Effectiveness and Safety of Antibiotic Prophylaxis for Persons Exposed to Cases of Invasive Group A Streptococcal Disease: A Systematic Review.

Among close contacts of patients with invasive group A streptococcal (iGAS) infection, the benefits and harms of chemoprophylaxis are uncertain. We conducted a systematic review of studies that reported on persons who, after being exposed to a case of laboratory-confirmed or probable iGAS, received any antibiotic prophylaxis for the prevention of GAS infection or carriage. Thirty-seven studies including 26 outbreak investigations and 11 case series or reports were included with predominantly descriptive information that suggested that antibiotic prophylaxis may be effective in preventing GAS infection or GAS carriage, with very few serious adverse events.

Describing the burden of diphtheria in Canada from 2006 to 2017, using hospital administrative data and reportable disease data.

Background: Canada has maintained a low incidence of toxigenic diphtheria since the 1990s, supported by continued commitment to publicly funded vaccination programs.

Objective: To determine whether hospitalization data, complemented with notifiable disease data, can describe the toxigenic respiratory and cutaneous diphtheria burden in Canada, and to assess if Canada is meeting its diphtheria vaccine-preventable disease-reduction target of zero annual cases of locally transmitted respiratory diphtheria.

Methods: Diphtheria-related hospital discharge data from 2006 to 2017 were extracted from the Discharge Abstract Database (DAD), and diphtheria case counts for the same period were retrieved from the Canadian Notifiable Disease Surveillance System (CNDSS), for descriptive analyses.

Combating ecosystem collapse from the tropics to the Antarctic.

Globally, collapse of ecosystems-potentially irreversible change to ecosystem structure, composition and function-imperils biodiversity, human health and well-being. We examine the current state and recent trajectories of 19 ecosystems, spanning 58° of latitude across 7.7 M km , from Australia's coral reefs to terrestrial Antarctica.

Acute flaccid myelitis in Canada, 2018 to 2019.

Starting in 2014, biennial clusters of acute flaccid myelitis (AFM), frequently described as "polio-like" illness, have been reported across the United States and elsewhere, often linked to enteroviruses. To assess AFM trends in Canada, we reviewed the Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS) for cases reported during the 2018 and 2019 calendar years that meet the Centers for Disease Control and Prevention case definitions for AFM. A total of 10 cases (8 in 2018 and 2 in 2019) met the confirmed AFM case definition and 30 (26 in 2018 and 4 in 2019) met the probable AFM case definition.

The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis.

Objective: This study assessed adherence with first-line gonorrhoea treatment recommendations in Ontario, Canada, following recent guideline changes due to antibiotic resistance.

Methods: We used interrupted times-series analyses to analyse treatment data for cases of uncomplicated gonorrhoea reported in Ontario, Canada, between January 2006 and May 2014. We assessed adherence with first-line treatment according to the guidelines in place at the time and the use of specific antibiotics over time.

A systematic review and appraisal of the quality of practice guidelines for the management of infections.

Background: Clinical guidelines help ensure consistent care informed by current evidence. As shifts in antimicrobial resistance continue to influence first-line treatment, up-to-date guidelines are important for preventing treatment failure. A guideline's development process will influence its recommendations and users' trust.