Extragenital testing increases case detection of gonorrhea and chlamydia: The impact of implementing nucleic acid amplification testing.

Background: Nucleic acid amplification testing (NAAT) was validated in Ontario in 2018 to test for chlamydia and gonorrhea at extragenital (pharyngeal, rectal) sites. Prior to this validation, extragenital testing could be done only by culture in Ontario. The objective of this study was to determine the number and proportion of gonorrhea and chlamydia cases that were detected exclusively through extragenital (pharyngeal and/or rectal) testing after the implementation of extragenital NAAT for these two infections at Sexual Health Clinic among gay, bisexual, and other men who have sex with men (gbMSM).

Inconclusive Syphilis Results: A Retrospective Review of Public Health Results.

In the context of increasing syphilis incidence in many Western countries, we sought to better understand the frequency and outcomes associated with inconclusive serologic syphilis results. To accomplish this, we reviewed all inconclusive results that arose from an indeterminant confirmatory treponemal screen (specifically the particulate agglutination test), which were reported to Ottawa Public Health from January 1, 2019, through December 31, 2019. Our case review identified that 52 persons generated such test results during the study period, of whom 44.

Infection prevention and control lapse involving medical equipment reprocessing at a family medicine clinic in Ottawa, Ontario, 2018.

Background: In April 2018, Ottawa Public Health identified a large-scale infection prevention and control (IPAC) lapse spanning 15 years related to inadequate reprocessing of reusable critical medical equipment used in a family medicine clinic.

Objectives: To describe the public health response to, and estimate the risk of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission from, this IPAC lapse.

Methods: Patients who underwent a procedure of concern (during which reusable equipment may have been used) at this clinic were identified using Ontario Health Insurance Plan data and individually notified.

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.

Comparing those diagnosed early versus late in their HIV infection: implications for public health.

Routine HIV surveillance cannot distinguish between recent and older infections: HIV-positive individuals reported soon or long after infection are both considered new diagnoses from a surveillance perspective, notwithstanding the time since infection. This lack of specificity makes it difficult to understand the jurisdiction-specific trends in HIV epidemiology needed for prevention planning. Previous efforts have been made to discern such timing of infection, but these methodologies are not easily applied in a public health setting.