Publications by authors named "Kibsey P"

Unlabelled: Urinary tract infections (UTIs) pose a significant challenge to human health. Accurate and timely detection remains pivotal for effective intervention. Current urine culture techniques, while essential, often encounter challenges where urinalysis yields positive results, but subsequent culture testing produces a negative result.

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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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Background: Invasive group A streptococcal disease (iGAS) is caused by group A bacteria. In 2022, multiple disease alerts for iGAS in the Island Health region, in the context of increased infections in the paediatric population in Europe and the United States, prompted further investigation into local trends. This surveillance study summarizes epidemiological trends of iGAS in the region covered by Island Health, a regional health authority in British Columbia, in 2022.

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Article Synopsis
  • Carbapenems are vital last-resort antibiotics against multidrug-resistant infections, but their effectiveness is threatened by the global rise of carbapenem-resistant bacteria due to carbapenemase genes.
  • In Canada, a specific carbapenemase type has been identified as prevalent, capable of breaking down various antibiotics, and commonly found on mobile genetic elements like plasmids and transposons.
  • Through whole genome sequencing of 829 carbapenemase-producing isolates from 2010 to 2021, researchers discovered diverse plasmid clusters responsible for resistance spread, revealing both clonal and horizontal transmission patterns across different bacterial strains in Canada.
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  • 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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  • - 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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  • - 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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Background: Antimicrobial resistance is a growing threat to the world's ability to prevent and treat infections. Links between quantitative antibiotic use and the emergence of bacterial resistance are well documented. This study presents benchmark antimicrobial use (AMU) rates for inpatient adult populations in acute-care hospitals across Canada.

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Background: Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality; however, outbreaks of IPD are relatively rare. Homelessness and substance use are known risk factors for IPD and have been associated with several outbreaks in Canada, despite national recommendations for routine childhood and targeted adult pneumococcal vaccination.

Objectives: To describe the epidemiology and public health challenges related to an outbreak of novel serotype 4 IPD in a homeless and unstably housed population in Victoria, British Columbia during the autumn and winter of 2016-2017.

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  • There has been a global rise in carbapenem-resistant Acinetobacter species (CRAs) and carbapenemase-producing variants (CPAs) in hospitals, leading Canadian health authorities to monitor these infections from 2010 to 2016.
  • Data from 58 hospitals showed a low incidence rate of CRA cases (0.02 per 10,000 patient days), with the majority of isolates being CPA and two main clusters linked to specific resistance genes (OXA-235 and OXA-23).
  • Although CRA infections were uncommon and did not increase significantly, a notable portion of cases was associated with patients who had traveled recently, and the 30-day mortality for infected
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  • The study looked at how infections in hospitals have changed in Canada since a specific type of bacteria (NAP1) was first reported over 15 years ago.
  • They tracked patients with infections between 2009 and 2015 in 64 hospitals and collected data on their health and outcomes.
  • The results showed the number of hospital infections decreased, but the NAP1 strain was still common and more dangerous, causing more deaths compared to other strains.
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  • * A total of 261 CPE isolates from 238 patients were reported, with a low incidence rate and specific carbapenemase genes (bla at 64.8% and bla at 17.6%) being the most common.
  • * The research highlighted that 21% of CPE cases were linked to patients who had received medical care during international travel, and the 30-day mortality rate for CPE cases was 17.1%, but no significant increase in CPE occurrences was
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Background. Clostridium difficile is a major cause of gastrointestinal illness. Epidemic NAP1 strains contain toxins A and B, a deletion in repressor tcdC, and a binary toxin.

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Article Synopsis
  • Infectious disease outbreaks, particularly Vancomycin Resistant Enterococci and Clostridium difficile, significantly disrupt patient care and clinical operations, prompting urgent infection control measures by the Vancouver Island Health Authority from 2008 to 2009.
  • A quality improvement methodology involving collaboration among healthcare staff was utilized to create and test new practices aimed at reducing hospital-acquired infections, implemented through rapid cycles of evaluation and adjustment in a community hospital.
  • The implemented changes improved control of antibiotic-resistant infections, enhanced routine clinical activities, saved approximately $6.5 million annually, and shifted the Infection Prevention and Control approach from rule-based to risk-based management.
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Background: Following a Clostridium difficile infection outbreak, the Infection Prevention and Control team at our institution queried the risk of transmission via bedpans reprocessed in washer disinfectors (WDs). This study's objective was to determine the effectiveness of the mechanical action, detergent, and temperature on the eradication of C difficile spores in 1 type of WD model.

Materials And Methods: Three types of reusable bedpans/pots were inoculated with sterile human feces that contained 1 × 10(7) CFU/mL C difficile spores.

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Carbapenemase-producing organisms (CPOs) are a serious emerging problem for health care facilities worldwide. Owing to their resistance to most antimicrobial therapies, CPOs are difficult to treat and pose a challenge for infection prevention and control. Since 2010, lab-based surveillance for CPOs and PCR-based testing were implemented in British Columbia (BC), Canada.

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Polyphasic taxonomic analysis was performed on a clinical isolate (NML 06-3099T) from a cystic fibrosis patient, including whole-genome sequencing, proteomics, phenotypic testing, electron microscopy, chemotaxonomy and a clinical investigation. Comparative whole-genome sequence analysis and multilocus sequence analysis (MLSA) between Tatumella ptyseos ATCC 33301T and clinical isolate NML 06-3099T suggested that the clinical isolate was closely related to, but distinct from, the species T. ptyseos.

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Background: Cryptococcus gattii (Cg) infection emerged in British Columbia in 1999. A longitudinal, clinical description of patients has not been reported.

Methods: Medical records were reviewed for Cg patients identified through surveillance (1999-2007).

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The usefulness of carbapenems for gram-negative infections is becoming compromised by organisms harboring carbapenemases, enzymes which can hydrolyze the drug. Currently KPC (class A), NDM (class B), and OXA-48 types (class D) are the most globally widespread carbapenemases. However, among the GES-type class A extended-spectrum β-lactamases (ESBLs) there are variants that hydrolyze carbapenems, with blaGES-5 being the most common.

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Background: Clostridium difficile is an anaerobic, Gram-positive bacterium that has been implicated as the leading cause of antibiotic-associated diarrhea. Metronidazole is currently the first-line treatment for mild to moderate C. difficile infections.

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Objectives: Emergence of plasmids harbouring bla(NDM-1) is a major public health concern due to their association with multidrug resistance and their potential mobility.

Methods: PCR was used to detect bla(NDM-1) from clinical isolates of Providencia rettgeri (PR) and Klebsiella pneumoniae (KP). Antimicrobial susceptibilities were determined using Vitek 2.

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Article Synopsis
  • Clostridium difficile is a major cause of antibiotic-associated diarrhea in healthcare settings, with metronidazole being the standard treatment, but recurrence rates can be high (15-35%).
  • A study characterized a metronidazole-resistant strain of C. difficile using whole-genome sequencing, revealing genetic changes related to core metabolic pathways that may underpin this resistance.
  • This research is significant as it provides the first stable characterization of metronidazole resistance in C. difficile, paving the way for further investigation into how this resistance develops and persists.
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Although community-onset bloodstream infection (BSI) is recognized as a major cause of morbidity and mortality, its epidemiology has not been well defined in non-selected populations. We conducted population-based laboratory surveillance in the Victoria area, Canada during 1998-2005 in order to determine the burden associated with community-onset BSI. A total of 2785 episodes were identified for an overall annual incidence of 101·2/100,000.

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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.

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