A5010833657- Antibiotic Use and Resistance
- COVID-19 Clinical Research Studies
- Nosocomial Infections in ICU
- COVID-19 and healthcare impacts
- Patient Satisfaction in Healthcare
- Pneumonia and Respiratory Infections
- Bacterial Identification and Susceptibility Testing
- Sepsis Diagnosis and Treatment
- Long-Term Effects of COVID-19
- SARS-CoV-2 and COVID-19 Research
- Antimicrobial Resistance in Staphylococcus
- Antibiotics Pharmacokinetics and Efficacy
- Urinary Tract Infections Management
- Meta-analysis and systematic reviews
- COVID-19 and Mental Health
- Vaccine Coverage and Hesitancy
- Xenotransplantation and immune response
- Pharmacovigilance and Adverse Drug Reactions
- Emergency and Acute Care Studies
- Antibiotic Resistance in Bacteria
- Health Systems, Economic Evaluations, Quality of Life
- Streptococcal Infections and Treatments
- Infection Control and Ventilation
- Disaster Response and Management
- Pneumocystis jirovecii pneumonia detection and treatment
Dalhousie University
2005-2025
St Joseph's Health Centre
2014-2024
University of Toronto
2011-2024
Sunnybrook Health Science Centre
2020-2024
North York General Hospital
2024
Monash Medical Centre
2024
University Health Network
2024
London Health Sciences Centre
2024
Monash University
2024
Toronto East General Hospital
2024
Background: It is uncertain if medical masks offer similar protection against COVID-19 compared with N95 respirators. Objective: To determine whether are noninferior to respirators prevent in health care workers providing routine care. Design: Multicenter, randomized, noninferiority trial. (ClinicalTrials.gov: NCT04296643). Setting: 29 facilities Canada, Israel, Pakistan, and Egypt from 4 May 2020 March 2022. Participants: 1009 who provided direct patients suspected or confirmed COVID-19....
Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment uncertain.
The objective of this study was to determine the impact selective susceptibility reporting on ciprofloxacin utilization and Gram-negative in a hospital setting. Historically at our institution, microbiology laboratory practice report for all Enterobacteriaceae regardless other agents. A policy implemented which involved suppression when there lack resistance antibiotics panel. Ciprofloxacin (measured defined daily doses [DDD] per 1,000 patient days) collected before after intervention...
Most of what physicians learn in their training when it comes to ethics focuses on the principles related doctor-patient relationship: beneficence, non-maleficence, and autonomy. At a system level, this translates into an obligation for advocate patients based these principles. Advocacy does not necessarily have answers resources are scarce, as result, often find that they “at table” important decisions made at organizational level. I will argue be more effective leaders within...
During September–November 2014, the New York State Department of Health (NYSDOH) was notified five state residents who had tested seropositive for Coxiella burnetii, causative agent Q fever. All patients symptoms compatible with fever (e.g., fever, fatigue, chills, and headache) a history travel to Germany receive medical treatment called "live cell therapy" (sometimes "fresh therapy") in May 2014. Live therapy is practice injecting processed cells from organs or fetuses nonhuman animals...
To describe the evolution of respiratory antibiotic prescribing during coronavirus disease 2019 (COVID-19) pandemic across 3 large hospitals that maintained antimicrobial stewardship services throughout pandemic.
Health care workers have a critical role in the pandemic response to COVID-19 and may be at increased risk of infection. The objective this study was assess seroprevalence SARS-CoV-2 immunoglobulin G (IgG) antibodies among health during after first wave pandemic. We conducted prospective multicentre cohort involving Ontario, Canada, detect IgG against SARS-CoV-2. Blood samples self-reported questionnaires were obtained enrolment, 6 weeks 12 weeks. A community hospital, tertiary pediatric...
Sepsis was recently redefined as “a life-threatening organ dysfunction caused by dysregulated host-response to systemic infection” based on the Third International Consensus Definitions for and Septic Shock (Sepsis-3). The incidence of sepsis is increasing despite global initiatives, with a mortality ranging from 30% 50%. A timely diagnosis pivotal prompt recognition appropriate intervention. Each hour delay in administration antibiotics results an increase 7.6% septic shock, yet...
Central nervous system (CNS) strongyloidiasis is a known but rare form of disseminated infection. The diagnosis often made postmortem, with only five published cases an antemortem diagnosis. We report two fatal CNS diagnosed antemortem, Strongyloides stercoralis larvae visualized in the sample one case. Risk factors for common to both included origination from Caribbean, underlying human T-lymphotropic virus-1 infection, and recent prednisone use. Both occurred Canada, where occurrence...
Abstract Background: Antimicrobial stewardship program (ASP) interventions, such as prospective audit and feedback (PAF), have been shown to reduce antimicrobial use improve patient outcomes. However, the optimal approach PAF is unknown. Objective: We examined impact of a high–intensity interdisciplinary rounds–based compared low–intensity on internal medicine wards in 400–bed community hospital. Methods: Prior intervention, ASP pharmacists performed with focus targeted antibiotics....
ABSTRACT Vancomycin-variable enterococcus (VVE) is an emerging pathogen. VVE isolates initially appear phenotypically susceptible to vancomycin but possesses the vanA gene and can develop in vitro vivo resistance vancomycin. We report a case of bacteremia describe how poses diagnostic therapeutic dilemmas.
The optimal treatment duration for patients with bloodstream infection is understudied. Bacteremia Antibiotic Length Actually Needed Clinical Effectiveness (BALANCE) pilot randomized clinical trial (RCT) determined that it was feasible to enroll and randomize intensive care unit (ICU) 7 versus 14 days of treatment, served as the vanguard ongoing BALANCE main RCT. We performed this BALANCE-Ward RCT examine feasibility impact potentially extending include hospitalized on non-ICU wards.We...
Abstract Objectives: An accurate estimate of the average number hand hygiene opportunities per patient hour (HHO rate) is required to implement group electronic monitoring systems (GEHHMSs). We sought identify predictors HHOs validate and a GEHHMS across network critical care units. Design: Multicenter, observational study (10 hospitals) followed by quality improvement intervention involving 24 units 12 hospitals in Ontario, Canada. Methods: Critical beds were randomized receive 1 continuous...
In pandemics, local hospitals need to anticipate a surge in health care needs. We examined the modelled because of coronavirus disease 2019 (COVID-19) pandemic that was used inform early hospital-level response against cases as they transpired.To estimate March and April 2020, we simulated range scenarios severe acute respiratory syndrome 2 (SARS-CoV-2) spread Greater Toronto Area (GTA), Canada, using best available data at time. applied outputs hospital-specific over 6 weeks (St. Michael's...
Studies have demonstrated improved clinical outcomes with extended infusion (EI) piperacillin/tazobactam (TZP) compared to standard (SI). However, there is less evidence on its benefits in noncritically-ill patients. Hospital-wide EI TZP was implemented at our site February 21, 2012. Our objectives were compare clinical, safety and economic between SI TZP.A retrospective cohort study of all adult patients who received (3.375 g IV q8h infused over 4 hours for ≥ 48 during 3 years pre-and...
What is already known on this topic?Q fever a zoonotic disease caused by Coxiella burnetii and usually transmitted through inhalation of air contaminated with animal excreta.The considered to be underdiagnosed because symptoms are nonspecific can vary from patient patient, making diagnosis difficult. added report?During September-October 2014, the New York State Department Health identified Q in five patients exposure treatment as live cell therapy, an alternative medicine practice involving...
Abstract Background: Prospective audit and feedback (PAF) is an established practice in critical care settings but not surgical populations. We pilot-tested a structured face-to-face PAF program for our acute-care surgery (ACS) service. Methods: This was mixed-methods study. For the quantitative analysis, period from August 1, 2017, to April 30, 2019. The ad hoc May 2019, January 31, 2021. Interrupted time-series segmented negative binomial regression analysis used evaluate change...