Australasian Collaboration in Endocarditis - ACE - Medical School

Thank you to all those who participated or supported the ACE 2024 symposium !

See symposium page

First photos now on news and photos page (scroll to bottom of this webpage)

Link to 2024 endocarditis Symposium

Inaugural ACE IE journal club is on this week!

Monthly at 12 noon Friday EST From 21st March 2025!

(no meeting April)

A new innovation from ACE to stimulate research, education and collaborations.

Opportunity to participate in discussions ranging from case reports with literature reviews, to studies.

Original work with literature reviews encouraged.

Please contact ieq@health.qld.gov.au if you'd like to present.

In discussion (and yet to be confirmed) best registrar/trainee presentation of year could potentially win a prize that encourages representation at ISCVID France in June 2026.

ACE family now includes New Zealand, Singapore, Malaysia and India with perhaps more to join in coming months!

Opportunity to hear opinions on IE issues and potentially network/collaborate if have similar cases you'd like to publish.

Inaugural session will be largely QLD speakers to "break the ice" and introduce the concept, to prepare for speakers from several nations in future sessions.

Topics planned: sample MDT of complex case to demonstrate MDT concept, C.acnes IE,B.cereus IE, Q fever IE, coding in IE.

The better the attendance, the better the chance this innovation will continue!

Invitation to participate!

To attend, please use the TEAMS link below

These sessions will NOT be recorded.

As original work is presented, we ask participants NOT to record without permission from the author(s).

ACE Journal Club Teams Link

Exciting news! Opportunity to road-test the ACE IE registry

The first open meeting was held on Wednesday November 27th 5pm-7pm EST/QLD time to discuss this concept with Session II on WEddnesday December 11th 5pm-7pm EST/Qld time.

The next open meeting will be on Wednesday May 21st 5pm-7pm QLD time

An invitation to anyone with an IE interest to road-test the ACE IE registry, with an open meeting on to discuss this concept.

Link:
ACE IE registry planning session V
Wednesday, 19th March 2025
5:00 pm - 7:00 pm (EST)

Meeting link: ACE IE registry planning session V | Microsoft Teams | Meetup-Join

Cut and paste into your browser to join meeting

All those who make a meaningful road-test/input in registry design will be acknowledged when project completed! The ACE IE registry is based on the ground-breaking Danish-Swedish NIDUS registry, but with additions for an Australasian mileu, and with the concept of 3 levels/tiers (non-CTS centres, CTS centres and voluntary). The November session is likely the only open planning session- don't miss it!

Be part of history!!

A link to the dedicated datafields/registry page is below where the draft datafields are viewable/downloadable.

Collaborations/ IE registry design

ACE is also proud to encourage Australasian involvement in ISCVID.

Mission Statement

Steering Committee Team

Eugene Athan

Director of the Barwon South West Public Health Unit. Professor of Infectious Disease at School of Medicine Deakin University

Dylan Bartholomeusz

Nuclear Medicine Physician and Gastroenterologist. Royal Adelaide Hospital. Head Nuclear Medicione, SA Medical Imaging.

Jayme Bennetts

Director of Cardiothoracic Surgery at Monash Health and Victorian Heart Hospital.

Julie Bradley

Senior Cardiologist and Clinical Lead of Cardiovascular Imaging, Royal Adelaide Hospital.

Alicia Chan

Cardiologist. Central Adelaide Local Health Network. SA.

Sharon Chen

Infectious Diseases Physician Westmead (NSW)

Microbiologist ICPMR New South Wales Pathology

Kathryn Colebourne

General Medical and Stroke Physician, The Prince Charles Hospital, Chermside

Ash Hardikar

Cardio-thoracic surgeon, Royal Adelaide Hospital.

Robert Horvath

Infectious Diseases Physician, The Prince Charles Hospital. Microbiologist, Pathology Queensland.

Siong Hui

Infectious Disease Physician. Fiona Stanley Hospital and Charles Gairdner Hospital, Perth WA.

Alison Keed

Infectious Diseases Physician, Royal Perth Hospital

Joshua Mahadevan

Neurologist and Stroke Physician.

Central Adelaide Local Health Network and Victorian Stroke Telemedicine.

Lachlan Marshall

Cardio-thoracic Surgeon, The Priince Charles Hospital.

Mbakise (Pula) Matebele

Intensivist, The Prince Charles Hospital, Brisbane.

Hugh McGann

Infectious Diseases Physician. Waikato, Heath New Zealand

Renjy Nelson

Infectious Diseases Physician. The Queen Elizabeth Hospital and Royal Adelaide Hospital. SA.

Veronica Playle

Infectious Diseases Physician and Microbiologist, Middlemore Hospital, Auckland NZ.

Chris Robson

Infectious Diseases Physician. Victorian Heart Hospital, Monash Health.

Indy Sandaradura

Infectious Diseases Physician Westmead (NSW)

Microbiologist ICPMR New South Wales Pathology

John Sedgwick

Cardiologist, The Prince Charles Hospital.

Mitra Shirazi

Cardiologist, Royal Adelaide Hospital.

Emily Tucker

Infectious Diseases Physician, Royal Adelaide and Queen Elizabeth Hospitals.

Kanthi Vemuri

Infectious Diseases Physician, The Prince Charles Hospital, Brisbane.

Livia Williams

MBBS (hons), BMedSci (hons), EMBA, FRACS (Cardiothoracic Surgery)

Cardiothoracic Surgeon/Senior Staff Specialist the Prince Charles Hospital

ACE Preamble

Endocarditis outcomes have only marginally improved since the 1980s, with a mortality rate of approximately 20%.

According to the ABS, in 2021 161 Australians had endocarditis listed on their death certificates.

Using 20% mortality rate as estimate, there are approximately 800 cases of IE diagnosed annually currently.

This compares to 2011 when 99 were certified.

This apparent increase in incidence is greater than the Australian population increase over the same period,which is part of a global phenomenon thought largely due to an increase of “IE risk populations”

There is a need to improve outcomes further as ~ 20% is a high mortality rate when compared to other infective conditions. ACE’s aim is to improve these outcomes (with an aspiration goal of “single-digit mortality rates”). As IE is such a complex condition with multiple variables, this process will be gradual and require significant levels of collaborations to achieve statistically meaningful results. It is unlikely any single Australian State would be able to provide these numbers, so a multi-centre multi-state collaboration appears the realistic way forward. Australia and NZ together have a population that will soon reach 30 million. In comparison, Scandinavia with it’s world-leading registries has a combined population of ~ 25 million.

Part of the efforts to improve outcomes includes registries which are not only for subtle management assessments but also to detect changes in epidemiology and to enable benchmarking and comparison between centres.

ACE also hopes to not only standardize outcomes in IE between centres, but also to improve awareness (both in the medical world and to the general public) of this disease, to aid in possible prevention (Q fever an example of this) but also early detection (greater recognition of when to suspect it, collect blood cultures etc) and to improve management (including access to TOEs other imaging modalities and CTS).

IE is one of the most complex conditions, requiring the input and co-ordination of multi specialties to maximize outcomes. ACE promotes the use of MDTs for “complex” cases.

In terms of research and management, IE is a subset of sepsis which is a WHO priority. Improvements in IE may be extrapolated to potentially improvements in other sepsis cases.

The various ACE projects will de described in their individual sections.

ACE Committees

ID-Micro section of Steering Committee.

Eugene Athan, Sharon Chen, Robert Horvath (chair), Siong Hui, Alison Keed, Hugh McGann, Renjy Nelson, Veronica Playle, Chris Robson, Indy Sandaradura, Emily Tucker,and Kanthi Vemuri.

Cardiology section of Steering Committee.

John Sedgwick, Alicia Chan, Julie Bradley, Mitra Shirazi.

Cardiothoracic Surgery (CTS) section of Steering Committee

Jayme Bennetts, Livia Williams, Lachlan Marshall, Ash Hardikar

Stroke medicine section of Steering Committee

Kathryn Colebourne, Joshua Mahadevan.

ICU section of Steering Committee

Mbakise (Pula) Matebele

Nuclear-imaging section of steering committee

Dylan Bartholomeusz

Other Sections TBA.

National IE Registry Proposal

ACE proposes a national registry to improve outcomes, not only by comparing specific organisms or therapeutics but also by enabling benchmarking between centres. Access to CTS and TOE in some centres may be a barrier to best outcomes, and this would enable comparisons to be made to improve logistics.

This would be a voluntary registry, expected to largely encompass centres that have IDPs. Data fields required would be dependant on logistics. Centres where a single physician is responsible for their registry would only be expected to fill in “essential data fields”. Larger centres with possibly MDT data collection would have extra data fields to provide additional information.

Progress of this will be detailed on the dedicated web-page (“click here”).