Longitudinal monitoring of sewershed resistomes in socioeconomically diverse urban neighborhoods.

Background: Understanding factors associated with antimicrobial resistance (AMR) distribution across populations is a necessary step in planning mitigation measures. While associations between AMR and socioeconomic-status (SES), including employment and education have been increasingly recognized in low- and middle-income settings, connections are less clear in high-income countries where SES remains an important influence on other health outcomes.

Methods: We explored the relationship between SES and AMR in Calgary, Canada using spatially-resolved wastewater-based surveillance of resistomes detected by metagenomics across eight socio-economically diverse urban neighborhoods.

Rates of post procedural prophylactic antibiotic use following cardiac implantable electronic device insertion and the impact on surgical site infections in Alberta, Canada.

Background: The necessity of post procedural prophylactic antibiotics following clean surgeries is controversial. While most evidence suggests that there is no benefit from these additional antibiotics and guidelines do not support their use, there is a paucity of evidence as to how often they are still being used and their impact on infection outcomes. The current study assessed the use of prophylactic antibiotics following cardiac implantable electronic device (CIED) implantations in the province of Alberta, and their impact on infection and mortality.

Antimicrobial Use among Adult Inpatients in Northern Canada, 2019-2021.

Background: Antimicrobial use data from inpatients in northern Canada suitable to inform stewardship programs are limited.

Objective: As a special project of the Canadian Nosocomial Infection Surveillance Program, to describe antimicrobial use for inpatients in northern Canadian acute care hospitals.

Methods: Participating acute care hospitals serving adult or mixed adult and pediatric populations in northern Canada submitted annual data on the use of all systemic antimicrobials from 2019 to 2021.

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.

Background: Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain.

Methods: In a multicenter, noninferiority trial, we randomly assigned hospitalized patients (including patients in the intensive care unit [ICU]) who had bloodstream infection to receive antibiotic treatment for 7 days or 14 days.

Health Economic Evaluation of Antimicrobial Stewardship, Procalcitonin Testing, and Rapid Blood Culture Identification in Sepsis Care: A 90-Day Model-Based, Cost-Utility Analysis.

Objective: We evaluated the cost-effectiveness of a bundled intervention including an antimicrobial stewardship program (ASP), procalcitonin (PCT) testing, and rapid blood culture identification (BCID), compared with pre-implementation standard care in critically ill adult patients with sepsis.

Methods: We conducted a decision tree model-based cost-effectiveness analysis alongside a previously published pre- and post-implementation quality improvement study. We adopted a public Canadian healthcare payer's perspective.

A quasi-experimental analysis comparing antimicrobial usage on COVID-19 and non-COVID-19 wards.

Objective: To describe antimicrobial usage (AMU) trends before and during the coronavirus disease 2019 (COVID-19) pandemic, between COVID-19 and non-COVID-19 wards, and if there was any association with a COVID-19 order set.

Design: Quasi-experimental retrospective interrupted time series analysis of AMU rates with a contemporaneous comparison of COVID-19 versus non-COVID-19 control wards. Analysis using incidence rate ratios (IRR) was conducted using a Poisson regression generalized linear model.

Evaluating the costs of bloodstream infections: a population-based cohort study in a large metropolitan Canadian region.

Objectives: We evaluated the costs of susceptible and resistant bloodstream infections (BSIs) in adults. Secondary outcomes were the impact of BSI on length of stay (LOS), readmissions and death.

Methods: We examined a population-based retrospective cohort of blood cultures from 2011 to 2018 in Calgary, Canada, linked to microcosting and gross costing data.

Clinical epidemiology and impact of Haemophilus influenzae airway infections in adults with cystic fibrosis.

Background: Haemophilus influenzae is prevalent within the airways of persons with cystic fibrosis (pwCF). H. influenzae is often associated with pulmonary exacerbations (PEx) in pediatric cohorts, but in adults, studies have yielded conflicting reports around the impact(s) on clinical outcomes such as lung function decline.

Corrigendum to "Rare but Not so Rare? The Evolving Spectrum of Whipple's Disease".

[This corrects the article DOI: 10.1155/2001/547516.].

Analysis of invasive group A streptococcal puerperal sepsis in Calgary, Alberta: clinical consequences and policy implications.

We analyzed invasive group A streptococcal puerperal sepsis cases in a large health zone in Alberta, Canada between 2013 and 2022. Of the 21 cases, 85.7% were adjudicated as hospital/delivery-acquired, with 2 clusters having identical isolates found through whole genome sequencing.

Real-world evidence of sotrovimab effectiveness for preventing severe outcomes in patients with COVID-19: A quality improvement propensity-matched retrospective cohort study of a pan-provincial program in Alberta, Canada.

Objectives: Post-marketing surveillance of sotrovimab's effect during implementation in the Canadian population is limited.

Methods: The study used a propensity score-matched retrospective cohort design. Follow-up began between the periods of December 15, 2021 and April 30 2022.

The airway microbiome of persons with cystic fibrosis correlates with acquisition and microbiological outcomes of incident infection.

Rationale: Chronic infection with in persons with cystic fibrosis (pwCF) has been linked to an increased risk of pulmonary exacerbations and lung function decline. We sought to establish whether baseline sputum microbiome associates with risk of incident infection and persistence in pwCF.

Methods: pwCF experiencing incident infections attending the Calgary Adult CF Clinic from 2010-2018 were compared with -negative sex, age (+/-2 years), and birth-cohort-matched controls.

The Role of Prophage ϕSa3 in the Adaption of ST398 Sublineages from Human to Animal Hosts.

sequence type (ST) 398 is a lineage affecting both humans and livestock worldwide. However, the mechanisms underlying its clonal evolution are still not clearly elucidated. We applied whole-genome sequencing (WGS) typing to 45 strains from China and Canada between 2005 and 2014, in order to gain insight into their evolutionary pathway.

The Use of Silver Oxynitrate Wound Dressings in the Treatment of Chronic Wounds: A Feasibility Pilot Study.

Objective: To evaluate the feasibility and effectiveness of a silver oxynitrate (Ag 7 NO 11 ) dressing on wound healing in patients with stalled chronic wounds.

Methods: A prospective pilot study was conducted to determine the feasibility and effect of using silver oxynitrate dressings within an outpatient setting in Alberta, Canada. A total of 23 patients (12 women and 11 men; mean age, 66.

Deployment of a human-centred clinical decision support system for pulmonary embolism: evaluation of impact on quality of diagnostic decisions.

Unlabelled: Pulmonary embolism (PE) is a serious condition that presents a diagnostic challenge for which diagnostic errors often happen. The literature suggests that a gap remains between PE diagnostic guidelines and adherence in healthcare practice. While system-level decision support tools exist, the clinical impact of a human-centred design (HCD) approach of PE diagnostic tool design is unknown.

Co-infection of SARS-CoV-2 with human coronavirus OC43 in a patient with underlying lung disease: A case report.

Co-infections with SARS-CoV-2 remain relatively rare and there is limited published data on the consequences of these events. We present the case of a 26-year-old man with SARS-CoV-2 and human coronavirus OC43 who had a severe infection resulting in prolonged hospitalization. Consideration of co-infections should be considered in high-risk patients.

Implementation strategies for hospital-based probiotic administration in a stepped-wedge cluster randomized trial design for preventing hospital-acquired Clostridioides difficile infection.

Background: Clostridioides difficile infection (CDI) is associated with considerable morbidity and mortality in hospitalized patients, especially among older adults. Probiotics have been evaluated to prevent hospital-acquired (HA) CDI in patients who are receiving systemic antibiotics, but the implementation of timely probiotic administration remains a challenge. We evaluated methods for effective probiotic implementation across a large health region as part of a study to assess the real-world effectiveness of a probiotic to prevent HA-CDI (Prevent CDI-55 +).

Effectiveness of Bio-K+ for the prevention of infection: Stepped-wedge cluster-randomized controlled trial.

Objective: To evaluate the impact of administering probiotics to prevent infection (CDI) among patients receiving therapeutic antibiotics.

Design: Stepped-wedge cluster-randomized trial between September 1, 2016, and August 31, 2019.

Setting: This study was conducted in 4 acute-care hospitals across an integrated health region.

Randomized trial of the safety and efficacy of anti-SARS-CoV-2 mAb in the treatment of patients with nosocomial COVID-19 (CATCO-NOS).

Background: Patients with nosocomial acquisition of COVID-19 have poor outcomes but have not been included in therapeutic trials to date.

Methods: A pragmatic open-label randomized controlled trial of anti-SARS-CoV-2 monoclonal antibodies (mAb) was performed in hospitalized patients with nosocomial COVID-19 infection in acute care hospitals spanning a provincial health care network. Participants within 5 days of first positive test or symptom onset were randomized to standard of care (SOC) plus a single dose intravenous mAb treatment (bamlanivimab or casirivimab/imdevimab) or SOC alone on a 2:1 basis.

Epidemiology and impact of methicillin-sensitive with β-lactam antibiotic inoculum effects in adults with cystic fibrosis.

is the most prevalent cystic fibrosis (CF) pathogen. Several phenotypes are associated with worsened CF clinical outcomes including methicillin-resistance and small-colony-variants. The inoculum effect (IE) is characterized by reduced β-lactam susceptibility when assessed at high inoculum.