The Univeristy of Melbourne The Royal Melbourne Hopspital

A joint venture between The University of Melbourne and The Royal Melbourne Hospital

Associate Professor Deborah Friedman

Associate Professor Deborah Friedman is the Director of VICNISS, appointed in 2023. She is an infectious diseases specialist at the Royal Melbourne Hospital, a clinical researcher at the Doherty Institute and an Honorary Associate Professor at The University of Melbourne.

She received her Infectious Diseases Fellowship at Duke University Medical Center, and her research in the area of infections that develop in hospitalised patients, defined the term healthcare-associated infection. Her other research into medical therapy for Buruli ulcer has influenced global treatment recommendations.

She received her MD in the area of Infection Control and hospital-acquired infections and completed a Masters of Public Health. She previously served as Deputy Chief Health Officer for Victoria until 2023, and as an infectious diseases physician and an educator of medical students and physician trainees at Barwon health and Deakin University. She has authored over 100 publications and is a recipient of a Queen's birthday public service medal in 2022. She is an appointed member of the Healthcare infection control special interest group (HICSIG), and an editorial board member of the American journal of Infection control.

  • Key Achievements
    • Achievements

      Major career achievements for A/Prof Friedman include her research in defining healthcare-associated infections, calculating risk scores for surgical patients and in creating a roadmap for responding to carbapenem resistance in Australia. 

      Her experience with and publications on medical therapy for Buruli ulcer in conjunction with Barwon Health colleagues has been internationally important in improving patient outcomes and in reducing toxicity. 

      Deborah has extensive experience with teaching, training and assessment of both medical students and physician trainees and serves as a National examiner for the RACP. 

      Deborah led the statewide infection prevention team at the Department of Health during the COVID-19 pandemic, and served as Deputy Chief Health Officer for Victoria, leading responses to communicable disease threats. 

      She is a public service medal (PSM) recipient in 2022 for service to Victoria particularly during the COVID-19 pandemic.

    • Publications

      Public health

      Thomson T, Marsland M, Minko C, Snow K, Friedman ND. Japanese encephalitis: a rapid review of reported prevalence of infection, clinical disease, and sequelae in immunologically naïve populations to inform Australia’s response. ANZ J Public Health 2023,

      Braddick M, Feldman R, Yuen A, Friedman ND. Early detection of Murray Valley encephalitis virus activity in Victoria using mosquito surveillance. Med J Aust 2023, doi: 10.5694/mja2.51987

      O'Brien HM, Jung MH, Tran SC, Lewis SI, Strachan JE, Ivan M, Braddick MS, Friedman ND. Absence of transmission of mpox infection on long international flights. Journal of travel medicine 2023: taad075.

      Haque M, Ferdous AS, Miller J, Linke JA, Dixon C, Athan E, Friedman ND. Barriers to performing onsite COVID-19 testing during the second wave in Victoria: experiences in general practices. Aust J Gen Prac 2021;50:845-849. doi: 10.31128/AJGP-05-21-6003.

      Masters PJ, Miller PJ, Sneath E, Wade AJ, Huffam S, Lim K, Pollard J, Standish J ,McCloskey K, Athan E, O’Brien DP, Friedman ND. Health issues of refugees attending an infectious disease refugee health clinic in a regional Australian hospital. Australian J Gen Practice 2018;47(5):305-310.

      Sharma S, Sneath E, Cheng AC, Friedman ND. Community-acquired syndromes causing morbidity and mortality in Australia.  Comm Dis Intell 2017;41:E49-57.

      Adler N, Mahony A, Friedman ND. Diphtheria - forgotten, but not gone. Int Med J 2013, 43:206.


      From the clinical environment

      Underwood K, Stupart D, Morgan FH, Scott B, Moxham‐Smith R, Moore EM, Friedman D. Can the alcohol withdrawal scale be applied to post‐operative patients? ANZ J Surg 2022;92(6):1377-81.

      Choy KH, McVeigh M, Delmenico L, Holgate S, Friedman ND. Rhabdomyolysis: review of cases over a decade at a regional teaching hospital. Renal Society of Australasia Journal 2020,

      Clarke MC, Cheng AC, Pollard JGD, Birch M, Cowan RU, Linke JA, Walton AL, Friedman ND. Lessons learned from a randomised controlled trial of short course intravenous antibiotic therapy for erysipelas and cellulitis of the lower limb (SWITCH Trial). Open Forum Inf Dis 2019;

      Sethwala A, Wang J, Sturm E, Collins KL, O’Donnabhain R, Friedman ND. Predictive value of symptoms, signs and biomarkers for predicting CTPA results. Int Med J 2017, doi: 10.1111/imj.13596.

      Friedman ND, Pollard J, Huffam S, Walton AL, O’Brien DP, et al. (2014) Randomized Controlled Trial of Short Course Intravenous Therapy for Cellulitis and Erysipelas of the Lower Limb (SWITCH): Study Protocol and Pilot Trial Results. J Clin Trials 4: 200. doi:10.4172/2167-0870.1000200.

      Adler NR, Gunadasa I, Weber H, Friedman ND. Adherence to therapeutic guidelines for patients with Community-Acquired Pneumonia (CAP) in Australian hospitals. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine 2014;8:17-20. DOI:10.4137/CCRPM.S17978.

      Friedman ND, Green JH, Weber H, Stephens S, Lane S, Ting A, Watson J. Hepatitis C virus treatment in the “real world”: how well do 'real' patients respond? J Clinical and Experimental Hepatology 2014 DOI:10.1016/j.jceh.2014.07.003.

      Friedman ND, Pollard J, Stupart D, Alfredson D, Knight D, Khajehnoori M, Davey E, Parry L, Riley TV. Prevalence of Clostridium difficile Colonisation among Healthcare workers. BMC Infect Dis 2013, 13:459. doi:10.1186/1471-2334-13-459.


      Medical training

      Parsons S, Hughes AJ, Friedman ND. “Please don’t call me Mister”: patient preferences of how they are addressed and their knowledge of their treating medical team in an Australian hospital. BMJ Open 2016;6:e008473 doi:10.1136/bmjopen-2015-008473.

      Friedman ND. Junior doctor training: Has the pendulum swung too far? Int Med Journal 2019; 49:1546-9.

      O’Donnabhain R, Friedman ND. What makes a good doctor? Int Med J 2018;48:879-82


      Healthcare-associared infection

      Cardoso T, Rodrigues PP, Nunes C, Almeida M, Cancela J, Rosa F,.& Friedman ND. Prospective international validation of the predisposition, infection, response and organ dysfunction (PIRO) clinical staging system among intensive care and general ward patients. Ann Intensive care 2021;11(1):1-7.

      Cardoso T, Pereira Rodrigues P, Nunes C, Almeida M, Cancela J, Rosa F, Rocha-Pereira N, Ferreira I, Seabra-Pereira F, Vaz P, Carneiro L, Andrade C, Davis J, Marçal A, Friedman ND. Identification of hospitalized patients with community-acquired infection in whom treatment guidelines do not apply: a validated model. J Antimicrob Chemother 2019. DOI:

      Friedman ND, Temkin E, Levit D, Taleb E, Mengesha B, Zaidenstein R, Lazarovitch T, Dadon M, Chen D, Kaye KS, Marchaim D. Towards a Definition for Healthcare-associated Infection. Open Forum Inf Dis 2018;5(6): p. ofy116.

      Friedman ND, Sexton DJ, Connelly SM, Kaye KS. Risk Factors for Surgical Site Infection Complicating Laminectomy. Infect Control Hosp Epidemiol 2007; 28:1060-1065.

      Friedman ND, Kotsanas D, Brett J, Billah B, Korman TM. Investigation of an Outbreak of Serratia marcescens in a Neonatal Unit via a case-control study and molecular typing. Am J Infect Control 2008; 36:22-28.

      Friedman ND, Kaye KS, Stout JE, McGarry SA, Trivette SL, Briggs JP, Lamm W, Clark C, MacFarquhar J, Walton AL, Reller LB, Sexton DJ. Healthcare- Associated Bloodstream Infections in Adults: A challenge to the accepted definition of community-acquired infections. Ann Intern Med 2002; 137(10):791-797.

      Friedman ND, Korman TM, Fairley CK, Franklin JC, Spelman DW. Bacteraemia due to Stenotrophomonas maltophilia: An analysis of 45 episodes. J Infect 2002; 45:47-53.


      Buruli ulcer

      Linke JA, Athan E, Friedman ND. Correlation between Buruli ulcer incidence and vectorborne diseases in southeastern Australia, 2000-2020. Emerg Infect Dis 2021; 27:3191-2. DOI:

      O’Brien DP, Friedman ND, Cowan RU, Walton AL, Athan E. Six versus eight weeks of antibiotics for small Mycobacterium ulcerans lesions in Australian Patients. Clin Infect Dis 2020; 70 (9):1993-1997.

      Walker G, Friedman ND, O’Brien M, McDonald A, Copper C, O’Brien DP. Buruli ulcer in Austrlaian children. J Paeds Child Health 2019. DOI:10.1111/jpc.14704.

      O’Brien DP, Friedman ND, McDonald A, Callan P, Hughes AJ, Walton AL, Athan E. Wound healing: Natural history and risk factors for delay in Australian patients treated with antibiotics for Mycobacterium ulcerans disease. PLOS NTD 2018;

      O’Brien DP, Friedman ND, Hughes AJ, Walton Al, Athan E. Antibiotic complications during the treatment of Mycobacterium ulcerans disease in Australian patients. Int Med J 2017; 47:1011-1019.

      Friedman ND, Athan E, Walton AL, O'Brien DP. Mycobacterium ulcerans disease: Increasing experience with Primary Oral Medical Therapy in an Australian cohort. Antimicrob Agents Chemother 2016; 60: 2692-2695.

      Friedman ND, Athan E, Hughes AJ, Khajehnoori  M, McDonald A, Callan P, Rahdon R, O’Brien.DP. Mycobacterium ulcerans disease: Experience with primary oral medical therapy in an Australian cohort. PLoS Negl Trop Dis 2013, 7(7): e2315. doi:10.1371/journal.pntd.0002315.

      Friedman ND, McDonald AH, Robson ME, O’Brien DP. (2012) Corticosteroid use for paradoxical reactions during antibiotic treatment for Mycobacterium ulcerans. PLoS Negl Trop Dis 2012; 6(9):e1767. DOI:10.1371/journal.pntd.0001767.


      Antimicrobial stewardship and antimicrobial resistance

      Friedman ND, Seok M Lim, James R, Ingram R, O’Reilly M, Pollard JGD, Koning S, George C, Rajkhowa A, Johnson DF, Buising KL Measuring antimicrobial prescribing quality in outpatient parenteral antimicrobial therapy (OPAT) services: development and evaluation of a dedicated national antimicrobial prescribing survey. JAC- Antimicrob Resist 2020;2(3):dlaa058.

      Friedman ND, Carmeli Y, Schwaber MJ. Carbapenem-resistant Enterobacteriaceae:  A strategic roadmap for infection control. Infect Control Hosp Epidemiol 2017. doi: Published online: 15 March 2017.

      Adler A, Friedman ND, Marchaim D. Multidrug-Resistant Gram-Negative Bacilli: Infection Control Implications. Infect Dis Clin North Am 2016,30:967-997.

      Friedman ND, Temkin E, Carmeli Y. The negative impact of antimicrobial resistance. Clin Micro Infect 2016; doi: 10.1016/j.cmi.2015.12.002.

      Cowan RU, Kishan D, Walton AL, Sneath E, Cheah T, Butwilowsky J, Friedman ND. Cleaning, resistant bacteria and antibiotic prescribing in residential aged care facilities. Am J Infect Control 2015, doi: 10.1016/j.ajic.2015.09.034.

      Friedman ND. Infection Prevention and Antimicrobial Stewardship:  Important in all settings (Editorial). Healthcare Infect 2015, 20:1-3. Doi:10.1071/HI15001.

      Friedman ND. Antimicrobial Stewardship: The Need To Cover All Bases. Antibiotics 2013, 2(3), 400-418; doi:10.3390/antibiotics2030400

      Friedman ND, Walton AL , Boyd S, Tremonti C, Low J, Styles K, Harris O, Alfredson D, Athan E. The Effectiveness of a single-stage versus traditional three-staged protocol of Hospital Disinfection at Eradicating Vancomycin-Resistant Enterococci from Frequently-Touched Surfaces. DOI:10.1016/j.ajic.2012.03.021. or Am J Infect Control 2013;41:227-231.

      Friedman ND, Jow J, Styles K, Gray A, Athan E. Compliance with surgical antibiotic prophylaxis at an Australian teaching hospital. Am J Infect Control 2012; DOI: 10.1016/j.ajic.2012.02.012

      Friedman ND, Midolo PD, Kotsanas D, Korman TM. Poor Specificity of screening tests for the detection of Staphylococcus aureus with reduced susceptibility to vancomycin. Int J Infect Control 2006; 2 (1):98-101.


      Infection surveillance

      Friedman ND, Bull AL, Russo PL, Gurrin L, Richards M. Performance of the National Nosocomial Infections Surveillance (NNIS) Risk Index at predicting surgical site infection (SSI) in an Australian setting. Infect Control Hosp Epidemiol 2007; 28:55-59.

      Friedman ND, Russo PL, Bull AL, Richards MJ, Kelly H. Validation of Coronary Artery Bypass Graft Surgical Site Infection Surveillance data from a State-wide Surveillance System in Australia. Infect Control Hosp Epidemiol 2007; 28:812-817.

      Friedman ND, Bull AL, Russo PL, Leder K, Reid C, Billah B, Marasco S, McBryde E, Richards MJ. An Alternative Scoring System to Predict Risk for Surgical Site Infection Complicating Coronary Artery Bypass Graft Surgery. Infect Control Hosp Epidemiol 2007; 28:1162-1169.

      Friedman ND, Russo PL, Richards M. Surveillance for Ventilator-Associated Pneumonia: the Challenges and Pitfalls. Aust Infect Control 2005;10:122-5.

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    Research Groups

      The VICNISS Coordinating Centre provides a state-wide, standardised surveillance service for healthcare associated infections (HAIs) and related events. The goal of VICNISS is to monitor and reduce the incidence of HAIs, providing support for health services in Victoria. VICNISS aims to support Victorian health services to carry out international best practice surveillance and analysis, and to lead interventions for quality improvement to improve the health of all Victorians.

      VICNISS provides a source of high quality data for regular performance monitoring, and for a valuable resource for the research community. Over the time of VICNISS surveillance, infection rates in key areas of focus have fallen markedly, reducing the significant financial and personal cost of these infections on both individual patients and the health system.

      VICNISS collaborates with the National Centre for Antimicrobial Stewardship (NCAS), with a major involvement in aged care NAPS (ac-NAPS). VICNISS is also engaged by DHHS Residential Aged Care Services to carry out monitoring of infection control indicators in Victoria’s public residential aged care services, including participation in ac-NAPS.

      Lab Team