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O'Brien S, Reedman C, Yi QL, Drews S. SARS-CoV-2 Seroprevalence in the Vaccine Era: The Canadian Blood Services Serosurvey January to November 2021. Transfus Med Rev 2023. [PMCID: PMC10008913 DOI: 10.1016/j.tmrv.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Lee BE, Sikora C, Faulder D, Risling E, Little LA, Qiu Y, Gao T, Bulat R, Craik S, Hrudey SE, Ohinmaa A, Estabrooks CA, Gingras AC, Charlton C, Kim J, Wood H, Robinson A, Kanji JN, Zelyas N, O'Brien SF, Drews S, Pang XL. Early warning and rapid public health response to prevent COVID-19 outbreaks in long-term care facilities (LTCF) by monitoring SARS-CoV-2 RNA in LTCF site-specific sewage samples and assessment of antibodies response in this population: prospective study protocol. BMJ Open 2021; 11:e052282. [PMID: 34417219 PMCID: PMC8382669 DOI: 10.1136/bmjopen-2021-052282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has an excessive impact on residents in long-term care facilities (LTCF), causing high morbidity and mortality. Early detection of presymptomatic and asymptomatic COVID-19 cases supports the timely implementation of effective outbreak control measures but repetitive screening of residents and staff incurs costs and discomfort. Administration of vaccines is key to controlling the pandemic but the robustness and longevity of the antibody response, correlation of neutralising antibodies with commercial antibody assays, and the efficacy of current vaccines for emerging COVID-19 variants require further study. We propose to monitor SARS-CoV-2 in site-specific sewage as an early warning system for COVID-19 in LTCF and to study the immune response of the staff and residents in LTCF to COVID-19 vaccines. METHODS AND ANALYSIS The study includes two parts: (1) detection and quantification of SARS-CoV-2 in LTCF site-specific sewage samples using a molecular assay followed by notification of Public Health within 24 hours as an early warning system for appropriate outbreak investigation and control measures and cost-benefit analyses of the system and (2) testing for SARS-CoV-2 antibodies among staff and residents in LTCF at various time points before and after COVID-19 vaccination using commercial assays and neutralising antibody testing performed at a reference laboratory. ETHICS AND DISSEMINATION Ethics approval was obtained from the University of Alberta Health Research Ethics Board with considerations to minimise risk and discomforts for the participants. Early recognition of a COVID-19 case in an LTCF might prevent further transmission in residents and staff. There was no direct benefit identified to the participants of the immunity study. Anticipated dissemination of information includes a summary report to the immunity study participants, sharing of study data with the scientific community through the Canadian COVID-19 Immunity Task Force, and prompt dissemination of study results in meeting abstracts and manuscripts in peer-reviewed journals.
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Affiliation(s)
- Bonita E Lee
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Women & Children's Health Research Institute, Li Ka Shing Institute of Virology, Edmonton, Alberta, Canada
| | - Christopher Sikora
- Medical Officer of Health (Edmonton Zone), Alberta Health Services, Edmonton, Alberta, Canada
- Department of Medicine, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Douglas Faulder
- Medical Director, Continuing Care (Edmonton Zone), Alberta Health Services, Edmonton, Alberta, Canada
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Eleanor Risling
- Executive Director, Continuing Care (Edmonton Zone), Alberta Health Services, Edmonton, Alberta, Canada
| | - Lorie A Little
- Director, Facility and Supportive Living (Edmonton Zone), Alberta Health Services, Edmonton, Alberta, Canada
| | - Yuanyuan Qiu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Tiejun Gao
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Ross Bulat
- EPCOR Water Services Inc, Edmonton, Alberta, Canada
| | | | - Steve E Hrudey
- Analytical and Environmental Toxicology, University of Alberta, Edmonton, Alberta, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Carmen Charlton
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Alberta Precision Laboratories, Public Health Laboratory; Li Ka Shing Institute of Virology, Alberta Health Services, Edmonton, Alberta, Canada
| | - John Kim
- National Microbiology Laboratory, Winnipeg, Manitoba, Canada
| | - Heidi Wood
- National Microbiology Laboratory, Winnipeg, Manitoba, Canada
| | | | - Jamil N Kanji
- Public Health Laboratory, Alberta Precision Laboratories, Calgary, Alberta, Canada
- Division of Infectious Diseases, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Alberta Precision Laboratories, Public Health Laboratory, Alberta Health Services, Edmonton, Alberta, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven Drews
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Alberta Precision Laboratories, Public Health Laboratory; Li Ka Shing Institute of Virology, Alberta Health Services, Edmonton, Alberta, Canada
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Berry I, Tuite AR, Salomon A, Drews S, Harris AD, Hatchette T, Johnson C, Kwong J, Lojo J, McGeer A, Mermel L, Ng V, Fisman DN. Association of Influenza Activity and Environmental Conditions With the Risk of Invasive Pneumococcal Disease. JAMA Netw Open 2020; 3:e2010167. [PMID: 32658286 PMCID: PMC7358913 DOI: 10.1001/jamanetworkopen.2020.10167] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Streptococcus pneumoniae is the most commonly identified cause of bacterial pneumonia, and invasive pneumococcal disease (IPD) has a high case fatality rate. The wintertime coseasonality of influenza and IPD in temperate countries has suggested that pathogen-pathogen interaction or environmental conditions may contribute to IPD risk. OBJECTIVES To evaluate the short-term associations of influenza activity and environmental exposures with IPD risk in temperate countries and to examine the generalizability of such associations across multiple jurisdictions. DESIGN, SETTING, AND PARTICIPANTS This case-crossover analysis of 19 566 individuals with IPD from 1998 to 2011 combined individual-level outcomes of IPD and population-level exposures. Participants lived in 12 jurisdictions in Canada (the province of Alberta and cities of Toronto, Vancouver, and Halifax), Australia (Perth, Sydney, Adelaide, Brisbane, and Melbourne), and the United States (Baltimore, Providence, and Philadelphia). Data were analyzed in 2019. EXPOSURES Influenza activity, mean temperature, absolute humidity, and UV radiation at delays of 1 to 3 weeks before case occurrence in each jurisdiction. MAIN OUTCOMES AND MEASURES Matched odds ratios (ORs) for IPD associated with changes in exposure variables, estimated using multivariable conditional logistic regression models. Heterogeneity in effects across jurisdictions were evaluated using random-effects meta-analytic models. RESULTS This study included 19 566 patients: 9629 from Australia (mean [SD] age, 42.8 [30.8] years; 5280 [54.8%] men), 8522 from Canada (only case date reported), and 1415 from the United States (only case date reported). In adjusted models, increased influenza activity was associated with increases in IPD risk 2 weeks later (adjusted OR [aOR] per SD increase, 1.07; 95% CI, 1.01-1.13). Increased humidity was associated with decreased IPD risk 1 week later (aOR per 1 g/m3, 0.98; 95% CI, 0.96-1.00). Other associations were heterogeneous; metaregression suggested that combinations of environmental factors might represent unique local risk signatures. For example, the heterogeneity in effects of UV radiation and humidity at a 2-week lag was partially explained by variation in temperature (UV index: coefficient, 0.0261; 95% CI, 0.0078 to 0.0444; absolute humidity: coefficient, -0.0077; 95% CI, -0.0125 to -0.0030). CONCLUSIONS AND RELEVANCE In this study, influenza was associated with increased IPD risk in temperate countries. This association was not explained by coseasonality or case characteristics and appears generalizable. Absolute humidity was associated with decreased IPD risk in the same jurisdictions. The generalizable nature of these associations has important implications for influenza control and advances the understanding of the seasonality of this important disease.
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Affiliation(s)
- Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ashleigh R. Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Salomon
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Steven Drews
- Canadian Blood Services, Ottawa, Ontario, Canada
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Todd Hatchette
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Caroline Johnson
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Jeff Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jose Lojo
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Allison McGeer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Leonard Mermel
- Warren Alpert School of Medicine of Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence
| | - Victoria Ng
- Public Health Agency of Canada, Guelph, Ontario, Canada
| | - David N. Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Salomon A, Berry I, Tuite AR, Drews S, Hatchette T, Jamieson F, Johnson C, Kwong J, Lina B, Lojo J, Mosnier A, Ng V, Vanhems P, Fisman DN. Influenza increases invasive meningococcal disease risk in temperate countries. Clin Microbiol Infect 2020; 26:1257.e1-1257.e7. [PMID: 31935565 DOI: 10.1016/j.cmi.2020.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Invasive meningococcal disease (IMD) is a severe bacterial infection that displays wintertime seasonality in temperate countries. Mechanisms driving seasonality are poorly understood and may include environmental conditions and/or respiratory virus infections. We evaluated the contribution of influenza and environmental conditions to IMD risk, using standardized methodology, across multiple geographical regions. METHODS We evaluated 3276 IMD cases occurring between January 1999 and December 2011 in 11 jurisdictions in Australia, Canada, France and the United States. Effects of environmental exposures and normalized weekly influenza activity on IMD risk were evaluated using a case-crossover design. Meta-analytic methods were used to evaluate homogeneity of effects and to identify sources of between-region heterogeneity. RESULTS After adjustment for environmental factors, elevated influenza activity at a 2-week lag was associated with increased IMD risk (adjusted odds ratio (OR) per standard deviation increase 1.29; 95% confidence interval, 1.04-1.59). This increase was homogeneous across the jurisdictions studied. By contrast, although associations between environmental exposures and IMD were identified in individual jurisdictions, none was generalizable. CONCLUSIONS Using a self-matched design that adjusts for both coseasonality and case characteristics, we found that surges in influenza activity result in an acute increase in population-level IMD risk. This effect is seen across diverse geographic regions in North America, France and Australia. The impact of influenza infection on downstream meningococcal risk should be considered a potential benefit of influenza immunization programmes.
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Affiliation(s)
- A Salomon
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - I Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - A R Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - S Drews
- Canadian Blood Services, Ottawa, Canada; University of Alberta, Edmonton, Canada
| | - T Hatchette
- Nova Scotia Health Authority, Halifax, Canada; Dalhousie University, Halifax, Canada
| | | | - C Johnson
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - J Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - B Lina
- Université de Lyon, Lyon, France; Laboratory of Virology, Centre National de Référence des Virus Influenzae, Hospices Civils de Lyon, Lyon, France
| | - J Lojo
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - A Mosnier
- Groupes Regionaux d'Observation de la Grippe, Open Rome, Paris, France
| | - V Ng
- Public Health Agency of Canada, Guelph, Canada
| | - P Vanhems
- Université de Lyon, Lyon, France; Unité d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - D N Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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Tarr GAM, Chui L, Lee BE, Pang XL, Ali S, Nettel-Aguirre A, Vanderkooi OG, Berenger BM, Dickinson J, Tarr PI, Drews S, MacDonald J, Kim K, Freedman SB. Performance of Stool-testing Recommendations for Acute Gastroenteritis When Used to Identify Children With 9 Potential Bacterial Enteropathogens. Clin Infect Dis 2019; 69:1173-1182. [PMID: 30517612 PMCID: PMC7348586 DOI: 10.1093/cid/ciy1021] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/29/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The ability to identify bacterial pathogens that necessitate specific clinical management or public health action in children with acute gastroenteritis is crucial to patient care and public health. However, existing stool-testing guidelines offer inconsistent recommendations, and their performance characteristics are unknown. We evaluated 6 leading gastroenteritis guidelines (eg, those of the Centers for Disease Control and Prevention and Infectious Disease Society of America) that recommend when to test children's stool for bacterial enteropathogens. METHODS Via 2 emergency departments in Alberta, Canada, we enrolled 2447 children <18 years old who presented with ≥3 episodes of diarrhea and/or vomiting in a 24-hour period. All participants were tested for 9 bacterial enteropathogens: Aeromonas, Campylobacter, Escherichia coli O157, other Shiga toxin-producing E. coli, enterotoxigenic E. coli, Salmonella, Shigella, Vibrio, and Yersinia. Patient data gathered at the index visit were used to determine whether guidelines would recommend testing. Sensitivity and specificity to recommend testing for children with bacterial enteropathogens were calculated for each guideline. RESULTS Outcome data were available for 2391 (97.7%) participants, and 6% (144/2391) of participants tested positive for a bacterial enteropathogen. Guideline sensitivity ranged from 25.8% (95% confidence interval [CI] 18.7-33.0%) to 66.9% (95% CI 59.3-74.6%), and varied for individual pathogens. Guideline specificity for all bacterial enteropathogens ranged from 63.6% (95% CI 61.6-65.6%) to 96.5% (95% CI 95.7-97.2%). CONCLUSIONS No guideline provided optimally balanced performance. The most sensitive guidelines missed one-third of cases and would drastically increase testing volumes. The most specific guidelines missed almost 75% of cases.
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Affiliation(s)
- Gillian A M Tarr
- Department of Pediatrics, University of Calgary, University of Alberta and Alberta Provincial Laboratory for Public Health, Alberta, Canada
| | - Linda Chui
- Department of Laboratory Medicine and Pathology, University of Alberta and Alberta Provincial Laboratory for Public Health, Alberta, Canada
| | - Bonita E Lee
- Department of Pediatrics, Women and Children’s Health Research Institute, University of Alberta, Alberta, Canada
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta and Alberta Provincial Laboratory for Public Health, Alberta, Canada
| | - Samina Ali
- Department of Pediatrics, Women and Children’s Health Research Institute, University of Alberta, Alberta, Canada
- Department of Emergency Medicine, Women and Children’s Health Research Institute, University of Alberta, Alberta, Canada
| | - Alberto Nettel-Aguirre
- Departments of Pediatrics and Community Health Sciences, University of Calgary, Alberta, Canada
| | - Otto G Vanderkooi
- Departments of Pediatrics, Microbiology, Immunology and Infectious Diseases, Pathology and Laboratory Medicine, and Community Health Sciences, Alberta Children’s Hospital Research Institute, Alberta, Canada
| | - Byron M Berenger
- Department of Pathology and Laboratory Medicine, University of Calgary, Alberta, Canada
- Alberta Provincial Laboratory for Public Health, Alberta, Canada
| | - James Dickinson
- Department of Family Medicine, University of Calgary, Alberta, Canada
| | - Phillip I Tarr
- Department of Pediatrics, Washington University in St. Louis School of Medicine, Missouri
| | - Steven Drews
- Department of Laboratory Medicine and Pathology, University of Alberta and Alberta Provincial Laboratory for Public Health, Alberta, Canada
| | - Judy MacDonald
- Alberta Health Services and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Kelly Kim
- Department of Pediatrics, University of Calgary, University of Alberta and Alberta Provincial Laboratory for Public Health, Alberta, Canada
| | - Stephen B Freedman
- Sections of Pediatric Emergency Medicine and Gastroenterology, Department of Pediatrics, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada
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Hass HG, Rockstroh J, Pech I, Drews S, Stepien J, Lerch J. Medical-professional rehabilitation after cancer – 2-years experience and evaluation of a multimodal rehabilitation concept. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- HG Hass
- Paracelsus-Klinik, Scheidegg, Deutschland
- Praxis für Onkologie und Hämatologie Westallgäu, Scheidegg, Deutschland
| | | | - I Pech
- Paracelsus-Klinik, Scheidegg, Deutschland
| | - S Drews
- Paracelsus-Klinik, Scheidegg, Deutschland
| | - J Stepien
- Paracelsus-Klinik, Scheidegg, Deutschland
| | - J Lerch
- Paracelsus-Klinik, Scheidegg, Deutschland
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Crowcroft NS, Johnson C, Chen C, Li Y, Marchand-Austin A, Bolotin S, Schwartz K, Deeks SL, Jamieson F, Drews S, Russell ML, Svenson LW, Simmonds K, Mahmud SM, Kwong JC. Under-reporting of pertussis in Ontario: A Canadian Immunization Research Network (CIRN) study using capture-recapture. PLoS One 2018; 13:e0195984. [PMID: 29718945 PMCID: PMC5931792 DOI: 10.1371/journal.pone.0195984] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/03/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction Under-reporting of pertussis cases is a longstanding challenge. We estimated the true number of pertussis cases in Ontario using multiple data sources, and evaluated the completeness of each source. Methods We linked data from multiple sources for the period 2009 to 2015: public health reportable disease surveillance data, public health laboratory data, and health administrative data (hospitalizations, emergency department visits, and physician office visits). To estimate the total number of pertussis cases in Ontario, we used a three-source capture-recapture analysis stratified by age (infants, or aged one year and older) and adjusting for dependency between sources. We used the Bayesian Information Criterion to compare models. Results Using probable and confirmed reported cases, laboratory data, and combined hospitalizations/emergency department visits, the estimated total number of cases during the six-year period amongst infants was 924, compared with 545 unique observed cases from all sources. Using the same sources, the estimated total for those aged 1 year and older was 12,883, compared with 3,304 observed cases from all sources. Only 37% of infants and 11% for those aged 1 year and over admitted to hospital or seen in an emergency department for pertussis were reported to public health. Public health reporting sensitivity varied from 2% to 68% depending on age group and the combination of data sources included. Sensitivity of combined hospitalizations and emergency department visits varied from 37% to 49% and of laboratory data from 1% to 50%. Conclusions All data sources contribute cases and are complementary, suggesting that the incidence of pertussis is substantially higher than suggested by routine reports. The sensitivity of different data sources varies. Better case identification is required to improve pertussis control in Ontario.
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Affiliation(s)
- Natasha S. Crowcroft
- Public Health Ontario, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- * E-mail:
| | | | | | - Ye Li
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Shelly Bolotin
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kevin Schwartz
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley L. Deeks
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Frances Jamieson
- Public Health Ontario, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Steven Drews
- ProvLab Alberta, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | | | - Lawrence W. Svenson
- Alberta Health, Edmonton, AB, Canada
- Division of Preventive Medicine, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Kimberley Simmonds
- Alberta Health, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Salaheddin M. Mahmud
- Vaccine and Drug Evaluation Centre, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jeffrey C. Kwong
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Kawaguchi A, Bates A, Lee BE, Drews S, Garros D. Virus detection in critically ill children with acute respiratory disease: a new profile in view of new technology. Acta Paediatr 2018; 107:504-510. [PMID: 29131392 PMCID: PMC7159542 DOI: 10.1111/apa.14148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/15/2022]
Abstract
AIM To describe the epidemiology of critically ill children admitted to a paediatric intensive care unit (PICU) with acute respiratory disease. The association with intubation was analysed for the three most prevalent viruses and in those with and without viral co-infection. METHODS Patients admitted to the PICU (2004-2014) with acute respiratory disease were included. Analyses were performed utilising each respiratory viral infection or multiple viral infections as an exposure. RESULTS There were 1766 admissions with acute respiratory disease of which 1372 had respiratory virus testing and 748 had one or more viruses detected. The risk of intubation before or during the PICU stay was higher if parainfluenza virus was detected compared to respiratory syncytial virus (RSV) (OR: 2.20; 95% CI: 1.06-4.56). Sixty-three admissions had two or more viruses detected, and the combination of RSV and Rhinovirus/enterovirus was the most common. No significant difference was observed in the risk of intubation between patients with multiple and single viral infections. CONCLUSION Higher risk of intubation was found in patients with parainfluenza as compared to RSV. The risk of intubation comparing parainfluenza virus to other viruses and for patients with multiple versus single virus needs to be further studied.
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Affiliation(s)
- Atsushi Kawaguchi
- Department of Pediatrics; Pediatric Critical Care Medicine; University of Alberta; Edmonton AB Canada
- School of Public Health; University of Alberta; Edmonton AB Canada
| | - Angela Bates
- Department of Pediatrics; Pediatric Critical Care Medicine; University of Alberta; Edmonton AB Canada
| | - Bonita E. Lee
- Department of Pediatrics; Pediatric Infectious Disease; University of Alberta; Edmonton AB Canada
| | - Steven Drews
- Provincial Laboratory for Public Health; Alberta Health Services; Edmonton AB Canada
- Department of Laboratory Medicine and Pathology; University of Alberta; Edmonton AB Canada
| | - Daniel Garros
- Department of Pediatrics; Pediatric Critical Care Medicine; University of Alberta; Edmonton AB Canada
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Bolotin S, Johnson C, Quach S, Ambrose A, DeCoutere S, Deeks SL, Drews S, Faheem A, Green K, Halperin SA, Hoang L, Jamieson F, Kollmann T, Marchand-Austin A, McCormack D, McGeer A, Murti M, Bba AO, Rebbapragada A, Vanderkooi OG, Wang J, Warshawsky B, Crowcroft NS. Case-control study of household contacts to examine immunological protection from Bordetella pertussis transmission - study protocol. CMAJ Open 2017; 5:E872-E877. [PMID: 29269437 PMCID: PMC5741426 DOI: 10.9778/cmajo.20170072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is mounting evidence that the recent resurgence of pertussis in many countries is in part related to the acellular vaccine, which has been administered in Canada since 1997. This vaccine elicits a different cell-mediated immune response than the previously used whole-cell vaccine, and its effectiveness wanes over time. The aim of this study is to understand the immunological, demographic and clinical factors that mediate protection from pertussis on exposure. METHODS This is a household case-control study protocol. Following notification of an index case in a household, a study team will conduct a home visit to collect data and biological specimens. The study team will return to the household 8 weeks from the onset of illness in the index case. The Th1, Th2 and Th17 responses, cytokine expression, IgG subclass, blood cell counts and presence of Bordetella pertussis will be determined. We will use laboratory and statistical analyses to determine immunological differences between contacts who are infected with B. pertussis and contacts who remain healthy, and to determine which clinical and demographic covariates are associated with a reduced risk of infection. INTERPRETATION The results of this study will be essential for understanding the immune response required for protection from infection with B. pertussis and will contribute to our understanding of the shortcomings of the current vaccine.
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Affiliation(s)
- Shelly Bolotin
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Caitlin Johnson
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Susan Quach
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Ardith Ambrose
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Sarah DeCoutere
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Shelley L Deeks
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Steven Drews
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Amna Faheem
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Karen Green
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Scott A Halperin
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Linda Hoang
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Frances Jamieson
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Tobias Kollmann
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Alex Marchand-Austin
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Deirdre McCormack
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Allison McGeer
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Michelle Murti
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Alison Orth Bba
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Anu Rebbapragada
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Otto G Vanderkooi
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Jun Wang
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Bryna Warshawsky
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
| | - Natasha S Crowcroft
- Affiliations: Public Health Ontario (Bolotin, Johnson, Quach, Deeks, Jamieson, Marchand-Austin, Warshawsky, Crowcroft); University of Toronto (Bolotin, Deeks, Jamieson, Crowcroft), Toronto, Ont.; Canadian Center for Vaccinology (Ambrose, DeCoutere, Halperin, Wang), Halifax, NS; Department of Laboratory Medicine and Pathology (Drews), University of Alberta; ProvLab Alberta (Drews), Edmonton, Alta.; North York General Hospital (Faheem); Mount Sinai Hospital (Green, McGeer), Toronto, Ont.; Department of Microbiology and Immunology (Halperin), Dalhousie University, Halifax, NS; British Columbia Centre for Disease Control (Hoang); Child and Family Research Institute (Kollmann), Vancouver, BC; McGill University Health Centre (McCormack), Montréal, Que.; Fraser Health Authority (Murti, Orth), Surrey, BC; Gamma Dynacare (Rebbapragada), Brampton, Ont.; University of Calgary (Vanderkooi), Calgary, Alta
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10
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Martin I, Sawatzky P, Liu G, Allen V, Lefebvre B, Hoang L, Drews S, Horsman G, Wylie J, Haldane D, Garceau R, Ratnam S, Wong T, Archibald C, Mulvey MR. Decline in Decreased Cephalosporin Susceptibility and Increase in Azithromycin Resistance in Neisseria gonorrhoeae, Canada. Emerg Infect Dis 2016; 22:65-7. [PMID: 26689114 PMCID: PMC4696705 DOI: 10.3201/eid2201.151247] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Antimicrobial resistance profiles were determined for Neisseria gonorrhoeae strains isolated in Canada during 2010–2014. The proportion of isolates with decreased susceptibility to cephalosporins declined significantly between 2011 and 2014, whereas azithromycin resistance increased significantly during that period. Continued surveillance of antimicrobial drug susceptibilities is imperative to inform treatment guidelines.
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11
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Fathima S, Simmonds K, Invik J, Scott AN, Drews S. Use of laboratory and administrative data to understand the potential impact of human parainfluenza virus 4 on cases of bronchiolitis, croup, and pneumonia in Alberta, Canada. BMC Infect Dis 2016; 16:402. [PMID: 27514690 PMCID: PMC4982406 DOI: 10.1186/s12879-016-1748-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 08/03/2016] [Indexed: 01/13/2023] Open
Abstract
Background Human Parainfluenza Virus (hPIV) causes severe respiratory illness in infants and adults. Our study describes the association of hPIV1–4 with bronchiolitis, croup, and pneumonia using retrospective laboratory, administrative and public health data. Due to issues including the historic lack of hPIV4 in some commercial respiratory virus panels, the description of the impact of hPIV4 on croup, bronchiolitis, and pneumonia at population levels has often been limited. This study will use routine clinical laboratory data, and administrative data to provide a preliminary description of the impact of hPIV4 on these diseases in our population. Methods A three year cohort of patients positive for hPIV was linked with data from physician visits and hospital admissions to define cases and hospitalization status. International Classification of Disease (ICD-9) codes were used to determine if cases had croup, bronchiolitis, and pneumonia. We also looked at differences in hospitalization status, age and gender among hPIV1–4. All statistical analysis was done using SPSS (Version 19.0.0, IBM Corp© 2010) and Graphpad Prism V6 (GraphPad Software, Inc., 2012). Results Only hPIV1 and hPIV4 specimens had positivity rates greater than 5 % of all specimens sent for respiratory virus panel testing. hPIV1 exhibited a biennial pattern while the pattern for hPIV3 was less interpretable due to lower positivity rates. Circulation patterns for hPIV2 and hPIV4 were not assessed due to the low positivity rates of theses specimens. From 2010 to 2013, there were 2300 hPIV cases with hPIV3 (46 %) being the most common, followed by hPIV1 (27 %), hPIV4 (16 %) and hPIV2 (11 %). The median age was 2 years for all hPIV types. Males were slightly greater than females for hPIV1 and hPIV2, with an equal distribution for hPIV3 and slightly more females than males for hPIV4. hPIV1 and hPIV2 had the highest or proportion of croup while hPIV3 and hPIV4 had the highest proportion of pneumonia. Within hPIV4 cases, distributions of diseases were; pneumonia (21 %, 95 % CI 17.1–25.7), bronchiolitis (18 %, 95 % CI 14.3–22.5), croup (2 %, 95 % CI 0.8–3.9), mixed illness of any of pneumonia, bronchiolitis or croup (4 %, 95 % CI 2.5–7.0) or other respiratory diseases (54 %, 95 % CI 49.1–59.6). Conclusions We used laboratory and administrative data to undertake a descriptive analysis of the association of hPIV1–4 with croup, bronchiolitis and pneumonia. hPIV4 appears to be more associated more with bronchiolitis and pneumonia and less with croup in our population.
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Affiliation(s)
- Sumana Fathima
- Provincial Laboratory for Public Health (ProvLab), Calgary, AB, Canada
| | - Kimberley Simmonds
- Alberta Health, Edmonton, AB, Canada.,University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Jesse Invik
- Provincial Laboratory for Public Health (ProvLab), Calgary, AB, Canada.,University of Calgary, Calgary, AB, T2N 1N4, Canada
| | | | - Steven Drews
- Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada. .,Provincial Laboratory for Public Health (ProvLab), Edmonton, AB, 2B1.03 WMC, Canada. .,University of Alberta Hospital, 8440-112 St, Edmonton, AB, T6G 2J2, Canada.
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12
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Freedman SB, Xie J, Neufeld MS, Hamilton WL, Hartling L, Tarr PI, Nettel-Aguirre A, Chuck A, Lee B, Johnson D, Currie G, Talbot J, Jiang J, Dickinson J, Kellner J, MacDonald J, Svenson L, Chui L, Louie M, Lavoie M, Eltorki M, Vanderkooi O, Tellier R, Ali S, Drews S, Graham T, Pang XL. Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis. Clin Infect Dis 2016; 62:1251-1258. [PMID: 26917812 DOI: 10.1093/cid/ciw099] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/13/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS). METHODS The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models. RESULTS Seventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I(2) = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I(2) = 0%). CONCLUSIONS Overall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.
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Affiliation(s)
- Stephen B Freedman
- Section of Gastroenterology, Alberta Children's Hospital, Alberta Children's Hospital Research Institute.,Section of Pediatric Emergency Medicine, Alberta Children's Hospital, University of Calgary, Canada
| | - Jianling Xie
- Section of Pediatric Emergency Medicine, Alberta Children's Hospital, University of Calgary, Canada
| | - Madisen S Neufeld
- Section of Pediatric Emergency Medicine, Alberta Children's Hospital, University of Calgary, Canada
| | - William L Hamilton
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, United Kingdom
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Phillip I Tarr
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
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13
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Drews S. Kontroversen in der Therapie früher Stadien des NSCLC – Chirurgische Resektion. Pneumologie 2016. [DOI: 10.1055/s-0035-1570299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Tsang RSW, Shuel M, Jamieson FB, Drews S, Hoang L, Horsman G, Lefebvre B, Desai S, St-Laurent M. Pertactin-negative Bordetella pertussis strains in Canada: characterization of a dozen isolates based on a survey of 224 samples collected in different parts of the country over the last 20 years. Int J Infect Dis 2014; 28:65-9. [PMID: 25244999 DOI: 10.1016/j.ijid.2014.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/29/2014] [Accepted: 08/02/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To detect and characterize pertactin-negative Bordetella pertussis in Canada, especially for isolates collected in recent years. METHODS A total of 224 isolates from the years 1994-2013 were screened by Western immuno-blot for expression of pertactin. Pertactin-negative isolates were characterized by serotyping, pulsed-field gel electrophoresis (PFGE), and genotyping of their pertactin, fimbriae 3, pertussis toxin subunit 1, and pertussis toxin gene promoter region, as well as the complete sequence of the pertactin gene. RESULTS Twelve isolates were pertactin-negative, giving an overall prevalence of 5.4%. However, no such isolate was found prior to 2011 and 17.8% of 62 isolates examined in 2012 were pertactin-negative. Ten pertactin-negative isolates contained a significant mutation in their pertactin (prn) genes. IS481 was found in the prn genes of eight isolates, while a single point mutation occurred either in the coding region (resulting in a premature stop codon) or in the promoter region (preventing gene transcription) in two other isolates. PFGE analysis also showed multiple profiles suggesting that several independent genetic events might have led to the emergence of these pertactin-negative strains rather than expansion of a single clone. CONCLUSIONS As reported elsewhere, pertactin-negative B. pertussis has emerged in Canada in recent years, notably in 2012. This coincided with an increase in pertussis activity in Canada. A further systematic study with a larger geographical representative sample is required to determine how these vaccine-negative strains may contribute to the overall changing epidemiology of pertussis in Canada.
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Affiliation(s)
- Raymond S W Tsang
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.
| | - Michelle Shuel
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada
| | - Frances B Jamieson
- Public Health Ontario, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Steven Drews
- ProvLab Alberta Health Services, Calgary, Alberta, Canada; Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta, Canada
| | - Linda Hoang
- Public Health Microbiology and Reference Laboratory, BC Public Health Microbiology and Reference Laboratory, Vancouver, British Columbia, Canada
| | - Greg Horsman
- Saskatchewan Disease Control Laboratory, Regina, Saskatchewan, Canada
| | - Brigitte Lefebvre
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Québec, Canada
| | - Shalini Desai
- Centre for Immunisation and Respiratory Infectious Diseases, Pubic Health Agency of Canada, Ottawa, Ontario, Canada
| | - Monique St-Laurent
- Centre for Immunisation and Respiratory Infectious Diseases, Pubic Health Agency of Canada, Ottawa, Ontario, Canada
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15
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Gratrix J, Bergman J, Egan C, Singh AE, Drews S, Read RR. P3.016 Prevalence and Correlates of Rectal-Only Chlamydia Infection at Two Canadian STI Clinics. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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16
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Pabbaraju K, Wong S, Song J, Singh AE, Drews S, Read RR. P2.030 Utility of Neisseria GonorrhoeaPositive APTIMA Specimens to Assess Strain Diversity and Antibiotic Resistance. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Bridger N, Drews S, Burdz T, Wiebe D, Pacheco AL, Ng B, Bernard K. Isolation and characterization of Pigmentiphaga-like isolates from human clinical material. J Med Microbiol 2013; 62:708-711. [PMID: 23355312 DOI: 10.1099/jmm.0.051615-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Species in the genus Pigmentiphaga are Gram-negative, catalase- and oxidase-positive rods derived exclusively to date from environmental sources. Features of strains most like Pigmentiphaga daeguensis or Pigmentiphaga kullae from a case of suppurative otitis media in a 6-year-old female post-transplant recipient and in a human stool sample are described.
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Affiliation(s)
- Natalie Bridger
- Memorial University, St John's NL, Canada.,Janeway Children's Health and Rehabilitation Centre, St John's NL, Canada
| | - Steven Drews
- Department of Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.,Provincial Laboratory of Public Health, Calgary AB, Canada
| | - Tamara Burdz
- Special Bacteriology Unit, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Deborah Wiebe
- Special Bacteriology Unit, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ana Luisa Pacheco
- Special Bacteriology Unit, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Betty Ng
- Special Bacteriology Unit, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Kathryn Bernard
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.,Special Bacteriology Unit, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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18
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Kuster SP, Drews S, Green K, Blair J, Davis I, Downey J, Fowler R, Katz K, Lapinsky S, McRitchie D, Pataki J, Powis J, Rose D, Sarabia A, Simone C, Simor A, Stewart T, McGeer A. Epidemiology of influenza-associated hospitalization in adults, Toronto, 2007/8. Eur J Clin Microbiol Infect Dis 2010; 29:835-43. [PMID: 20428910 PMCID: PMC2889286 DOI: 10.1007/s10096-010-0935-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Accepted: 04/03/2010] [Indexed: 11/25/2022]
Abstract
The purpose of this investigation was to identify when diagnostic testing and empirical antiviral therapy should be considered for adult patients requiring hospitalization during influenza seasons. During the 2007/8 influenza season, six acute care hospitals in the Greater Toronto Area participated in active surveillance for laboratory-confirmed influenza requiring hospitalization. Nasopharyngeal (NP) swabs were obtained from patients presenting with acute respiratory or cardiac illness, or with febrile illness without clear non-respiratory etiology. Predictors of influenza were analyzed by multivariable logistic regression analysis and likelihoods of influenza infection in various patient groups were calculated. Two hundred and eighty of 3,917 patients were found to have influenza. Thirty-five percent of patients with influenza presented with a triage temperature >or=38.0 degrees C, 80% had respiratory symptoms in the emergency department, and 76% were >or=65 years old. Multivariable analysis revealed a triage temperature >or=38.0 degrees C (odds ratio [OR] 3.1; 95% confidence interval [CI] 2.3-4.1), the presence of respiratory symptoms (OR 1.7; 95% CI 1.2-2.4), admission diagnosis of respiratory infection (OR 1.8; 95% CI 1.3-2.4), admission diagnosis of exacerbation of chronic obstructive pulmonary disease (COPD)/asthma or respiratory failure (OR 2.3; 95% CI 1.6-3.4), and admission in peak influenza weeks (OR 4.2; 95% CI 3.1-5.7) as independent predictors of influenza. The likelihood of influenza exceeded 15% in patients with respiratory infection or exacerbation of COPD/asthma if the triage temperature was >or=38.0 degrees C or if they were admitted in the peak weeks during the influenza season. During influenza season, diagnostic testing and empiric antiviral therapy should be considered in patients requiring hospitalization if respiratory infection or exacerbation of COPD/asthma are suspected and if either the triage temperature is >or=38.0 degrees C or admission is during the weeks of peak influenza activity.
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Affiliation(s)
- S. P. Kuster
- Department of Microbiology, Room 210, Mount Sinai Hospital, 600 University Ave., Toronto, Ontario M5G 1X5 Canada
- University of Toronto, Toronto, Canada
| | - S. Drews
- University of Toronto, Toronto, Canada
- Ontario Public Health Laboratory, Toronto, Canada
| | - K. Green
- Department of Microbiology, Room 210, Mount Sinai Hospital, 600 University Ave., Toronto, Ontario M5G 1X5 Canada
| | - J. Blair
- Ontario Public Health Laboratory, Toronto, Canada
| | - I. Davis
- The Scarborough Hospital, Toronto, Canada
| | - J. Downey
- Toronto East General Hospital, Toronto, Canada
| | - R. Fowler
- University of Toronto, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - K. Katz
- University of Toronto, Toronto, Canada
- North York General Hospital, Toronto, Canada
| | | | - D. McRitchie
- University of Toronto, Toronto, Canada
- North York General Hospital, Toronto, Canada
| | - J. Pataki
- Credit Valley Hospital, Mississauga, Canada
| | - J. Powis
- Toronto East General Hospital, Toronto, Canada
| | - D. Rose
- The Scarborough Hospital, Toronto, Canada
| | - A. Sarabia
- Credit Valley Hospital, Mississauga, Canada
| | - C. Simone
- Toronto East General Hospital, Toronto, Canada
| | - A. Simor
- University of Toronto, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | | | - A. McGeer
- Department of Microbiology, Room 210, Mount Sinai Hospital, 600 University Ave., Toronto, Ontario M5G 1X5 Canada
- University of Toronto, Toronto, Canada
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Scully L, Zhang S, Witkowska M, Drews S, Richardson S. O7 Evaluation of Pyrosequencing® of the secA1 gene for the identification of Nocardia species. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70154-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Higgins R, Hung S, Stewart T, Berry R, Hamid-Allie A, Mazzulli T, Drews S. O51 Human surveillance for West Nile meningoencephalitis infection in Ontario in 2007 and 2008. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Gundling N, Drews S, Hoedemaker M. Comparison of Two Different Programmes of Ovulation Synchronization in the Treatment of Ovarian Cysts in Dairy Cows. Reprod Domest Anim 2009; 50:893-900. [PMID: 19416488 DOI: 10.1111/j.1439-0531.2009.01342.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2008] [Indexed: 11/28/2022]
Abstract
It was the aim of this field study to evaluate two different protocols of ovulation synchronization for the treatment of ovarian cysts and their effect on reproductive performance in dairy cows. In addition, factors with a possible influence on treatment success and pregnancy outcome as well as costs per pregnancy were analysed. The study was performed with 130 German Holsteins with ovarian cysts diagnosed on days 55 to 60 postpartum. Cows belonging to group 1 (n = 65) received a modified ovsynch protocol [day 0: 0.15 mg cloprostenol (PGF) + 0.02 mg buserelin acetate (GnRH); day 14: PGF; day 16: GnRH]. Group 2 (n = 65) was treated with the conventional ovsynch protocol (day 0: GnRH; day 7: PGF; day 9: GnRH). Timed artificial insemination was performed 20 to 24 h later. Cows without ovarian cysts served as controls. Treatment success (disappearance of the ovarian cyst) after the first ovsynch cycle was higher in group 1 (66.2%) than in group 2 (23.1%, p < 0.05). Reproductive measures in group 1 were comparable with those of the control group and, compared with group 2, were conspicuously better (66.2%, 76.9%, 83.1%, 59.5% vs. 40.0%, 50.7%, 60.0%, 27.5% for cumulative pregnancy rate after treatment cycle 1 to 3 and second service conception rate, respectively, p < 0.05). Overconditioned cows and cows with larger ovarian cysts showed a diminished treatment and pregnancy success. In group 1, costs per pregnancy were only slightly higher than in the control group (group 1: €352.44, group 2: €484.59, control group: €333.77). In conclusion, our results suggest that ovsynch protocols can be used in the treatment of ovarian cysts. The modified ovsynch protocol led to a better cure rate as well as a better reproductive performance, and was economically beneficial compared with a conventional ovsynch protocol.
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Affiliation(s)
- N Gundling
- Production Medicine Unit, Clinic for Cattle, University of Veterinary Medicine Hannover, Hannover, Germany
| | - S Drews
- Production Medicine Unit, Clinic for Cattle, University of Veterinary Medicine Hannover, Hannover, Germany
| | - M Hoedemaker
- Production Medicine Unit, Clinic for Cattle, University of Veterinary Medicine Hannover, Hannover, Germany
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22
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Mühlhofer H, Ercan Y, Drews S, Matsuura M, Meissner J, Linsenmaier U, Putz R, Müller-Gerbl M. Mineralisation and mechanical strength of the subchondral bone plate of the inferior tibial facies. Surg Radiol Anat 2008; 31:237-43. [DOI: 10.1007/s00276-008-0430-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 10/06/2008] [Indexed: 10/21/2022]
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23
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Vayalumkal JV, Streitenberger L, Wray R, Goldman C, Freeman R, Drews S, Matlow A. Survey of isolation practices at a tertiary care pediatric hospital. Am J Infect Control 2007; 35:207-11. [PMID: 17482990 DOI: 10.1016/j.ajic.2006.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Revised: 03/06/2006] [Accepted: 03/06/2006] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although isolation precautions are an important aspect of hospital infection control, current rates of isolation in a pediatric hospital and rates of compliance with established precautions are unknown. We therefore initiated hospital-wide point prevalence studies to determine unit-specific rates of patient isolation and compliance with proper isolation requirements focusing on communication of isolation status and availability of personal protective equipment. In this report, we present data from the first 14 months of the study. METHODS This was a prospective observational study. Twice monthly, between January 2004 and February 2005, infection control professionals reviewed the types and appropriateness of isolation of all hospitalized patients, except for those on the psychiatry unit. RESULTS Seventeen percent of patients in the hospital during the study period were isolated, most frequently for community-acquired infections. Droplet isolation precautions were the most common form of isolation. Overall, only 74.6% of patients were isolated appropriately. The solid organ transplantation, hematology/oncology, and bone marrow transplantation units were those with the highest rates of inappropriate isolation. CONCLUSION At our hospital, community-acquired infections, in particular respiratory infections, were the most common reasons for patient isolation. Monitoring of the appropriateness of isolation precautions offers the opportunity to reduce health care-related transmission of infection and identify specific target areas for improvement.
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Affiliation(s)
- Joseph V Vayalumkal
- Division of Infectious Diseases, The Hospital For Sick Children, Toronto, Canada
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Abstract
Ginkgo biloba extract EGb 761 was studied for its nephroprotective effects in experimentally diabetic and hypoxic rats. Duration of streptozotocin-induced diabetes was 4 months, that of respiratoric hypoxia of the diabetic group 20 min. The daily dose of 100 mg EGb/kg bodyweight started 1 month after induction of the diabetes. EGb reduced diabetes-induced morphological alterations of the kidney such as increase in volume of glomeruli, capillary tufts, urinary space, and thickening of Bowman's capsule basement membrane. Diabetically increased immunostaining of interstitial collagenes of types I, III, and VI was diminished by the EGb extract. EGb reduced the relative total SOD activity from 163% in diabetic kidney to 46%. Additional hypoxia-induced ultrastructural damage was also diminished.
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Affiliation(s)
- K Welt
- Department of Medicine, Institute of Anatomy, University of Leipzig, Germany
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25
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Machraoui A, Möllmann HW, Drews S, Jädicke W, Barmeyer J. [Aortic insufficiency with signs of inflammation and negative blood cultures]. Internist (Berl) 1992; 33:613-7. [PMID: 1356942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Affiliation(s)
- A Machraoui
- Abteilung für Kardiologie und Angiologie, Medizinische Universitätsklinik und Poliklinik, Bergmannsheil, Bochum
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Jäger D, Drews S, Hüppe D, Machraoui A, Krieg M, Barmeyer J. [Successful fibrinolytic therapy of early diagnosed coumarin necrosis]. Med Klin (Munich) 1992; 87:334-8. [PMID: 1635524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- D Jäger
- Abteilung für Kardiologie und Angiologie, Universitätsklinik, Ruhr-Universität Bochum
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Machraoui A, Hinrichsen M, Jäger D, Lemke B, Drews S, Lange S, Barmeyer J. [Intolerance reactions to ionic and nonionic contrast media in cardiac diagnosis. A randomized double-blind study]. Dtsch Med Wochenschr 1991; 116:321-6. [PMID: 1997305 DOI: 10.1055/s-2008-1063614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Reactions to an ionic and a nonionic contrast medium were compared in a randomized double-blind trial involving 1153 patients (897 men, 256 women; mean age 56 [18-84] years) who underwent left-heart catheterization with coronary angiography. 584 patients (group 1) received the ionic contrast medium meglumine diatrizoate (Urografin 76%), while 569 (group 2) received the nonionic iopromide (Ultravist -370). Reactions of skin and mucosae, heart and circulation, lungs and respiratory tract, as well as of the central nervous system were noted. There was no significant difference between the two groups with respect to age, weight, height, allergic predisposition, left-ventricular ejection fraction, or serum electrolyte concentrations. Mild reactions, not requiring any treatment, occurred in 108 of the 1153 patients (9.4%), 85 (14.6%) in group 1 and 23 (4%) in group 2 (P less than 0.001). Severe reaction requiring treatment occurred in eight patients of group 1 (1.4%) and 14 of group 2 (2.5%)--difference not significant. Ventricular fibrillation was more frequent among group 2 patients (four compared with one in group 1), while two of three asystoles requiring treatment occurred in group 1 patients. The results show that, while mild reactions not requiring treatment were clearly less frequent after nonionic contrast medium injection, the risk of severe reactions was not reduced by their use.
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Affiliation(s)
- A Machraoui
- Abteilung für Kardiologie und Angiologie, Berufsgenossenschaftliche Krankenanstalten Bergmannsheil Bochum
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Moersch E, Kerz-Rühling I, Drews S, Nern RD, Kennel K, Kelleter R, Rodriguez C, Fischer R, Goldschmidt O. [Psychopathology of myocardial infarct patients]. Psyche (Stuttg) 1980; 34:493-587. [PMID: 7414000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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