Publications by authors named "Jeannette Comeau"

Introduction: Acceptance of recommended vaccines is lower among pregnant people compared to non-pregnant adults, yet no tool has specifically measured prenatal vaccine hesitancy. We evaluated the performance of an existing adult Vaccine Hesitancy Scale (aVHS) in measuring vaccine hesitancy toward routinely recommended prenatal vaccines.

Methods: Between December 2021 and April 2022, we conducted a cross-sectional national online survey with 917 US postpartum adults 18-49 years old who had given birth in the past six months.

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Evidence-based insertion and maintenance bundles are effective in reducing the incidence of central line-associated bloodstream infections (CLABSI) in intensive care unit (ICU) settings. We studied the adoption and compliance of CLABSI prevention bundle programs and CLABSI rates in ICUs in a large network of acute care hospitals across Canada.

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Article Synopsis
  • * 81% of the 5,143 pediatric cases occurred during the Omicron period, with fewer children needing intensive care compared to pre-Omicron times (11% vs. 14%), but no notable difference in mortality rates was found.
  • * The findings emphasize that many hospitalized children had pre-existing health conditions and indicate a surge in healthcare-associated COVID-19 cases during Omicron, although overall disease severity appeared to decline.
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The purpose of this study was to better understand barriers and enabling conditions for HPV vaccination in school-based vaccination programs in Canada. Semi-structured interviews were conducted by telephone or in person with parents, nurses, and school staff (n = 50) in three Canadian provinces. Interviews explored views on HPV and HPV vaccination, strengths and weaknesses of the school-based HPV vaccination programs and proposed interventions to increase uptake.

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Aim: To co-create parental presence practice recommendations across Canadian NICUs during pandemics caused by respiratory pathogens such as COVID-19.

Methods: Recommendations were developed through evidence, context, Delphi and Values and Preferences methods. For Delphi 1 and 2, participants rated 50 items and 20 items respectively on a scale from 1 (very low importance) to 5 (very high).

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Canada is one of the most multicultural countries in the world, with growing numbers of families who do not speak English or French as a first language. However, providing language-concordant services for patients with non-official language preference (NOLP) is not a standardized or measured component of our healthcare system, reflecting the historical marginalization of minority groups in our society. Existing evidence from other countries demonstrates the importance of language as a social determinant of health, and illustrates improved healthcare outcomes for patients with NOLP with the use of medical interpretation.

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Unlabelled: Lyme arthritis can present similarly to other causes of joint pain and swelling including septic arthritis and other acute and chronic arthropathies of childhood. Septic arthritis, although rare, constitutes an orthopedic emergency and requires early surgical intervention to reduce the risk of permanent joint damage. Currently, results of standard serologic tests to diagnose Lyme disease take days to weeks, which is unhelpful in acute clinical decision-making.

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Background: There has been dramatic reduction in serotype b (Hib) since introduction of Hib vaccines, but children still experience serious invasive (Hi) disease caused by various serotype and non-typeable bacteria. The object of this study was to describe the serotype distribution and clinical spectrum of Hi bacteremia in children admitted to Canadian hospitals.

Methods: All children with Hi bacteremia admitted 2013 through 2017 to 10 centres across Canada were included.

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Background: Recent studies have demonstrated the effectiveness of nirmatrelvir-ritonavir in reducing the risk of progression to severe disease among outpatients with mild to moderate coronavirus disease 2019 (COVID-19); however, data are limited regarding the use and role of nirmatrelvir-ritonavir among hospitalized patients. This study describes the use and outcomes of nirmatrelvir-ritonavir among adults hospitalized with COVID-19 in a sentinel network of Canadian acute care hospitals during the Omicron variant phase of the pandemic.

Methods: The Canadian Nosocomial Infection Surveillance Program conducts surveillance of hospitalized patients with COVID-19 in acute care hospitals across Canada.

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This rapid systematic review of evidence asks whether (i) wearing a face mask, (ii) one type of mask over another and (iii) mandatory mask policies can reduce the transmission of SARS-CoV-2 infection, either in community-based or healthcare settings. A search of studies published 1 January 2020-27 January 2023 yielded 5185 unique records. Due to a paucity of randomized controlled trials (RCTs), observational studies were included in the analysis.

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Article Synopsis
  • Trends in severe COVID-19 outcomes in Canada highlight a shift in hospitalization rates and associated risks during different waves of the pandemic, particularly higher admissions in the later waves.
  • A study conducted across 155 hospitals included both adults and children, examining data from March 2020 to May 2022, focusing on severe outcomes such as ICU admissions and death rates.
  • Findings indicate that while overall hospitalizations increased in later waves, the rates of severe outcomes were lower, especially among vaccinated patients compared to the unvaccinated.
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  • Antimicrobial resistance poses a significant challenge in treating infections, particularly in hospitalized patients, but there is limited data regarding its use in pediatric populations compared to adults.
  • A study analyzed antimicrobial use (AMU) in nine Canadian hospitals, collecting data from pediatric inpatients over 2017 and 2018, with results reported as days of therapy (DOT) per 1000 patient days (DOT/1000pd).
  • The findings indicated that the overall AMU was 481 DOT/1000pd, with the highest usage in Pediatric ICUs, and identified specific antimicrobials commonly used in different wards, highlighting the need for ongoing surveillance and stewardship efforts.
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  • Clostridioides difficile infection (CDI) is a significant health issue for children, particularly in hospitals, leading to various health complications.
  • * The study focuses on the trends of CDI in both healthcare environments and the community in Canada, detailing cases in inpatient and outpatient settings.
  • * It also addresses the prevalence of recurrent CDI infections among affected children, highlighting the ongoing challenge in managing this condition.*
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Background: Use of quality indicators is one strategy recommended to assess antimicrobial prescribing for pediatric inpatients.

Objective: To achieve consensus from infectious diseases clinicians on quality indicators that characterize appropriate empiric antimicrobial use for the management of infectious syndromes in pediatric inpatients.

Methods: This study was completed using the Delphi technique.

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Objectives: To improve dissemination and accessibility of guidelines to healthcare providers at our institution, guidance for infectious syndromes was incorporated into an electronic application (e-app). The objective of this study was to compare empiric antimicrobial prescribing before and after implementation of the e-app.

Design: This study was a before-and-after trial.

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Under-vaccination is a complex problem that is not simple to address whether this is for routine childhood immunization or for coronavirus disease 2019 (COVID-19) vaccination. Vaccination mandates has been one policy instrument used to try to increase vaccine uptake. While the concept may appear straight forward there is no standard approach.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a respiratory illness called the novel coronavirus 2019 (COVID-19). COVID-19 was declared a pandemic on March 11, 2020. Bow tie analysis (BTA) was applied to analyze the hazard of SARS-CoV-2 for three receptor groups: patient or family member at the IWK Health Centre in acute care, staff member at a British Columbia Forest Safety Council (BCFSC) wood pellet facility, and staff member at the Suncor refinery in Sarnia, Ontario.

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Article Synopsis
  • - The COVID-19 pandemic has heavily impacted healthcare systems and resource availability.
  • - A study was conducted comparing Clostridioides difficile infection (CDI) rates before and during the pandemic in 71 Canadian hospitals.
  • - Results from the study showed a significant increase in CDI rates during the pandemic period.
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Cerebrospinal fluid shunt-associated surgical site infection surveillance for 3 months compared to 12 months after surgery captures 83% of cases with no significant differences in patient characteristics, surgery types, or pathogens. A shorter 3-month follow-up can reduce resource use and allow for more timely reporting of healthcare-associated infection rates for hospitals.

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Article Synopsis
  • - The study examined over 18,000 cases of Clostridioides difficile infection (CDI) in Canadian hospitals from 2015 to 2019, finding that healthcare-associated (HA) infections accounted for 74.4% while community-associated (CA) infections made up 25.6%.
  • - During the study period, HA CDI rates dropped by 23.8% and CA rates by 18.8%, with HA CDI linked to higher 30-day mortality rates compared to CA CDI.
  • - The most prevalent ribotypes were RT027, RT106, RT014, and RT020, with RT027 showing a stronger association with CDI-related deaths; the findings emphasize the need for ongoing infection prevention
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  • The study aimed to review existing evidence regarding the impact of four SARS-CoV-2 variants of concern (Alpha, Beta, Gamma, Delta) on public health measures as of May 2021.
  • A rapid scoping review was conducted by analyzing data from multiple databases, focusing on studies published after October 2020 that addressed VOCs and their relation to public health.
  • Results indicated that most studies centered on the Alpha variant and emphasized the importance of enhanced infection control measures and accelerated vaccine rollouts to manage the spread of these variants effectively.
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  • A study analyzed hospitalized pertussis cases in Australia from 2012 to 2019, focusing on the effects of antenatal vaccination on severe pertussis cases in children aged 0 to 15 years.
  • Results showed a significant decrease in cases under 2 months of age after the introduction of maternal vaccination, with vaccine effectiveness estimated at 84.3%.
  • Despite high immunization rates, older children (12+ months) still accounted for a notable percentage of hospitalizations, highlighting the need for new vaccine strategies to further protect this age group.
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Background: Immunizations have led to a decrease in the incidence of invasive meningococcal disease (IMD) in Canada, but this infection still leads to significant morbidity and mortality.

Objectives: The purpose of this study was to determine the burden of illness and management of IMD in paediatric hospitals.

Methods: Data were collected on all cases of IMD in eight paediatric hospitals from 2013 to 2017.

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For control of COVID-19, community immunity is required, necessitating widespread immunization. COVID-19 vaccines are coming to Canada, with the government announcing in August 2020 agreements with four different companies for their COVID-19 vaccine if their trials are successful. Never before has public health had to rapidly develop a vaccine introduction program for multiple new but differing vaccines with the added pressure that the program is needed across all ages and in all Canadian communities and there is high probability of not enough vaccine to go around at the start.

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