JAMMI最新文献

{"title":"Hepatitis C Screening in Community Pharmacies-A Feasibility and Knowledge Transfer Study: PHARMA-C.","authors":"Rose Prévost, Émilie Roy-St-Pierre, Kamilia Idir, Azam Khodamoradi, Frédéric Provost, Dominic Martel, Nancy L Sheehan, Valérie Martel-Laferrière, Rachel Therrien","doi":"10.3138/jammi-2024-0010","DOIUrl":"10.3138/jammi-2024-0010","url":null,"abstract":"<p><strong>Background: </strong>New strategies are needed to increase access to hepatitis C virus (HCV) testing. This study evaluated the feasibility of HCV rapid testing in community pharmacies in Quebec (Canada) and assessed knowledge transfer (KT).</p><p><strong>Methods: </strong>PHARMA-C was a 6-month (February to September 2022) prospective KT study. Community pharmacists (CPs) were recruited and trained to identify HCV risk factors, conduct rapid antibody tests (OraQuickHCV), and pre- and post-test counselling, and link positive cases to care. Health care users (HUs) were included according to HCV risk factors. An advisory committee and focus groups provided guidance, feedback, and identified barriers and facilitators to improve the program. A pre- and post-intervention questionnaire was completed by CPs to assess feasibility and KT. HUs completed a satisfaction survey.</p><p><strong>Results: </strong>A total of 32 CPs were included and 16 performed 101 HCV tests. Two positive cases were identified and linked to care. Comparison of pre- and post-intervention surveys shows that pharmacists felt more confident in identifying HCV risk factors, communicating information to patients related to HCV, and performing the HCV screening test at the end of the intervention. HCV screening in pharmacies was considered feasible by 77.8% of CPs. The intervention lasted approximately 22 minutes. The main barriers to implementation were lack of time and fear of stigmatizing HUs. Promotional material and training were the main facilitators.</p><p><strong>Conclusion: </strong>HCV point-of-care testing by CPs is feasible in Quebec. Expanding pharmacists' scope of practice to include HCV screening and increasing pharmacists' role in the HCV care cascade is encouraged in order to further efforts toward HCV elimination.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"161-172"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Rothia Aeria</i> Bacteremia Complicated by Cerebral Mycotic Aneurysms: A Case Report.","authors":"Yoko Schreiber, Armelle Perez Cortes Villalobos, James McEachern, Andrew Walkty","doi":"10.3138/jammi-2023-0040","DOIUrl":"10.3138/jammi-2023-0040","url":null,"abstract":"<p><strong>Background: </strong><i>Rothia aeria</i> is a gram-positive bacterium that is considered a member of the normal human oral flora. Serious infections due to this organism are rare, with only eight case reports of endocarditis due to <i>R. aeria</i> published worldwide in the English language literature.</p><p><strong>Methods: </strong>We report the case of a previously healthy 43-year-old man who presented with multiple acute subarachnoid hemorrhages secondary to cerebral mycotic aneurysms after several weeks of weight loss and headache, and we summarize previously published cases of endocarditis due to <i>R. aeria</i>.</p><p><strong>Results: </strong>Blood cultures yielded filamentous gram-positive bacilli identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry as <i>R. aeria</i>. The patient was treated with antimicrobial therapy (initially aqueous penicillin G, then ceftriaxone) for 12 weeks with a good clinical response. Endocarditis was suspected but not definitively proven on echocardiography. There was no clear odontogenic source of infection.</p><p><strong>Conclusion: </strong>This report of cerebral mycotic aneurysms secondary to possible endocarditis highlights the potential pathogenic nature of <i>R. aeria</i> infection, and supports the use of MALDI-TOF in rapid identification of uncommon bacterial pathogens.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"188-195"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidemia Treatment is Improved by Infectious Disease Consultation: A Population-Based Cohort Study.","authors":"Samuel Bourassa-Blanchette, Marit M Biesheuvel, John C Lam, Alexander Kipp, Deirdre Church, Julie Carson, Bruce Dalton, Michael D Parkins, Herman W Barkema, Daniel B Gregson","doi":"10.3138/jammi-2024-0001","DOIUrl":"10.3138/jammi-2024-0001","url":null,"abstract":"<p><strong>Introduction: </strong>Candidemia is a common bloodstream infection with morbidity and mortality. Both the European Society of Clinical Microbiology and Infectious Diseases and Infectious Diseases Society of America have evidence-based recommendations for its management. While infectious diseases consultation (IDC) reduced mortality, effects on guideline concordance remain unclear.</p><p><strong>Methods: </strong>We conducted a multicentre retrospective cohort study (2010-2018) in Canada to characterize the role of IDC in attaining evidence-based recommendations for adults with candidemia. Such recommendations include follow-up blood cultures to document blood clearance, prompt antifungal initiation and selection, source control, treatment duration determination, and ancillary investigations. We measured associations between IDC and adherence to evidence-based recommendations.</p><p><strong>Results: </strong>Patients with candidemia who received IDC were more likely not to be left without antifungal therapy (26% versus 4.8%). Echocardiograms were more common in noncritically ill patients with IDC (64% versus 44%; <i>P</i> < 0.01) and in all critically ill patients, irrespective of IDC status (75% versus 63%; <i>P</i> = 0.08). In patients with uncomplicated candidemia, treatment duration ≥14 days was similar with or without IDC (78% versus 70%; <i>P</i> = 0.15). Patients with complicated candidemia and IDC were more likely treated for ≥42 days (an appropriate duration; 100% versus 47%; <i>P</i> = 0.06). Fluconazole (transition therapy) was not affected by IDC for critically ill (41% and 29%; <i>P</i> = 0.34) or noncritically ill patients (34% versus 24%; <i>P</i> = 0.51). Mortality rates at 30 and 60 days after candidemia diagnosis were lower in patients receiving IDC (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Best practice guidelines were issued for patients with candidemia; adherence varied, but involvement of an infectious disease physician increased implementation and was associated with considerably decreased mortality.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"129-139"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Prescribing for Urinary Tract Infections in Women Residing in Long-Term Care: A Retrospective Cohort Study.","authors":"Shanna C Trenaman, Maia von Maltzahn, Samuel Alan Stewart, Hala Tamim, Ingrid Sketris, Emily Black","doi":"10.3138/jammi-2023-0029","DOIUrl":"10.3138/jammi-2023-0029","url":null,"abstract":"<p><strong>Introduction: </strong>This study describes all antibiotics dispensed to long-term care (LTC)-dwelling women with a suspected or confirmed uncomplicated urinary tract infection (UTI) in health administrative data. The outcomes of ambulatory visits, hospitalizations, and dispensation of additional antibiotics were compared for those dispensed fluoroquinolones (FQs) and those dispensed other antibiotics.</p><p><strong>Methods: </strong>This retrospective cohort study assessed administrative health data collected between January 2005 and March 2020 in Nova Scotia, Canada. Women aged 65 years or older who resided in LTC, identified with ICD 9 or 10 codes that represented an uncomplicated UTI and had an antibiotic dispensation within 5 days of the identified UTI code, were included. Antibiotic dispensations were reported descriptively and a Mann-Kendall test was used to assess change over time. A logistic regression model estimated the odds ratios for FQ compared to non-FQ recipients for all outcome events.</p><p><strong>Results: </strong>There were 15,276 uncomplicated UTI events reported in 7,078 women. UTI events decreased significantly over time (1,387 in 2005 to 402 in 2019 [<i>p</i> < 0.001]). The most dispensed antibiotics were trimethoprim-sulfamethoxazole (25.8%), nitrofurantoin (25.5%), and ciprofloxacin (18.6 %). Compared to all other antibiotics, FQ dispensation was not associated with any difference in need for hospitalization. There was a reduced risk of subsequent antibiotic dispensation and follow-up ambulatory care visits for those dispensed FQs in the adjusted analysis.</p><p><strong>Conclusions: </strong>A decline in antibiotic dispensations associated with uncomplicated UTI events was observed over the 15-year period. The findings support guideline recommendations to limit FQ prescribing for uncomplicated UTI, as few differences for the outcomes investigated were identified.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"151-160"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Screen or Not to Screen-Controversies in Testing for <i>Mycoplasma Genitalium</i>.","authors":"Angela Copete, Zulma Vanessa Rueda, Ameeta Singh, Kevin B Laupland, Yoav Keynan","doi":"10.3138/jammi-2024-0628","DOIUrl":"10.3138/jammi-2024-0628","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"125-128"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Syphilis in Canada: What Can We Do?","authors":"Joan L Robinson, Petra Smyzcek, Ameeta E Singh","doi":"10.3138/jammi-2024-0604","DOIUrl":"10.3138/jammi-2024-0604","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"121-124"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Life Support for Severe Leptospirosis: Case Series and Narrative Review.","authors":"Lazar Milovanovic, Gurmeet Singh, Derek Townsend, Jayan Nagendran, Wendy Sligl","doi":"10.3138/jammi-2023-0033","DOIUrl":"10.3138/jammi-2023-0033","url":null,"abstract":"<p><strong>Introduction: </strong>Leptospirosis can be associated with multi-system organ failure (MSOF) and significant morbidity and mortality. Extracorporeal life support (ECLS) has been used as salvage therapy for severe leptospirosis complicated by acute respiratory distress syndrome (ARDS). Current knowledge in this field is limited, with no standardized treatment approaches. We aim to describe the literature to date on the use of ECLS in patients with leptospirosis, highlighting associations, outcomes, and complications.</p><p><strong>Methods: </strong>We report on the successful use of ECLS in two cases of severe leptospirosis and conduct a narrative review of the literature. Using a search strategy developed in consultation with a medical librarian and validated across pre-selected articles, several databases were searched. We included case reports, case series, cohort studies, and prospective studies of adult patients with confirmed leptospirosis undergoing ECLS. Editorials, surveys, or opinion articles without primary patient data were excluded. Overall mortality was our primary outcome.</p><p><strong>Results: </strong>Two cases of previously healthy males presenting with ARDS due to leptospiral infection are described. Literature review identified 25 articles containing 43 reported cases of patients treated with ECLS for severe leptospirosis. Patients were mostly young and male. Overall mortality was 16%. The most common complication recognized was acute renal failure requiring renal replacement therapy. Additional complications included diffuse intravascular coagulation, necrotizing pancreatitis, and limb ischemia.</p><p><strong>Conclusion: </strong>Leptospirosis should be considered in patients with epidemiologic exposure(s) presenting with critical illness, including ARDS and MSOF. ECLS is a viable rescue strategy in severe leptospirosis, even with established MSOF.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"173-182"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine-Associated Measles in an Immunocompromised Host: Hospital Infection Prevention and Control and Public Health Response.","authors":"Dara Petel, Nabilah Juma, Cara-Lee Coghill, Sarah Wilson, Austin Zygmunt, Manal Tadros, Aaron Campigotto, Carolyn E Beck, Kescha Kazmi, Mohsin Ali, Michelle Science","doi":"10.3138/jammi-2023-0026","DOIUrl":"10.3138/jammi-2023-0026","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccine-associated measles is generally not considered to be transmissible, as opposed to wild-type measles, which is one of the most highly contagious diseases. Data on contact and exposure management of vaccine-associated measles is limited, with varied approaches to such cases described in the literature.</p><p><strong>Methods: </strong>We report the case of a 2-year-old immunosuppressed child who developed a febrile exanthem with mild conjunctivitis 18 days after receiving the measles-mumps-rubella-varicella vaccine.</p><p><strong>Results: </strong>Given the patient's recent measles-containing vaccination while on immunosuppressive medications, consistent clinical findings, and the lack of epidemiological risk factors for wild-type infection the decision was made to treat this as a presumptive case of vaccine-associated measles virus prior to return of confirmatory genotyping results. After consultation with public health experts, contact tracing was not considered necessary. No secondary measles cases were identified, despite a large exposure potential due to lack of consistent airborne precautions during hospital admission.</p><p><strong>Discussion: </strong>This case highlights the lack of transmissibility of vaccine-associated measles in immunocompromised hosts, adding to the scant body of literature on this topic, with the potential to inform hospital infection prevention and control as well as public health management in similar situations.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"183-187"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guideline-Supported Administration of Monoclonal Antibody Therapy for High-Risk Patients with COVID-19: Experience of a Quaternary Care Centre.","authors":"Keely Hammond, François Bourdeau, Marina Klein, Donald C Vinh, Makeda Semret","doi":"10.3138/jammi-2024-0005","DOIUrl":"10.3138/jammi-2024-0005","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised patients remain at risk of progression to severe COVID-19 disease.</p><p><strong>Methods: </strong>We describe clinical COVID-19-related outcomes after administration of anti-SARS-CoV-2 monoclonal antibodies (mAb) following institutional clinical practice guidelines (CPGs) in 205 high-risk patients between November 2021 and April 2022 at a Canadian quaternary care centre.</p><p><strong>Results: </strong>Median patient age was 59 years; 102 (50%) were female. Eighty-two (40%) were transplant recipients, 47 (23%) patients had hematologic malignancies, 25 (12%) had solid organ malignancies, and 51 (25%) had another indication. Forty-eight (23%) had received fewer than two doses of anti-SARS-CoV-2 vaccines. The majority (80%) had mild disease at presentation with 14% moderate and 6% severe. Median time from symptom onset to mAb administration was 3 days (IQR 2.0-5.5 days). Of those who received mAb as outpatients, 90 (93%) had favourable clinical outcomes (no COVID-19-related hospitalizations or death within 3 months). Of those who received mAb as inpatients, 93 (86%) had favourable outcomes (discharged without COVID-19-related re-admission or death), 4% were re-admitted, and 10% died. In logistic regression analysis, only disease severity at time of mAb administration was associated with unfavourable outcomes. Fewer than two vaccine doses was not associated with unfavourable outcomes, suggesting potential benefit among the under-vaccinated. There was a significant difference in adherence to CPGs between administration of mAb in outpatients versus inpatients (adherent for 85% versus 58%, <i>p</i> < 0.001), where non-adherence occurred in cases of severe disease.</p><p><strong>Conclusion: </strong>CPG-supported mAb administration for management of COVID-19 in high-risk patients was associated with favourable clinical outcomes and may be a useful model to guide future therapies.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 3","pages":"140-150"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of climate change on amoeba and the bacteria they host.","authors":"Ashley Heilmann, Zulma Rueda, David Alexander, Kevin B Laupland, Yoav Keynan","doi":"10.3138/jammi-2023-09-08","DOIUrl":"https://doi.org/10.3138/jammi-2023-09-08","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"9 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}