A5010749025- Antibiotic Use and Resistance
- Bacterial Identification and Susceptibility Testing
- Antibiotic Resistance in Bacteria
- COVID-19 epidemiological studies
- Urinary Tract Infections Management
- Infection Control and Ventilation
- Antibiotics Pharmacokinetics and Efficacy
- Pneumonia and Respiratory Infections
- COVID-19 Clinical Research Studies
- Sepsis Diagnosis and Treatment
- Patient Satisfaction in Healthcare
- HIV/AIDS Research and Interventions
- Nosocomial Infections in ICU
- SARS-CoV-2 detection and testing
- Streptococcal Infections and Treatments
- Antimicrobial Resistance in Staphylococcus
- Drug-Induced Adverse Reactions
- COVID-19 Pandemic Impacts
- Mycobacterium research and diagnosis
- Clostridium difficile and Clostridium perfringens research
- HIV, Drug Use, Sexual Risk
- Genomics and Phylogenetic Studies
- Glioma Diagnosis and Treatment
- Respiratory viral infections research
- COVID-19 and healthcare impacts
Ottawa Hospital
2020-2025
Ottawa Hospital Research Institute
2020-2025
University of Ottawa
2020-2025
University of Toronto
2014-2024
Institute for Clinical Evaluative Sciences
2013-2024
Sunnybrook Health Science Centre
2013-2024
University Health Network
2012-2024
Canadian Electricity Association
2024
North York General Hospital
2024
Monash Medical Centre
2024
Background. Reported allergy to beta-lactam antibiotics is common and often leads unnecessary avoidance in patients who could tolerate these antibiotics. We prospectively evaluated the impact of reported allergies on clinical outcomes. Methods. conducted a trainee-led prospective cohort study determine burden seen by infectious diseases consultation services at 3 academic hospitals. The primary outcome was composite measure readmission for same infection, acute kidney injury, Clostridium...
Antibiotic use is a primary driver of antibiotic resistance. However, can be distributed in different ways population, and the association between distribution resistance has not been explored. Here, we tested hypothesis that repeated antibiotics stronger with population-wide than broadly-distributed, low-intensity use. First, characterized outpatient across US states, finding uneven makes up minority Second, compared for 72 pathogen-antibiotic combinations states. Finally, having...
Bloodstream infections (BSIs) represent a substantial mortality risk, yet most studies are limited to select pathogens or populations. The aim of this study was describe the population-wide prevalence BSIs and examine associated risk for responsible microorganisms. We conducted retrospective cohort in Ontario 2017. Blood culture data collected from almost all microbiology laboratories linked sets patient characteristics. For each organism, we determined crude using logistic regression...
Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment uncertain.
Background: Sex differences in the use and outcomes of implantable cardioverter-defibrillators (ICDs) have not been fully studied. Objective: To examine potential sex ICD implantation device outcomes. Design: Health payer–mandated, prospective study patients referred for implantation, with comprehensive, longitudinal follow-up complications, deaths, Setting: 18 centers Ontario, Canada. Patients: 6021 (4733 men) from February 2007 to July 2010. Measurements: Multivariate-adjusted rate,...
BackgroundThe rapid increase of bacterial antibiotic resistance could soon render our most effective method to address infections obsolete. Factors influencing pathogen prevalence in human populations remain poorly described, though temperature is known contribute mechanisms spread.AimTo quantify the role temperature, spatially and temporally, as a mechanistic modulator transmission resistant microbes.MethodsAn ecologic analysis was performed on country-level three common pathogens across 28...
Abstract Surveillance of drug-resistant bacteria is essential for healthcare providers to deliver effective empirical antibiotic therapy. However, traditional molecular epidemiology does not typically occur on a timescale that could affect patient treatment and outcomes. Here, we present method called ‘genomic neighbour typing’ inferring the phenotype bacterial sample by identifying its closest relatives in database genomes with metadata. We show this technique can infer susceptibility...
Staphylococcus aureus bloodstream (SAB) infection is a common and severe infectious disease, with 90-day mortality of 15%-30%. Despite this, <3000 people have been randomized into clinical trials treatments for SAB infection. The limited evidence base partly results from infections being difficult to complete at scale using traditional trial methods. Here we provide the rationale framework an adaptive platform applied infections. We detail design features Network Adaptive Platform (SNAP)...
Abstract Objective To identify temporal trends in outpatient antibiotic use and prescribing practice among older adults a high income country. Design Observational study using United States Medicare administrative claims 2011-15. Setting Medicare, US national healthcare program for which 98% of are eligible. Participants 4.5 million fee-for-service beneficiaries aged 65 years old older. Main outcome measurements Overall rates prescription claims, potentially appropriate inappropriate...
Abstract Background Governments have implemented population-wide physical distancing measures to control COVID-19, but metrics evaluating their effectiveness are not readily available. Methods We used a publicly available mobility index from popular transit application evaluate the effect of on infection growth rates and reproductive numbers in 40 jurisdictions between March 23 April 12, 2020. Findings A 10% decrease was associated with 14.6% (exp(β) = 0·854; 95% credible interval: 0·835,...
The COVID-19 pandemic has had an effect on the incidence of infectious diseases and medical care. This study aimed to describe impact community-level antibiotic use.Using national dispensing data from IQVIA's CompuScript database, this ecological investigated through community retail pharmacies in Canada November 2014 October 2020. Analyses were stratified by age, sex, prescription origin approximate indication.Adjusting for seasonality, rate decreased 26.5% (50.4 37.0 average prescriptions...
Abstract Background Physicians face competing demands of maximizing pathogen coverage while minimizing unnecessary use broad-spectrum antibiotics when managing sepsis. We sought to identify physicians’ perceived likelihood achieved by their usual empiric antibiotic regimen, along with minimum thresholds they would be willing accept these patients. Methods conducted a scenario-based survey internal medicine physicians from across Canada using 2 × factorial design, varied infection source...
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has potentially impacted outpatient antibiotic prescribing. Investigating this impact may identify stewardship opportunities in the ongoing COVID-19 period and beyond. Methods We conducted an interrupted time series analysis on prescriptions prescriptions/patient visits Ontario, Canada, between January 2017 December 2020 to evaluate of population-level prescribing by prescriber specialty, patient demographics, conditions....
The role of antibiotics in preventing urinary tract infection (UTI) older adults is unknown. We sought to quantify the benefits and risks antibiotic prophylaxis among adults.We conducted a matched cohort study comparing (≥66 years) receiving prophylaxis, defined as treatment for ≥30 days starting within 30 positive culture, with patients urine cultures who received but did not receive prophylaxis. each recipient 10 nonrecipients based on organism, number cultures, propensity score. Outcomes...
Abstract Background The use of adjunctive antibiotics directed against exotoxin production in Staphylococcus aureus bacteremia (SAB) is widespread, and it recommended many guidelines, but this based on limited evidence. Existing guidelines are the theoretical premise toxin suppression, as strains S. produce toxins such leukocidins (eg, Panton-Valentine leukocidin, toxic shock syndrome 1, exfoliative toxins, various enterotoxins). Many clinicians therefore believe that limiting release by...
ObjectivesThe utility of follow-up blood cultures (FUBCs) in patients with Gram-negative bloodstream infection (GN-BSI) is controversial. Observational studies have suggested significant mortality benefit, but may be limited by single-center designs, immortal time bias, and residual confounding. We examined the impact FUBCs on GN-BSI a retrospective population-wide cohort study Ontario, Canada.MethodsAdult hospitalized between April-2017 December-2021 were included. Primary outcome was...