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3. Laboratory Features of Trichinellosis and Eosinophilia Threshold for Testing, Nunavik, Quebec, Canada, 2009-2019

Author

Harrison, Luke B., Libman, Michael D., Caya, Chelsea, Ndao, Momar, and Yansouni, Cedric P.

Subjects
Trichinosis -- Diagnosis, Blood cell count -- Usage, Eosinophilia -- Diagnosis, Diagnosis, Laboratory -- Methods, Health
Abstract

Trichinella nativa infection is associated with ingestion of parasitized sylvatic animals and periodic outbreaks among residents of northern Canada (2-3). In the Arctic region of Nunavik in Quebec, outbreaks associated [...]

Published
2022
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4. Clinical Outcomes of Rapid Respiratory Virus Testing in Emergency Departments

Author

Schober, Tilmann, primary, Wong, Kimberly, additional, DeLisle, Gaëlle, additional, Caya, Chelsea, additional, Brendish, Nathan J., additional, Clark, Tristan W., additional, Dendukuri, Nandini, additional, Doan, Quynh, additional, Fontela, Patricia S., additional, Gore, Genevieve C., additional, Li, Patricia, additional, McGeer, Allison J., additional, Noël, Kim Chloe, additional, Robinson, Joan L., additional, Suarthana, Eva, additional, and Papenburg, Jesse, additional

Published
2024
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6. Characteristics associated with SARS-CoV-2 testing, infection and vaccine uptake among essential non-healthcare workers in Montréal, 2021.

Author

Caya, Chelsea, Menzies, Dick, Papenburg, Jesse, Yansouni, Cedric, and Campbel, Jonathon

Subjects
VACCINATION status, COVID-19 vaccines, LOGISTIC regression analysis, CROSS-sectional method, DATA analysis
Abstract

Background: Essential non-healthcare workers experienced higher rates of SARS-CoV-2 infection compared to non-essential workers. Objective: Identify characteristics associated with SARS-CoV-2 testing, infection and vaccine uptake among essential non-healthcare workers in Montréal, Québec. Methods: Secondary, cross-sectional analysis of data collected from participants prospectively recruited in two observational studies (first study, Onsite Testing Study, January-March 2021; second study, Self-Testing Study, July-October 2021) of essential non-healthcare workers in 2021. Logistic regression with generalized linear mixed models was used to explore characteristics associated with our outcomes (previous SARS-CoV-2 testing, exposure and vaccination). Results: Overall, 2,755 participants were included (first study, Onsite Testing Study, n=2,128; and second study, Self-Testing Study, n=627). A higher proportion of participants identified as male (n=1,601; 58%), non-White (n=1,527; 55%) and worked in the manufacturing/supplier sector (n=1,706; 62%). Relative to the first study, Onsite Testing Study, participants in the second study, Self-Testing Study, had higher odds (78% vs. 46%; aOR 4.1, 95% CI: 3.2-5.2) of previous SARS-CoV-2 testing and of testing positive prior to study enrolment (6.2% vs. 4.3%; aOR 1.7, 95% CI: 1.1-2.6). Individuals reporting recent SARS-CoV-2 exposure had higher odds of previous SARS-CoV-2 testing (aOR 4.0, 95% CI: 3.0-5.4), while older age (aOR 0.98, 95% CI: 0.98-0.99 per one-year increase) and being male (aOR 0.6, 95% CI: 0.5-0.7) were associated with lower odds of previous testing. Results were similar in stratified analyses. Participants from businesses with more than 50 employees had higher odds of having received a SARS-CoV-2 vaccine (91% vs. 80%; aOR 2.6, 95% CI: 1.4-4.8). Conclusion: Consideration of individual and business characteristics associated with testing and vaccination programs for SARS-CoV-2 could improve equity, uptake and impact. [ABSTRACT FROM AUTHOR]

Published
2024
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7. The Population-Level Impact of Introducing Rapid Diagnostic Tests on Syphilis Transmission in Canadian Arctic Communities - a Mathematical Modeling Study

Author

Xia, Yiqing, primary, Caya, Chelsea, additional, Morin, Véronique, additional, Singh, Ameeta E., additional, Serhir, Bouchra, additional, Libman, Michael D., additional, Goldfarb, David M., additional, Wong, Tom, additional, Xiu, Fanyu, additional, Bélanger, Richard, additional, Touchette, Jean-Sébastien, additional, Yansouni, Cedric P., additional, and Maheu-Giroux, Mathieu, additional

Published
2024
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8. Two‐phase Bayesian latent class analysis to assess diagnostic test performance in the absence of a gold standard: COVID‐19 serological assays as a proof of concept

Author

Camirand Lemyre, Felix, primary, Honfo, Sewanou Hermann, additional, Caya, Chelsea, additional, Cheng, Matthew P., additional, Colwill, Karen, additional, Corsini, Rachel, additional, Gingras, Anne‐Claude, additional, Jassem, Agatha, additional, Krajden, Mel, additional, Márquez, Ana Citlali, additional, Mazer, Bruce D., additional, McLennan, Meghan, additional, Renaud, Christian, additional, Yansouni, Cedric P., additional, Papenburg, Jesse, additional, and Lewin, Antoine, additional

Published
2023
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9. qSOFA does not predict bacteremia in patients with severe manifestations of sepsis

Author

Cheng, Matthew P, Paquette, Katryn, Lawandi, Alexander, Stabler, Sarah N, Akhter, Murtaza, Davidson, Adam C, Gavric, Marko, Jinah, Rehman, Saeed, Zahid, Demir, Koray, Sangsari, Sassan, Huang, Kelly, Mahpour, Amirali, Shamatutu, Chris, Caya, Chelsea, Troquet, Jean-Marc, Clark, Greg, Rush, Barret, Wong, Titus, Stenstrom, Robert, Sweet, David, and Yansouni, Cedric P

Subjects
Microbiology (medical), Infectious Diseases, Brief Report
Abstract

BACKGROUND: Bloodstream infections in septic patients may be missed due to preceding antibiotic therapy prior to obtaining blood cultures. We leveraged the FABLED cohort study to determine if the quick Sequential Organ Failure Assessment (qSOFA) score could reliably identify patients at higher risk of bacteremia in patients who may have false negative blood cultures due to previously administered antibiotic therapy. METHODS: We conducted a multi-centre diagnostic study among adult patients with severe manifestations of sepsis. Patients were enrolled in one of seven participating centres between November 2013 and September 2018. All patients from the FABLED cohort had two sets of blood cultures drawn prior to the administration of antimicrobial therapy, as well as additional blood cultures within 4 hours of treatment initiation. Participants were categorized according to qSOFA score, with a score ≥2 being considered positive. RESULTS: Among 325 patients with severe manifestations of sepsis, a positive qSOFA score (defined as a score ≥2) on admission was 58% sensitive (95% CI 48% to 67%) and 41% specific (95% CI 34% to 48%) for predicting bacteremia. Among patients with negative post-antimicrobial blood cultures, a positive qSOFA score was 57% sensitive (95% CI 42% to 70%) and 42% specific (95% CI 35% to 49%) to detect patients who were originally bacteremic prior to the initiation of therapy. CONCLUSIONS: Our results suggest that the qSOFA score cannot be used to identify patients at risk for occult bacteremia due to the administration of antibiotics pre-blood culture.

Published
2022

12. Risk factors for severe PCR-positive SARS-CoV-2 infection in hospitalised children

Author

Schober, Tilmann, primary, Caya, Chelsea, additional, Barton, Michelle, additional, Bayliss, Ann, additional, Bitnun, Ari, additional, Bowes, Jennifer, additional, Brenes-Chacon, Helena, additional, Bullard, Jared, additional, Cooke, Suzette, additional, Dewan, Tammie, additional, Dwilow, Rachel, additional, El Tal, Tala, additional, Foo, Cheryl, additional, Gill, Peter, additional, Haghighi Aski, Behzad, additional, Kakkar, Fatima, additional, Lautermilch, Janell, additional, Lefebvre, Marie-Astrid, additional, Leifso, Kirk, additional, Le Saux, Nicole, additional, Lopez, Alison, additional, Manafi, Ali, additional, Merckx, Joanna, additional, Morris, Shaun K, additional, Nateghian, Alireza, additional, Panetta, Luc, additional, Petel, Dara, additional, Piché, Dominique, additional, Purewal, Rupeena, additional, Restivo, Lea, additional, Roberts, Ashley, additional, Sadarangani, Manish, additional, Scuccimarri, Rosie, additional, Soriano-Fallas, Alejandra, additional, Tehseen, Sarah, additional, Top, Karina A, additional, Ulloa-Gutierrez, Rolando, additional, Viel-Theriault, Isabelle, additional, Wong, Jacqueline, additional, Yea, Carmen, additional, Yeh, Ann, additional, Yock-Corrales, Adriana, additional, Robinson, Joan L, additional, and Papenburg, Jesse, additional

Published
2022
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13. Urgent air transfers for acute respiratory infections among children from Northern Canada, 2005–2014

Author

Prendergast, Caitlin, primary, Robinson, Joan, additional, Caya, Chelsea, additional, Perez Trejo, Maria E., additional, Guan, Iline, additional, Hébert-Murakami, Veronica, additional, Marianayagam, Justina, additional, Wong, Zing-Wae, additional, Walker, Celia, additional, Goldfarb, David M., additional, Barrowman, Nick, additional, Jetty, Radha, additional, Embree, Joanne, additional, and Papenburg, Jesse, additional

Published
2022
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16. Specificity of SARS-CoV-2 Antibody Detection Assays against S and N Proteins among Pre-COVID-19 Sera from Patients with Protozoan and Helminth Parasitic Infections

Author

Yansouni, Cedric P., primary, Papenburg, Jesse, additional, Cheng, Matthew P., additional, Corsini, Rachel, additional, Caya, Chelsea, additional, Vasquez Camargo, Fabio, additional, Harrison, Luke B., additional, Zaharatos, Gerasimos, additional, Büscher, Philippe, additional, Faye, Babacar, additional, Ndiaye, Magatte, additional, Matlashewski, Greg, additional, and Ndao, Momar, additional

Published
2022
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17. Stopping Syphilis Transmission in Arctic Communities Through Rapid Diagnostic Testing (STAR Study): A Multisite Prospective Field Diagnostic Accuracy Study in an Intended-Use Setting

Author

Caya, Chelsea, primary, Singh, Ameeta E., additional, Serhir, Bouchra, additional, Morin, Veronique, additional, Libman, Michael D., additional, Corsini, Rachel, additional, Goldfarb, David M., additional, Wong, Tom, additional, Xia, Yiqing, additional, Maheu-Giroux, Mathieu, additional, and Yansouni, Cedric P., additional

Published
2022
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19. Risk factors for severe PCR-positive SARS-CoV-2 infection in hospitalized children: a multicenter cohort study

Author

Schober, Tilmann, primary, Caya, Chelsea, additional, Barton, Michelle, additional, Bayliss, Ann, additional, Bitnun, Ari, additional, Bowes, Jennifer, additional, Brenes-Chacon, Helena, additional, Bullard, Jared, additional, Cooke, Suzette, additional, Dewan, Tammie, additional, Dwilow, Rachel, additional, El Tal, Tala, additional, Foo, Cheryl, additional, Gill, Peter, additional, Haghighi Aski, Behzad, additional, Kakkar, Fatima, additional, Lautermilch, Janell, additional, Laxer, Ronald M., additional, Lefebvre, Marie-Astrid, additional, Leifso, Kirk, additional, Le Saux, Nicole, additional, Lopez, Alison, additional, Manafi, Ali, additional, Morris, Shaun K., additional, Nateghian, Alireza, additional, Panetta, Luc, additional, Petel, Dara, additional, Piche, Dominique, additional, Purewal, Rupeena, additional, Restivo, Lea, additional, Roberts, Ashley, additional, Sadarangani, Manish, additional, Scuccimarri, Rosie, additional, Soriano-Fallas, Alejandra, additional, Tehseen, Sarah, additional, Top, Karina A., additional, Ulloa-Gutierrez, Rolando, additional, Viel-Theriaul, Isabelle, additional, Wong, Jacqueline K., additional, Yea, Carmen, additional, Yeh, Ann, additional, Yock-Corrales, Adriana, additional, Robinson, Joan, additional, and Papenburg, Jesse, additional

Published
2021
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20. Specificity of SARS-CoV-2 antibody-detection assays against S and N protein among pre-COVID-19 sera from patients with protozoan and helminth parasitic infections

Author

Yansouni, Cedric P, primary, Papenburg, Jesse, additional, Cheng, Matthew P., additional, Corsini, Rachel, additional, Caya, Chelsea, additional, Camargo, Fabio Vasquez, additional, Harrison, Luke B, additional, Zaharatos, Gerasimos, additional, Büscher, Philippe, additional, Faye, Babacar, additional, Ndiaye, Magatte, additional, Matlashewski, Greg, additional, and Ndao, Momar, additional

Published
2021
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21. Neither Blood Culture Positivity nor Time to Positivity Is Associated With Mortality Among Patients Presenting With Severe Manifestations of Sepsis: The FABLED Cohort Study

Author

Paquette, Katryn, primary, Sweet, David, additional, Stenstrom, Robert, additional, Stabler, Sarah N, additional, Lawandi, Alexander, additional, Akhter, Murtaza, additional, Davidson, Adam C, additional, Gavric, Marko, additional, Jinah, Rehman, additional, Saeed, Zahid, additional, Demir, Koray, additional, Sangsari, Sassan, additional, Huang, Kelly, additional, Mahpour, Amirali, additional, Shamatutu, Chris, additional, Caya, Chelsea, additional, Troquet, Jean-Marc, additional, Clark, Greg, additional, Wong, Titus, additional, Yansouni, Cedric P, additional, and Cheng, Matthew P, additional

Published
2021
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22. Evaluation of a Commercial Culture-Free Neutralization Antibody Detection Kit for Severe Acute Respiratory Syndrome-Related Coronavirus-2 and Comparison With an Antireceptor-Binding Domain Enzyme-Linked Immunosorbent Assay

Author

Papenburg, Jesse, primary, Cheng, Matthew P, additional, Corsini, Rachel, additional, Caya, Chelsea, additional, Mendoza, Emelissa, additional, Manguiat, Kathy, additional, Lindsay, L Robbin, additional, Wood, Heidi, additional, Drebot, Michael A, additional, Dibernardo, Antonia, additional, Zaharatos, Gerasimos, additional, Bazin, Reneé, additional, Gasser, Romain, additional, Benlarbi, Mehdi, additional, Gendron-Lepage, Gabrielle, additional, Beaudoin-Bussières, Guillaume, additional, Prévost, Jérémie, additional, Finzi, Andrés, additional, Ndao, Momar, additional, and Yansouni, Cedric P, additional

Published
2021
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23. Serodiagnostics for Severe Acute Respiratory Syndrome–Related Coronavirus-2

Author

Cheng, Matthew P., Yansouni, Cedric P., Basta, Nicole E., Desjardins, Michaël, Kanjilal, Sanjat, Paquette, Katryn, Caya, Chelsea, Semret, Makeda, Quach, Caroline, Libman, Michael, Mazzola, Laura, Sacks, Jilian A., Dittrich, Sabine, and Papenburg, Jesse

Subjects
Reviews
Abstract

Accurate serologic tests to detect host antibodies to severe acute respiratory syndrome–related coronavirus-2 (SARS-CoV-2) will be critical for the public health response to the coronavirus disease 2019 pandemic. Many use cases are envisaged, including complementing molecular methods for diagnosis of active disease and estimating immunity for individuals. At the population level, carefully designed seroepidemiologic studies will aid in the characterization of transmission dynamics and refinement of disease burden estimates and will provide insight into the kinetics of humoral immunity. Yet, despite an explosion in the number and availability of serologic assays to test for antibodies against SARS-CoV-2, most have undergone minimal external validation to date. This hinders assay selection and implementation, as well as interpretation of study results. In addition, critical knowledge gaps remain regarding serologic correlates of protection from infection or disease, and the degree to which these assays cross-react with antibodies against related coronaviruses. This article discusses key use cases for SARS-CoV-2 antibody detection tests and their application to serologic studies, reviews currently available assays, highlights key areas of ongoing research, and proposes potential strategies for test implementation., Accurate serologic tests to detect host antibodies to SARS-CoV-2 will be critical for the public health response to the COVID-19 pandemic. This article discusses key use cases for SARS-CoV-2 antibody detection tests, their application to serologic studies, and the currently available assays. The authors also highlight key areas of ongoing research and propose potential strategies for test implementation.

Published
2020

24. Multicenter cohort study of children hospitalized with SARS-CoV-2 infection

Author

Barton, Michelle, primary, Papenburg, Jesse, additional, Ulloa-Gutierrez, Rolando, additional, Brenes-Chacon, Helena, additional, Yock-Corrales, Adriana, additional, Ivankovich-Escoto, Gabriela, additional, Soriano-Fallas, Alejandra, additional, Mezerville, Marcela Hernandez-de, additional, Bitnun, Ari, additional, Morris, Shaun K., additional, Tal, Tala El, additional, Yeh, E. Ann, additional, Gill, Peter, additional, Laxer, Ronald M., additional, Nateghian, Alireza, additional, Aski, Behzad Haghighi, additional, Manafif, Ali, additional, Lefebvre, Marie-Astrid, additional, Caya, Chelsea, additional, Cooke, Suzette, additional, Dewan, Tammie, additional, Restivo, Lea, additional, Viel-Thériault, Isabelle, additional, Trajtman, Adriana, additional, Dwilow, Rachel, additional, Bullard, Jared, additional, Sadarangani, Manish, additional, Roberts, Ashley, additional, Saux, Nicole Le, additional, Bowes, Jennifer, additional, Wong, Jacqueline K., additional, Purewal, Rupeena, additional, Lautermilch, Janell, additional, Leifso, Kirk, additional, Foo, Cheryl, additional, Newhook, Leigh Anne, additional, Bayliss, Ann, additional, Petel, Dara, additional, and Robinson, Joan, additional

Published
2021
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26. Evaluation of a Commercial Culture-free Neutralization Antibody Detection Kit for Severe Acute Respiratory Syndrome-Related Coronavirus-2 and Comparison with an Anti-RBD ELISA Assay

Author

Papenburg, Jesse, primary, Cheng, Matthew P., additional, Corsini, Rachel, additional, Caya, Chelsea, additional, Mendoza, Emelissa, additional, Manguiat, Kathy, additional, Lindsay, L. Robbin, additional, Wood, Heidi, additional, Drebot, Michael A., additional, Dibernardo, Antonia, additional, Zaharatos, Gerasimos, additional, Bazin, Reneée, additional, Gasser, Romain, additional, Benlarbi, Mehdi, additional, Gendron-Lepage, Gabrielle, additional, Beaudoin-Bussières, Guillaume, additional, Prévost, Jérémie, additional, Finzi, Andrés, additional, Ndao, Momar, additional, and Yansouni, Cedric P, additional

Published
2021
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27. Real-world Time to Positivity of 2 Widely Used Commercial Blood Culture Systems in Patients With Severe Manifestations of Sepsis: An Analysis of the FABLED Study

Author

Butler-Laporte, Guillaume, primary, Yansouni, Cedric P, additional, Paquette, Katryn, additional, Lawandi, Alexander, additional, Stabler, Sarah N, additional, Akhter, Murtaza, additional, Davidson, Adam C, additional, Gavric, Marko, additional, Jinah, Rehman, additional, Saeed, Zahid, additional, Demir, Koray, additional, Sangsari, Sassan, additional, Huang, Kelly, additional, Mahpour, Amirali, additional, Shamatutu, Chris, additional, Caya, Chelsea, additional, Troquet, Jean-Marc, additional, Clark, Greg, additional, Wong, Titus, additional, Lee, Todd C, additional, Stenstrom, Robert, additional, Sweet, David, additional, and Cheng, Matthew P, additional

Published
2020
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29. SARS-CoV-2 Clinical Characteristics and Viral Shedding in Kuwait.

Author

Alghounaim, Mohammad, Caya, Chelsea, Alothman, Khalid, Alhasawi, Almonther, and Papenburg, Jesse

Subjects
*VIRAL shedding, *LEUKOCYTE count, *COVID-19, *SARS-CoV-2, *REGRESSION analysis
Abstract

Objectives: We aimed to describe the clinical characteristics of SARS-CoV-2 infection and estimate viral shedding duration in respiratory specimens. Methods: A retrospective cohort study was performed from February 25 to March 25, 2020. In Kuwait, all suspected coronavirus disease 2019 (COVID-19) cases, contacts of cases, and returning travelers were systematically tested for SARS-CoV-2 by RT-PCR. All infected persons, regardless of symptoms, were hospitalized and serially tested until they had two negative results. Descriptive statistics and regression analyses were performed. Results: Two hundred seven cases of SARS-CoV-2 infection were included in this study. About half of the cases were asymptomatic and 1.9% died. The median time to negative RT-PCR was 22 days. Increasing age, ARDS, and low peripheral white blood cell count were associated with prolonged PCR positivity. Conclusion: Predictors for prolonged RT-PCR positivity included increasing age, ARDS, and low white blood cell count. The findings of this study may aid in better understanding of the epidemiology of SARS-CoV-2 infection and molecular testing dynamics. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis A Diagnostic Study

Author

Cheng, Matthew P., Stenstrom, Robert, Paquette, Katryn, Stabler, Sarah N., Akhter, Murtaza, Davidson, Adam C., Gavric, Marko, Lawandi, Alexander, Jinah, Rehman, Saeed, Zahid, Demir, Koray, Huang, Kelly, Mahpour, Amirali, Shamatutu, Chris, Caya, Chelsea, Troquet, Jean-Marc, Clark, Greg, Yansouni, Cedric P., Sweet, David, Davidson, Adam, Yansouni, Cedric, Ryan, Emily, Kadatz, Matthew J., Sekhon, Myphinder, Sangsari, Sassan, Osati, Farzaneh, Cheng, Matthew P., Stenstrom, Robert, Paquette, Katryn, Stabler, Sarah N., Akhter, Murtaza, Davidson, Adam C., Gavric, Marko, Lawandi, Alexander, Jinah, Rehman, Saeed, Zahid, Demir, Koray, Huang, Kelly, Mahpour, Amirali, Shamatutu, Chris, Caya, Chelsea, Troquet, Jean-Marc, Clark, Greg, Yansouni, Cedric P., Sweet, David, Davidson, Adam, Yansouni, Cedric, Ryan, Emily, Kadatz, Matthew J., Sekhon, Myphinder, Sangsari, Sassan, and Osati, Farzaneh

Abstract

Background: Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity. Objective: To determine the sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy in patients with severe manifestations of sepsis. Design: Patient-level, single-group, diagnostic study. (Clinical Trials.gov: NCT01867905) Setting: 7 emergency departments in North America. Participants: Adults with severe manifestations of sepsis, including systolic blood pressure less than 90 mm Hg or a serum lactate level of 4 mmol/L or more. Intervention: Blood cultures were obtained before and within 120 minutes after initiation of antimicrobial treatment. Measurements: Sensitivity of blood cultures obtained after initiation of antimicrobial therapy. Results: Of 3164 participants screened, 325 were included in the study (mean age, 65.6 years; 62.8% men) and had repeated blood cultures drawn after initiation of antimicrobial therapy (median time, 70 minutes [interquartile range, 50 to 110 minutes]). Preantimicrobial blood cultures were positive for 1 or more microbial pathogens in 102 of 325 (31.4%) patients. Post-antimicrobial blood cultures were positive for 1 or more microbial pathogens in 63 of 325 (19.4%) patients. The absolute difference in the proportion of positive blood cultures between pre- and postantimicrobial testing was 12.0% (95% CI, 5.4% to 18.6%; P < 0.001). Sensitivity of postantimicrobial culture was 52.9% (CI, 42.8% to 62.9%). When the results of other microbiological cultures were included, microbial pathogens were found in 69 of 102 (67.6% [CI, 57.7% to 76.6%]) patients. Limitation: Only a proportion of screened patients were recruited. Conclusion: Among patients with severe manifestations of sepsis, initiation of empirical antimicrobial therapy significantly reduces the sensitivity of blood cultures drawn shortly

Published
2019

31. 847. The Effect of Antimicrobial Administration on Blood Culture Positivity in Patients with Severe Manifestations of Sepsis

Author

Cheng, Matthew P, primary, Stenstrom, Robert, additional, Paquette, Katryn, additional, Stabler, Sarah, additional, Akhter, Murtaza, additional, Davidson, Adam, additional, Gavric, Marko, additional, Lawandi, Alexander, additional, Jinah, Rehman, additional, Saheed, Zahid, additional, Demir, Koray, additional, Huang, Kelly, additional, Mahpour, Amirali, additional, Shamatutu, Chris, additional, Caya, Chelsea, additional, Troquet, Jean-Marc, additional, Clark, Greg, additional, Yansouni, Cedric, additional, and Sweet, David, additional

Published
2019
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36. Molecular and epidemiologic investigation of a rhinovirus outbreak in a neonatal intensive care unit

Author

El Idrissi, Kenza Rahmouni, Isabel, Sandra, Carbonneau, Julie, Lafond, Martine, Quach, Caroline, Caya, Chelsea, Fontela, Patricia S., Beltempo, Marc, Boivin, Guy, Lefebvre, Marie-Astrid, and Papenburg, Jesse

Abstract

We performed a molecular and epidemiologic study of a healthcare-associated rhinovirus outbreak to better understand transmission in neonatal intensive care settings. Sequencing of the 7 outbreak strains revealed 4 distinct clades, indicating multiple sources. A single clade infected 3 patients in adjacent rooms, suggesting horizontal transmission. We observed 1 rhinovirus-associated death.

Published
2019
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37. qSOFA does not predict bacteremia in patients with severe manifestations of sepsis.

Author

Cheng MP, Paquette K, Lawandi A, Stabler SN, Akhter M, Davidson AC, Gavric M, Jinah R, Saeed Z, Demir K, Sangsari S, Huang K, Mahpour A, Shamatutu C, Caya C, Troquet JM, Clark G, Rush B, Wong T, Stenstrom R, Sweet D, and Yansouni CP

Abstract

Background: Bloodstream infections in septic patients may be missed due to preceding antibiotic therapy prior to obtaining blood cultures. We leveraged the FABLED cohort study to determine if the quick Sequential Organ Failure Assessment (qSOFA) score could reliably identify patients at higher risk of bacteremia in patients who may have false negative blood cultures due to previously administered antibiotic therapy., Methods: We conducted a multi-centre diagnostic study among adult patients with severe manifestations of sepsis. Patients were enrolled in one of seven participating centres between November 2013 and September 2018. All patients from the FABLED cohort had two sets of blood cultures drawn prior to the administration of antimicrobial therapy, as well as additional blood cultures within 4 hours of treatment initiation. Participants were categorized according to qSOFA score, with a score ≥2 being considered positive., Results: Among 325 patients with severe manifestations of sepsis, a positive qSOFA score (defined as a score ≥2) on admission was 58% sensitive (95% CI 48% to 67%) and 41% specific (95% CI 34% to 48%) for predicting bacteremia. Among patients with negative post-antimicrobial blood cultures, a positive qSOFA score was 57% sensitive (95% CI 42% to 70%) and 42% specific (95% CI 35% to 49%) to detect patients who were originally bacteremic prior to the initiation of therapy., Conclusions: Our results suggest that the qSOFA score cannot be used to identify patients at risk for occult bacteremia due to the administration of antibiotics pre-blood culture., Competing Interests: The authors have nothing to disclose., (Copyright © 2022, Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada).)

Published
2022
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38. Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study.

Author

Cheng MP, Stenstrom R, Paquette K, Stabler SN, Akhter M, Davidson AC, Gavric M, Lawandi A, Jinah R, Saeed Z, Demir K, Huang K, Mahpour A, Shamatutu C, Caya C, Troquet JM, Clark G, Yansouni CP, and Sweet D

Subjects
Acute Disease, Aged, Female, Humans, Male, Sensitivity and Specificity, Sepsis diagnosis, Sepsis drug therapy, Anti-Infective Agents therapeutic use, Blood Culture statistics & numerical data, Sepsis microbiology
Abstract

Background: Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity., Objective: To determine the sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy in patients with severe manifestations of sepsis., Design: Patient-level, single-group, diagnostic study. (ClinicalTrials.gov: NCT01867905)., Setting: 7 emergency departments in North America., Participants: Adults with severe manifestations of sepsis, including systolic blood pressure less than 90 mm Hg or a serum lactate level of 4 mmol/L or more., Intervention: Blood cultures were obtained before and within 120 minutes after initiation of antimicrobial treatment., Measurements: Sensitivity of blood cultures obtained after initiation of antimicrobial therapy., Results: Of 3164 participants screened, 325 were included in the study (mean age, 65.6 years; 62.8% men) and had repeated blood cultures drawn after initiation of antimicrobial therapy (median time, 70 minutes [interquartile range, 50 to 110 minutes]). Preantimicrobial blood cultures were positive for 1 or more microbial pathogens in 102 of 325 (31.4%) patients. Postantimicrobial blood cultures were positive for 1 or more microbial pathogens in 63 of 325 (19.4%) patients. The absolute difference in the proportion of positive blood cultures between pre- and postantimicrobial testing was 12.0% (95% CI, 5.4% to 18.6%; P < 0.001). Sensitivity of postantimicrobial culture was 52.9% (CI, 42.8% to 62.9%). When the results of other microbiological cultures were included, microbial pathogens were found in 69 of 102 (67.6% [CI, 57.7% to 76.6%]) patients., Limitation: Only a proportion of screened patients were recruited., Conclusion: Among patients with severe manifestations of sepsis, initiation of empirical antimicrobial therapy significantly reduces the sensitivity of blood cultures drawn shortly after treatment initiation., Primary Funding Source: Vancouver Coastal Health, St. Paul's Hospital Foundation Emergency Department Support Fund, the Fonds de recherche Santé-Québec, and the Maricopa Medical Foundation.

Published
2019
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