and highlight mosquito control as a Buruli ulcer prevention measure.
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    Non-SARS-CoV-2 respiratory viral detection and whole genome sequencing from COVID-19 rapid antigen test devices: a laboratory evaluation study.
    Moso, MA ; Taiaroa, G ; Steinig, E ; Zhanduisenov, M ; Butel-Simoes, G ; Savic, I ; Taouk, ML ; Chea, S ; Moselen, J ; O'Keefe, J ; Prestedge, J ; Pollock, GL ; Khan, M ; Soloczynskyj, K ; Fernando, J ; Martin, GE ; Caly, L ; Barr, IG ; Tran, T ; Druce, J ; Lim, CK ; Williamson, DA (Elsevier BV, 2024-04)
    BACKGROUND: There has been high uptake of rapid antigen test device use for point-of-care COVID-19 diagnosis. Individuals who are symptomatic but test negative on COVID-19 rapid antigen test devices might have a different respiratory viral infection. We aimed to detect and sequence non-SARS-CoV-2 respiratory viruses from rapid antigen test devices, which could assist in the characterisation and surveillance of circulating respiratory viruses in the community. METHODS: We applied archival clinical nose and throat swabs collected between Jan 1, 2015, and Dec 31, 2022, that previously tested positive for a common respiratory virus (adenovirus, influenza, metapneumovirus, parainfluenza, rhinovirus, respiratory syncytial virus [RSV], or seasonal coronavirus; 132 swabs and 140 viral targets) on PCR to two commercially available COVID-19 rapid antigen test devices, the Panbio COVID-19 Ag Rapid Test Device and Roche SARS-CoV-2 Antigen Self-Test. In addition, we collected 31 COVID-19 rapid antigen test devices used to test patients who were symptomatic at The Royal Melbourne Hospital emergency department in Melbourne, Australia. We extracted total nucleic acid from the device paper test strips and assessed viral recovery using multiplex real-time PCR (rtPCR) and capture-based whole genome sequencing. Sequence and genome data were analysed through custom computational pipelines, including subtyping. FINDINGS: Of the 140 respiratory viral targets from archival samples, 89 (64%) and 88 (63%) were positive on rtPCR for the relevant taxa following extraction from Panbio or Roche rapid antigen test devices, respectively. Recovery was variable across taxa: we detected influenza A in nine of 18 samples from Panbio and seven of 18 from Roche devices; parainfluenza in 11 of 20 samples from Panbio and 12 of 20 from Roche devices; human metapneumovirus in 11 of 16 from Panbio and 14 of 16 from Roche devices; seasonal coronavirus in eight of 19 from Panbio and two of 19 from Roche devices; rhinovirus in 24 of 28 from Panbio and 27 of 28 from Roche devices; influenza B in four of 15 in both devices; and RSV in 16 of 18 in both devices. Of the 31 COVID-19 devices collected from The Royal Melbourne Hospital emergency department, 11 tested positive for a respiratory virus on rtPCR, including one device positive for influenza A virus, one positive for RSV, four positive for rhinovirus, and five positive for SARS-CoV-2. Sequences of target respiratory viruses from archival samples were detected in 55 (98·2%) of 56 samples from Panbio and 48 (85·7%) of 56 from Roche rapid antigen test devices. 98 (87·5%) of 112 viral genomes were completely assembled from these data, enabling subtyping for RSV and influenza viruses. All 11 samples collected from the emergency department had viral sequences detected, with near-complete genomes assembled for influenza A and RSV. INTERPRETATION: Non-SARS-CoV-2 respiratory viruses can be detected and sequenced from COVID-19 rapid antigen devices. Recovery of near full-length viral sequences from these devices provides a valuable opportunity to expand genomic surveillance programmes for public health monitoring of circulating respiratory viruses. FUNDING: Australian Government Medical Research Future Fund and Australian National Health and Medical Research Council.
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    Evolution of Humoral and Cellular Immunity Post-Breakthrough Coronavirus Disease 2019 in Vaccinated Patients With Hematologic Malignancy Receiving Tixagevimab-Cilgavimab
    Hall, VG ; Nguyen, THO ; Allen, LF ; Rowntree, LC ; Kedzierski, L ; Chua, BY ; Lim, C ; Saunders, NR ; Klimevski, E ; Tennakoon, GS ; Seymour, JF ; Wadhwa, V ; Cain, N ; Vo, KL ; Nicholson, S ; Karapanagiotidis, T ; Williamson, DA ; Thursky, KA ; Spelman, T ; Yong, MK ; Slavin, MA ; Kedzierska, K ; Teh, BW (OXFORD UNIV PRESS INC, 2023-11-01)
    BACKGROUND: In-depth immunogenicity studies of tixagevimab-cilgavimab (T-C) are lacking, including following breakthrough coronavirus disease 2019 (COVID-19) in vaccinated patients with hematologic malignancy (HM) receiving T-C as pre-exposure prophylaxis. METHODS: We performed a prospective, observational cohort study and detailed immunological analyses of 93 patients with HM who received T-C from May 2022, with and without breakthrough infection, during a follow-up period of 6 months and dominant Omicron BA.5 variant. RESULTS: In 93 patients who received T-C, there was an increase in Omicron BA.4/5 receptor-binding domain (RBD) immunoglobulin G (IgG) antibody titers that persisted for 6 months and was equivalent to 3-dose-vaccinated uninfected healthy controls at 1 month postinjection. Omicron BA.4/5 neutralizing antibody was lower in patients receiving B-cell-depleting therapy within 12 months despite receipt of T-C. COVID-19 vaccination during T-C treatment did not incrementally improve RBD or neutralizing antibody levels. In 16 patients with predominantly mild breakthrough infection, no change in serum neutralization of Omicron BA.4/5 postinfection was detected. Activation-induced marker assay revealed an increase in CD4+ (but not CD8+) T cells post infection, comparable to previously infected healthy controls. CONCLUSIONS: Our study provides proof-of-principle for a pre-exposure prophylaxis strategy and highlights the importance of humoral and cellular immunity post-breakthrough COVID-19 in vaccinated patients with HM.
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    Durable reprogramming of neutralizing antibody responses following Omicron breakthrough infection
    Lee, WS ; Tan, H-X ; Reynaldi, A ; Esterbauer, R ; Koutsakos, M ; Nguyen, J ; Amarasena, T ; Kent, HE ; Aggarwal, A ; Turville, SG ; Taiaroa, G ; Kinsella, P ; Liew, KC ; Tran, T ; Williamson, DA ; Cromer, D ; Davenport, MP ; Kent, SJ ; Juno, JA ; Khoury, DS ; Wheatley, AK (AMER ASSOC ADVANCEMENT SCIENCE, 2023-07)
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection of vaccinated individuals is increasingly common with the circulation of highly immune evasive and transmissible Omicron variants. Here, we report the dynamics and durability of recalled spike-specific humoral immunity following Omicron BA.1 or BA.2 breakthrough infection, with longitudinal sampling up to 8 months after infection. Both BA.1 and BA.2 infections robustly boosted neutralization activity against the infecting strain while expanding breadth against BA.4, although neutralization activity was substantially reduced for the more recent XBB and BQ.1.1 strains. Cross-reactive memory B cells against both ancestral and Omicron spike were predominantly expanded by infection, with limited recruitment of de novo Omicron-specific B cells or antibodies. Modeling of neutralization titers predicts that protection from symptomatic reinfection against antigenically similar strains will be durable but is undermined by new emerging strains with further neutralization escape.
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    Universal lymphogranuloma venereum (LGV) testing of rectal chlamydia in men who have sex with men and detection of asymptomatic LGV
    Hughes, Y ; Chen, MY ; Fairley, CK ; Hocking, JS ; Williamson, D ; Ong, JJ ; De Petra, V ; Chow, EPF (BMJ PUBLISHING GROUP, 2022-12)
    BACKGROUND: Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis serovars L1-L3. This study determined the positivity for LGV testing before and after introduction of universal LGV testing of positive rectal Chlamydia trachomatis samples in men who have sex with men (MSM). METHODS: From March 2015 to February 2018, MSM with rectal C. trachomatis were not routinely tested for LGV at the Melbourne Sexual Health Centre unless they had HIV or symptoms of proctitis. From February 2018, universal testing for LGV of all positive rectal C. trachomatis specimens in men over the age of 25 years, regardless of symptoms was undertaken. LGV positivity was defined as the detection of LGV-associated C. trachomatis serovars. RESULTS: There were 3429 and 4020 MSM who tested positive for rectal chlamydia in the selective and universal LGV-testing periods, respectively. Of the total 3027 assessable specimens in both periods, 97 (3.2%; 95% CI 2.6% to 3.9%) specimens tested positive for LGV. LGV positivity in the selective testing period was higher than in the universal testing period (6.6% (33/502) vs 2.5% (64/2525), p<0.001). The proportion of LGV cases that were asymptomatic increased from 15.2% (5/33) in the selective testing period to 34.4% (22/64) in the universal testing period (p=0.045). Of the 70 symptomatic LGV cases symptoms included rectal discharge (71.4%, n=45) and rectal pain (60.0%, n=42). CONCLUSION: Universal LGV testing of all positive rectal chlamydia samples in MSM compared with selective testing led to the detection of asymptomatic rectal LGV, which constituted 34% of rectal LGV cases.
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    Robust SARS-CoV-2 antibody and T cell immunity following three COVID-19 vaccine doses in inflammatory bowel disease patients receiving anti-TNF or alternative treatments
    Zhang, E ; Nguyen, THO ; Allen, LF ; Kedzierski, L ; Rowntree, LC ; Chang, SY ; Zhang, W ; Habel, JR ; Foo, IJ ; Menon, T ; Mitchell, J ; Leong, RW ; Bond, K ; Williamson, DA ; Kedzierka, K ; Christensen, B (BMJ PUBLISHING GROUP, 2024-04)
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    SARS-CoV-2 breakthrough infection induces rapid memory and de novo T cell responses
    Koutsakos, M ; Reynaldi, A ; Lee, WS ; Nguyen, J ; Amarasena, T ; Taiaroa, G ; Kinsella, P ; Liew, KC ; Tran, T ; Kent, HE ; Tan, H-X ; Rowntree, LC ; Nguyen, THO ; Thomas, PG ; Kedzierska, K ; Petersen, J ; Rossjohn, J ; Williamson, DA ; Khoury, D ; Davenport, MP ; Kent, SJ ; Wheatley, AK ; Juno, JA (CELL PRESS, 2023-04-11)
    Although the protective role of neutralizing antibodies against COVID-19 is well established, questions remain about the relative importance of cellular immunity. Using 6 pMHC multimers in a cohort with early and frequent sampling, we define the phenotype and kinetics of recalled and primary T cell responses following Delta or Omicron breakthrough infection in previously vaccinated individuals. Recall of spike-specific CD4+ T cells was rapid, with cellular proliferation and extensive activation evident as early as 1 day post symptom onset. Similarly, spike-specific CD8+ T cells were rapidly activated but showed variable degrees of expansion. The frequency of activated SARS-CoV-2-specific CD8+ T cells at baseline and peak inversely correlated with peak SARS-CoV-2 RNA levels in nasal swabs and accelerated viral clearance. Our study demonstrates that a rapid and extensive recall of memory T cell populations occurs early after breakthrough infection and suggests that CD8+ T cells contribute to the control of viral replication in breakthrough SARS-CoV-2 infections.
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    Immune profiling of SARS-CoV-2 infection during pregnancy reveals NK cell and ?? T cell perturbations
    Habel, JR ; Chua, BY ; Kedzierski, L ; Selva, KJ ; Damelang, T ; Haycroft, ER ; Nguyen, THO ; Koay, H-F ; Nicholson, S ; McQuilten, HA ; Jia, X ; Allen, LF ; Hensen, L ; Zhang, W ; Sandt, CEVD ; Neil, JA ; Pragastis, K ; Lau, JSY ; Jumarang, J ; Allen, EK ; Amanant, F ; Krammer, F ; Wragg, KM ; Juno, JA ; Wheatley, AK ; Tan, H-X ; Pell, G ; Walker, S ; Audsley, J ; Reynaldi, A ; Thevarajan, I ; Denholm, JT ; Subbarao, K ; Davenport, MP ; Hogarth, PM ; Godfrey, DI ; Cheng, AC ; Tong, SYC ; Bond, K ; Williamson, DA ; McMahon, JH ; Thomas, PG ; Pannaraj, PS ; James, F ; Holmes, NE ; Smibert, OC ; Trubiano, JA ; Gordon, CL ; Chung, AW ; Whitehead, CL ; Kent, SJ ; Lappas, M ; Rowntree, LC ; Kedzierska, K (AMER SOC CLINICAL INVESTIGATION INC, 2023-03-22)
    Pregnancy poses a greater risk for severe COVID-19; however, underlying immunological changes associated with SARS-CoV-2 during pregnancy are poorly understood. We defined immune responses to SARS-CoV-2 in unvaccinated pregnant and nonpregnant women with acute and convalescent COVID-19, quantifying 217 immunological parameters. Humoral responses to SARS-CoV-2 were similar in pregnant and nonpregnant women, although our systems serology approach revealed distinct antibody and FcγR profiles between pregnant and nonpregnant women. Cellular analyses demonstrated marked differences in NK cell and unconventional T cell activation dynamics in pregnant women. Healthy pregnant women displayed preactivated NK cells and γδ T cells when compared with healthy nonpregnant women, which remained unchanged during acute and convalescent COVID-19. Conversely, nonpregnant women had prototypical activation of NK and γδ T cells. Activation of CD4+ and CD8+ T cells and T follicular helper cells was similar in SARS-CoV-2-infected pregnant and nonpregnant women, while antibody-secreting B cells were increased in pregnant women during acute COVID-19. Elevated levels of IL-8, IL-10, and IL-18 were found in pregnant women in their healthy state, and these cytokine levels remained elevated during acute and convalescent COVID-19. Collectively, we demonstrate perturbations in NK cell and γδ T cell activation in unvaccinated pregnant women with COVID-19, which may impact disease progression and severity during pregnancy.
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    Robust SARS-CoV-2 T cell responses with common TCRab motifs toward COVID-19 vaccines in patients with hematological malignancy impacting B cells
    Nguyen, THO ; Rowntree, LC ; Allen, LF ; Chua, BY ; Kedzierski, L ; Lim, C ; Lasica, M ; Tennakoon, GS ; Saunders, NR ; Crane, M ; Chee, L ; Seymour, JF ; Anderson, MA ; Whitechurch, A ; Clemens, EB ; Zhang, W ; Chang, SY ; Habel, JR ; Jia, X ; McQuilten, HA ; Minervina, AA ; Pogorelyy, MV ; Chaurasia, P ; Petersen, J ; Menon, T ; Hensen, L ; Neil, JA ; Mordant, FL ; Tan, H-X ; Cabug, AF ; Wheatley, AK ; Kent, SJ ; Subbarao, K ; Karapanagiotidis, T ; Huang, H ; Vo, LK ; Cain, NL ; Nicholson, S ; Krammer, F ; Gibney, G ; James, F ; Trevillyan, JM ; Trubiano, JA ; Mitchell, J ; Christensen, B ; Bond, KA ; Williamson, DA ; Rossjohn, J ; Crawford, JC ; Thomas, PG ; Thursky, KA ; Slavin, MA ; Tam, CS ; Teh, BW ; Kedzierska, K (CELL PRESS, 2023-04-18)
    Immunocompromised hematology patients are vulnerable to severe COVID-19 and respond poorly to vaccination. Relative deficits in immunity are, however, unclear, especially after 3 vaccine doses. We evaluated immune responses in hematology patients across three COVID-19 vaccination doses. Seropositivity was low after a first dose of BNT162b2 and ChAdOx1 (∼26%), increased to 59%-75% after a second dose, and increased to 85% after a third dose. While prototypical antibody-secreting cells (ASCs) and T follicular helper (Tfh) cell responses were elicited in healthy participants, hematology patients showed prolonged ASCs and skewed Tfh2/17 responses. Importantly, vaccine-induced expansions of spike-specific and peptide-HLA tetramer-specific CD4+/CD8+ T cells, together with their T cell receptor (TCR) repertoires, were robust in hematology patients, irrespective of B cell numbers, and comparable to healthy participants. Vaccinated patients with breakthrough infections developed higher antibody responses, while T cell responses were comparable to healthy groups. COVID-19 vaccination induces robust T cell immunity in hematology patients of varying diseases and treatments irrespective of B cell numbers and antibody response.
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    Prospective comprehensive profiling of immune responses to COVID-19 vaccination in patients on zanubrutinib therapy.
    Nguyen, THO ; Lim, C ; Lasica, M ; Whitechurch, A ; Tennakoon, S ; Saunders, NR ; Allen, LF ; Rowntree, LC ; Chua, BY ; Kedzierski, L ; Tan, H-X ; Wheatley, AK ; Kent, SJ ; Karapanagiotidis, T ; Nicholson, S ; Williamson, DA ; Slavin, MA ; Tam, CS ; Kedzierska, K ; Teh, BW (Wiley, 2023-02)
    Zanubrutinib-treated and treatment-naïve patients with chronic lymphocytic leukaemia (CLL) or Waldenstrom's macroglobulinaemia were recruited in this prospective study to comprehensively profile humoral and cellular immune responses to COVID-19 vaccination. Overall, 45 patients (median 72 years old) were recruited; the majority were male (71%), had CLL (76%) and were on zanubrutinib (78%). Seroconversion rates were 65% and 77% following two and three doses, respectively. CD4+ and CD8+ T-cell response rates increased with third dose. In zanubrutinib-treated patients, 86% developed either a humoral or cellular response. Patients on zanubrutinib developed substantial immune responses following two COVID-19 vaccine doses, which further improved following a third dose.