JAMMI最新文献

{"title":"Investigating in-hospital transmission of <i>Clostridioides difficile</i> from asymptomatic patients.","authors":"Sheridan J C Baker, Julia Maciejewski, Mary-Theresa Usuanlele, Jodi Gilchrist, Dhundi Raj Sharma, David Bulir, Marek Smieja, Mark Loeb, Michael G Surette, Andrew G McArthur, Dominik Mertz","doi":"10.3138/jammi-2024-0041","DOIUrl":"https://doi.org/10.3138/jammi-2024-0041","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> is a bacillus that can colonize the intestinal tract. <i>C. difficile</i> infection (CDI) is a common, health care-associated disease often coinciding with antibiotic use, with presentation ranging from diarrhea to toxic megacolon and death. However, individuals can carry the pathogen without exhibiting symptoms of disease. <i>C. difficile</i> carriers may serve as an important reservoir for in-hospital transmission of <i>C. difficile.</i> The objective of this study was to assess the role asymptomatic <i>C. difficile</i> carriers may play in pathogen transmission.</p><p><strong>Methods: </strong>In this retrospective cohort study, rectal swabs collected to test for antimicrobial-resistant organisms either upon admission or during the hospital stay were used to test for asymptomatic <i>C. difficile</i> carriage using molecular testing, with positive samples cultured and subsequently sequenced. Sampling occurred across three tertiary care hospitals with predominantly multi-bedded rooms. A whole-genome single-nucleotide variant phylogenetic tree was then constructed and closely related samples from patients that had spatial and temporal in-hospital overlap were identified as putative transmission events.</p><p><strong>Results: </strong>Approximately 11% of the 1,467 patients tested were carriers of <i>C. difficile</i>. Seventy-four of the carriers were culture-positive, of which 43 had a suitable sequence for typing. Of the sequenced samples, 40% were identified as belonging to a potential transmission event. Six different potential transmission groups were identified, with the largest putative transmission group spanning two hospitals and 6 months.</p><p><strong>Conclusions: </strong>Our results suggest that asymptomatic transmission in hospital settings may be much more common than previously thought, with asymptomatic individuals colonized with <i>C. difficile</i> providing a sizable source of transmission of the pathogen.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 3","pages":"228-238"},"PeriodicalIF":1.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12657012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640714","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":"Appropriateness of intravenous vancomycin prescribing in a Canadian acute care hospital.","authors":"Heather Glassman, Arif Ismail, Dima Kabbani, Stephanie W Smith, Jackson J Stewart, Cecilia Lau, Justin Z Chen","doi":"10.3138/jammi-2024-0040","DOIUrl":"https://doi.org/10.3138/jammi-2024-0040","url":null,"abstract":"<p><strong>Background: </strong>There are associated adverse effects with intravenous (IV) vancomycin, yet there is a paucity of published literature surveying the appropriateness of use. The objective of the study was to assess the appropriateness of IV vancomycin prescriptions at a Canadian acute care hospital.</p><p><strong>Methods: </strong>A pilot, pragmatic antimicrobial stewardship initiative using prospective audit and feedback (PAF) was conducted on incident IV vancomycin prescriptions for 4 weeks in 2022. The primary outcome was the percentage of IV vancomycin prescriptions assessed as appropriate against institutional prescribing guidelines. The secondary outcomes were to evaluate factors affecting appropriateness and to determine the number and types of ASP recommendations where IV vancomycin was assessed as suboptimal.</p><p><strong>Results: </strong>Out of 109 prescriptions audited, 43 (39%) were assessed to be suboptimal. Discontinuing or changing the agent was recommended in 39 cases (91%) and regimen optimization (duration or frequency change) was only recommended in only 4 (9%). ASP recommendations were fully or partially accepted in 88%. Infectious disease consultation (IDC) was associated with greater appropriateness (83% versus 53%; <i>p</i> = 0.004), as was Methicillin resistant <i>Staphylococcus aureus</i> (MRSA) colonization (75% versus 55%; <i>p</i> = 0.047), but not acute kidney injury (AKI) (62% versus 60%; <i>p</i> = 0.889). Adjusting for age, AKI and MRSA colonization, IDC remained a significant predictor of vancomycin appropriateness (adjusted odds ratio [aOR] = 4.27, [95% CI 1.44 to 12.70]; <i>p</i> = 0.009).</p><p><strong>Conclusions: </strong>Prospective audit and feedback demonstrated inappropriate IV vancomycin use at our centre and an opportunity for quality improvement.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 3","pages":"252-256"},"PeriodicalIF":1.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12656756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640783","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":"Diagnosing and Treating Community-Acquired Pneumonia-A Double-Blind Study?","authors":"Yoav Keynan, Sylvain A Lother, Kevin Laupland, Zulma V Rueda","doi":"10.3138/jammi-2025-0226","DOIUrl":"10.3138/jammi-2025-0226","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650815","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":"Corrigendum.","authors":"","doi":"10.3138/jammi-2025-0506","DOIUrl":"https://doi.org/10.3138/jammi-2025-0506","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3138/jammi-2024-0018.].</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"209"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650814","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":"Use of Oral Antibiotic Therapy for Prosthetic Joint Infections: Considerations for Implementation of Interdisciplinary Practice Changes.","authors":"Philip W Lam, Philippe Lagacé-Wiens, Wayne L Gold, Shaqil Peermohamed, Larissa M Matukas, Susan M Poutanen, Marie-Félixe Granger, Deborah Yamamura, Jerome A Leis","doi":"10.3138/jammi-2025-0326","DOIUrl":"10.3138/jammi-2025-0326","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"105-111"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132159","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":"Antiviral Therapy for HPAI and Reported Oseltamivir Resistance in Canada.","authors":"Samira Mubareka, Jesse Papenburg, Robyn Harrison, Upton Allen, Danuta M Skowronski, Todd F Hatchette, Gerald A Evans","doi":"10.3138/jammi-2025-0307","DOIUrl":"10.3138/jammi-2025-0307","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"101-104"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650861","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 the COVID-19 Pandemic on Hospital Antimicrobial Purchasing in Canada (2018-2021): An Exploratory Analysis.","authors":"Janine Xu, Jessica J Bartoszko, Joëlle Cayen, Glenys Smith, John Conly, Charles Frenette, Jennifer Happe, B Lynn Johnston, Yves Longtin, Dominik Mertz, Robyn Mitchell, Linda Pelude, Kathryn N Suh, Daniel Jg Thirion, Wallis Rudnick","doi":"10.3138/jammi-2024-0017","DOIUrl":"10.3138/jammi-2024-0017","url":null,"abstract":"<p><strong>Background: </strong>The impact of the COVID-19 pandemic on antimicrobial use in Canadian hospitals is not well characterized. We explored the relationship between the COVID-19 pandemic and Canadian hospital antimicrobial purchasing (AMP)-a proxy for consumption.</p><p><strong>Methods: </strong>Hospital-level AMP data were obtained from IQVIA, a health analytics company, and matched with inpatient patient-day denominator data from 28 hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Monthly AMP was measured using defined daily doses (DDDs) per 1,000 patient-days. Segmented linear regression with hospital-level clustering assessed for step and slope changes in AMP between pre-pandemic (January 1, 2018 - February 29, 2020) and pandemic (March 1, 2020 - December 31, 2021) periods.</p><p><strong>Results: </strong>Although we found an initial increase in AMP with the onset of the pandemic (+42 DDDs/1,000 patient-days [pd]) followed by a decreasing trend in AMP during the pandemic (-5 DDDs/1,000 pd per month), neither was statistically significant. Changes in trends varied across antimicrobial classes/subclasses, with decreases in broad-spectrum penicillins (-2 DDDs/1,000 pd per month, <i>p</i> < .001) and macrolides/lincosamides (-2 DDDs/1,000 pd per month, <i>p</i> < .001) and an increase in carbapenems (1 DDD/1,000 pd per month, <i>p</i> < .001). These results coincided with decreases in piperacillin/tazobactam (<i>p</i> = .003) and azithromycin (<i>p</i> = .001) and an increase in meropenem (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>We observed a transient increase in overall AMP with the onset of the pandemic (March 2020) in this exploratory analysis of a sample of 28 hospitals. Changes in trends varied by antimicrobial class/subclass and individual agent. Further work is needed to discern contributors to these trends, such as changes in inpatient characteristics and treatment guidelines.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"146-159"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650816","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":"Trends in Oral Antibiotic Treatment in Patients Hospitalized with Diabetic Foot Osteomyelitis: A Single-Centre Experience.","authors":"Darren Rich, Nick Daneman, Philip W Lam","doi":"10.3138/jammi-2024-0042","DOIUrl":"10.3138/jammi-2024-0042","url":null,"abstract":"<p><strong>Background: </strong>The Oral Versus Intravenous Antibiotics for Bone and Joint Infection (OVIVA) trial demonstrated the efficacy of highly bioavailable oral antibiotic therapy for the treatment of osteoarticular infections. However, there continues to be significant variability in practice. This study aimed to assess changes in oral antibiotic use in the treatment of diabetic foot osteomyelitis (DFO) at a large academic hospital.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients admitted to Sunnybrook Health Sciences Centre from January 1, 2016, to December 31, 2022, with a diagnosis of DFO. The primary outcome was the proportion of patients who received definitive oral antibiotic treatment during two timeframes (Pre-OVIVA publication: January 1, 2016, through February 28, 2019, and post-OVIVA publication: March 1, 2019, to December 31, 2022). Patients were excluded if they had another indication for long-term intravenous antibiotics, if they did not receive antibiotic treatment for osteomyelitis, or if they underwent amputation without the need for postoperative antibiotics.</p><p><strong>Results: </strong>A total of 145 patients were included in the analysis. (65 patients pre-OVIVA and 80 patients post-OVIVA). The majority of patients had a history of peripheral arterial disease (59%) and gangrene (66%) present on hospital admission. Use of definitive oral antibiotic therapy increased from 10.8% in the pre-OVIVA period to 21.2% in the post-OVIVA period (<i>p</i> = 0.14).</p><p><strong>Conclusions: </strong>There was a trend toward increased definitive oral antibiotic therapy for DFO, but overall use remained low. Further studies are needed to explore the factors influencing the selection of oral antibiotic therapy in this population.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"179-185"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650819","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":"Concordance of Anosmia Between Household Members Affected by COVID-19 Infection.","authors":"Sheliza Halani, Alex Kiss, Jose Estrada-Codecido, Amal Ga'al, Abby Kapsack, Alice Zhabokritsky, Adrienne K Chan, Philip W Lam, Andrew Simor, Jerome A Leis, Samira Mubareka, Nick Daneman, Nisha Andany","doi":"10.3138/jammi-2025-0002","DOIUrl":"10.3138/jammi-2025-0002","url":null,"abstract":"<p><strong>Background: </strong>Alterations in smell (anosmia) and taste (dysgeusia) are common with SARS-CoV-2. The study objective was to evaluate for concordance in anosmia and dysgeusia among household members affected by COVID-19.</p><p><strong>Methods: </strong>A retrospective cohort study of individuals followed by the COVIDEO program at Sunnybrook Health Sciences Centre was performed for patients ≥4 years old diagnosed with COVID-19 between April 1, 2020, to December 31, 2020. Households were identified, and index cases were selected based on the first subject assessed by COVIDEO. Controls for each household contact were identified from the COVIDEO database by matching age (within 10 years) and date of diagnosis (closest within 3 months thereafter). Concordance of anosmia and dysgeusia was determined between index cases and household contacts compared to nonhousehold controls.</p><p><strong>Results: </strong>A total of 353 households were identified: 963 subjects (353 index cases, 600 household contacts) and 600 controls. Median age was 30 years (interquartile range [IQR]: 16, 49), and 50% (475/953) were women. Prevalence of anosmia and dysgeusia were 23.6% and 22.7%, respectively. Anosmia concordance was 64.3% between index cases and nonhousehold controls, compared to 65.7% (<i>p</i> = 0.09) between index cases and nongenetically related household members, and 69.4% (<i>p</i> = 0.74) between index cases and genetically related household members. In multivariate analysis, anosmia was more likely to be reported with longer time from symptom onset (OR 1.06 per day [95% CI 1.02 to 1.1]), and with rhinorrhea (OR 2.2 [95% CI 1.6 to 3.0]), or dyspnea (OR 2.4 [95% CI 1.3 to 4.4]).</p><p><strong>Conclusions: </strong>There was no significant difference in anosmia and dysgeusia concordance between genetically related and unrelated household members or non-household controls.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"186-191"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650813","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":"Surveillance for Health Care-Associated Infections, Antimicrobial Resistant Organisms and Antimicrobial use in Canadian Long-Term Care Homes: A Cross-Sectional Survey.","authors":"Jessica J Bartoszko, Andrew Neitzel, Zainab Suleman, Tamara Duncombe, George Golding, Jennifer Happe, Alexandra C McFarlane, Allison McGeer, Marjorie Belzile, Christine Cohoon, Youhanna Salib, Julie Weir, Jennie Johnstone, Ramona Rodrigues, Barbara Catt, Kelly Choi, Svjetlana Crkvenjas, Lunadel Daclan, Yvette Gable, Robyn Mitchell, Kathryn Suh, Esther Thompson, B Lynn Johnston, Olivia Varsaneux","doi":"10.3138/jammi-2024-0019","DOIUrl":"10.3138/jammi-2024-0019","url":null,"abstract":"<p><strong>Background: </strong>Our understanding of health care-associated infection (HAI), antimicrobial resistant organism (ARO), and antimicrobial use (AMU) surveillance activities across Canadian long-term care homes (LTCHs) is limited, in part because nationwide surveillance in this setting has yet to be established.</p><p><strong>Methods: </strong>To address this knowledge gap, the Canadian Nosocomial Infection Surveillance Program administered a 12-item cross-sectional survey to LTCHs across all provinces and territories in English and French. LTCHs were defined as government-licensed homes for individuals with medical needs who require 24-hour onsite access to registered nurse care and/or treatment.</p><p><strong>Results: </strong>Between June 1 and November 28, 2023, 770 of an estimated 2,076 LTCHs responded to the survey (37%). Of the respondents, 41% (318/770) were publicly funded, 67% (504/758) had between 51 and 200 long-term care beds, and 92% (694/758) reported having a designated person who leads infection prevention and control. The majority of LTCHs reported conducting outbreak surveillance (680/713, 95%) and surveillance for at least one type of HAI (672/740, 91%). The most common HAIs under surveillance were urinary tract infection (576/725, 79%), <i>Clostridioides difficile</i> infection (546/725, 75%), and gastroenteritis (545/725, 75%). Half of the LTCHs reported testing new residents for AROs via pre-admission or admission cultures (368/713, 52%). Almost two-thirds (441/703, 63%) reported monitoring systemic antibiotic use.</p><p><strong>Conclusions: </strong>Despite differences in the scope of surveillance activities, mechanisms to measure the burden of HAIs and AROs in this setting exist and may provide the foundation for future national surveillance activities. Generalizability to all Canadian LTCHs is uncertain due to possible sampling, non-response, and social desirability biases.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 2","pages":"160-170"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650817","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}