Pneumococcal vaccination programs and the burden of invasive pneumococcal disease in Ontario, Canada, 1995-2011.

Background: In 1995, a publicly funded pneumococcal vaccination program for 23-valent polysaccharide vaccine (PPV23) was introduced in Ontario. Conjugate vaccines were authorized in 2001 (PCV7), 2009 (PCV10) and 2010 (PCV13).

Methods: From 1995-2011, active, population-based surveillance for invasive pneumococcal disease (IPD) was conducted in Metropolitan Toronto and Peel Region, Canada.

Temporal quantification of oxygen saturation ranges: an effort to reduce hyperoxia in the neonatal intensive care unit.

Objective: To reduce exposure to hyperoxia and its associated morbidities in preterm neonates.

Study Design: A multidisciplinary group was established to evaluate oxygen exposure in our neonatal intensive care unit. Infants were assigned target saturation ranges and signal extraction technology implemented to temporally quantify achievement of these ranges.

Epidemiology and outcome of pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) in Canadian hospitals.

Background: MRSA remains a leading cause of hospital-acquired (HAP) and healthcare-associated pneumonia (HCAP). We describe the epidemiology and outcome of MRSA pneumonia in Canadian hospitals, and identify factors contributing to mortality.

Methods: Prospective surveillance for MRSA pneumonia in adults was done for one year (2011) in 11 Canadian hospitals.

Obesity is associated with sensorineural hearing loss in adolescents.

Objectives/hypothesis: Childhood obesity, defined as body mass index (BMI) ≥ 95%, is a significant health problem associated with a variety of disorders, and in adults it has been found to be a risk factor for hearing loss. We investigated the hypothesis that obese children are at increased risk of sensorineural hearing loss (SNHL).

Study Design: A complex, multistage, stratified geographic area design for collecting representative data from noninstitutionalized U.

Prevalence of methicillin-resistant Staphylococcus aureus in skin and soft tissue infections in patients presenting to Canadian emergency departments.

Background: Community-associated methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common cause of skin and soft tissue infection (SSTI) worldwide. The prevalence of MRSA in SSTIs across Canada has not been well described. Studies in the United States have shown significant geographic variability in the prevalence of MRSA.

Efficacy of admission screening for extended-spectrum beta-lactamase producing Enterobacteriaceae.

Objective: We hypothesized that admission screening for extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) reduces the incidence of hospital-acquired ESBL-E clinical isolates.

Design: Retrospective cohort study.

Setting: 12 hospitals (6 screening and 6 non-screening) in Toronto, Canada.

Risk factors for influenza among health care workers during 2009 pandemic, Toronto, Ontario, Canada.

This prospective cohort study, performed during the 2009 influenza A(H1N1) pandemic, was aimed to determine whether adults working in acute care hospitals were at higher risk than other working adults for influenza and to assess risk factors for influenza among health care workers (HCWs). We assessed the risk for influenza among 563 HCWs and 169 non-HCWs using PCR to test nasal swab samples collected during acute respiratory illness; results for 13 (2.2%) HCWs and 7 (4.

Sexually transmitted infections among HIV-infected women in Thailand.

Background: Data on sexually transmitted infections (STI) prevalence among HIV-infected women in Thailand are limited. We studied, among HIV-infected women, prevalence of STI symptoms and signs; prevalence and correlates of having any STI; prevalence and correlates of Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (GC) among women without CT and/or GC symptoms or signs; and number of women without CT and/or GC symptoms or signs needed to screen (NNS) to detect one woman with CT and/or GC overall, among pregnant women, and among women ≤25 years.

Methods: During October 2004-September 2006, HIV-infected women at 3 obstetrics and gynecology clinics were asked about sexual behaviors and STI symptoms, physically examined, and screened for chlamydia, gonorrhea, trichomoniasis, and syphilis.

Performance of Clinical Criteria for Screening of Possible Antiretroviral Related Mitochondrial Toxicity in HIV-Infected Children in Accra.

Mitochondrial damage is implicated in highly active antiretroviral therapy (HAART) toxicity. HIV infection also causes mitochondrial toxicity (MT). Differentiating between the two is critical for HIV management.

Knowledge, attitudes, and practices regarding syphilis screening among men who have sex with men in San Francisco.

Background: Syphilis screening for men who have sex with men (MSM) in San Francisco (SF) is recommended every 3 to 6 months. We surveyed MSM in SF to determine the prevalence and factors associated with complying with that recommendation, identify screening barriers, and investigate whether identifying low perceived syphilis risk as a reason for not testing correlated with syphilis risk factors.

Methods: We conducted a cross-sectional survey as part of the National HIV Behavioral Surveillance System.

The NIH genetic testing registry: a new, centralized database of genetic tests to enable access to comprehensive information and improve transparency.

The National Institutes of Health Genetic Testing Registry (GTR; available online at http://www.ncbi.nlm.

Sentinel surveillance for influenza-like illness, severe acute respiratory illness, and laboratory-confirmed influenza in Kinshasa, Democratic Republic of Congo, 2009-2011.

Little is known about influenza in central Africa. We conducted sentinel surveillance for influenza-like illness, severe acute respiratory illness, and laboratory-confirmed influenza at 5 sites in Kinshasa, Democratic Republic of Congo, from January 2009 through April 2011. We obtained samples from 4156 patients, of whom 605 (15%) had specimens containing laboratory-confirmed influenza virus.

A hairy tale: successful patient education strategies to reduce prehospital hair removal by patients undergoing elective caesarean section.

Inappropriate hair removal is a risk factor for postoperative surgical site infections (SSIs). A series of obstetric patient awareness interventions were introduced regarding hair self-removal before presentation at hospital. Active inpatient and outpatient surveillance of SSIs following caesarean section was undertaken prospectively.

A left cerebellar pathway mediates language in prematurely-born young adults.

Preterm (PT) subjects are at risk for developmental delay, and task-based studies suggest that developmental disorders may be due to alterations in neural connectivity. Since emerging data imply the importance of right cerebellar function for language acquisition in typical development, we hypothesized that PT subjects would have alternate areas of cerebellar connectivity, and that these areas would be responsible for differences in cognitive outcomes between PT subjects and term controls at age 20 years. Nineteen PT and 19 term control young adults were prospectively studied using resting-state functional MRI (fMRI) to create voxel-based contrast maps reflecting the functional connectivity of each tissue element in the grey matter through analysis of the intrinsic connectivity contrast degree (ICC-d).

Fractures and refractures after femoral locking compression plate fixation in children and adolescents.

Background: Locking compression plates (LCPs) are being increasingly utilized in fixation of fractures and osteotomies in the pediatric population. However, plate insertion or removal may pose a risk of femoral fractures or refractures. The goal of this study was to analyze failure patterns associated with LCPs and identify possible contributing factors.

4-aminopyridine toxicity: a case report and review of the literature.

Introduction: 4-Aminopyridine (4-AP) selectively blocks voltage-gated potassium channels, prolongs the action potential, increases calcium influx, and subsequently, enhances interneuronal and neuromuscular synaptic transmission. This medication has been studied and used in many disease processes hallmarked by poor neuronal transmission in both the central and peripheral nervous systems including: multiple sclerosis (MS), spinal cord injuries (SCI), botulism, Lambert-Eaton syndrome, and myasthenia gravis. It has also been postulated as a potential treatment of verapamil toxicity and reversal agent for anesthesia-induced neuromuscular blockade.

Assessing motivational interviewing integrity for group interventions with adolescents.

The group format is commonly used in alcohol and other drug (AOD) adolescent treatment settings, but little research exists on the use of motivational interviewing (MI) in groups. Further, little work has assessed the integrity of MI delivered in group settings. This study describes an approach to evaluate MI integrity using data from a group MI intervention for at-risk youth.

Decreased susceptibility to noncarbapenem antimicrobials in extended-spectrum-β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in Toronto, Canada.

Retrospective review from 11 Canadian hospitals showed increasing incidence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae from 0.12 per 1,000 inpatient days during 2005 to 0.47 per 1,000 inpatient days during 2009.

Carbapenem-resistant Gram-negative bacilli in Canada 2009-10: results from the Canadian Nosocomial Infection Surveillance Program (CNISP).

Objectives: To investigate the occurrence and molecular mechanisms associated with carbapenemases in carbapenem-resistant Gram-negative isolates from Canadian cases.

Methods: Twenty hospital sites across Canada submitted isolates for a 1 year period starting 1 September 2009. All Enterobacteriaceae with MICs ≥ 2 mg/L and Acinetobacter baumannii and Pseudomonas aeruginosa with MICs ≥ 16 mg/L of carbapenems were submitted to the National Microbiology Laboratory (NML) where carbapenem MICs were confirmed by Etest and isolates were characterized by PCR for carbapenemase genes, antimicrobial susceptibilities, PFGE and plasmid isolation.

Too close for comfort: screening strategy to detect methicillin-resistant Staphylococcus aureus conversion in exposed roommates.

All 899 roommates exposed to methicillin-resistant Staphylococcus aureus (MRSA) index cases were studied over 57 months. MRSA detection is better at approximately 3 days (50%-55%) or 7 days (56%) after contact has been broken than day 0 (30%). Polymerase chain reaction testing at day 3 performs similarly to culture at day 7.