Correlation of fecal calprotectin levels with the detection of treatable enteric pathogens in children with severe acute diarrheal disease in Botswana.

Diarrheal disease is a leading cause of death among young children globally. Current guidelines recommend supportive treatment of acute diarrhea and using antimicrobials only with presence of blood in the stool. Select enteric pathogens, including Shigella, commonly cause disease in high-burden settings; targeted treatment of these pathogens could decrease morbidity and mortality.

Whole-genome sequencing confirms infection in a child with shock and suspected multisystem inflammatory syndrome in children: A case report.

Background: Differentiating severe systemic inflammatory syndromes from sepsis can be challenging. The diagnostic process may be further complicated by concurrent infection and hyperinflammation, with important management implications. We report a child with suspected multisystem inflammatory syndrome in children, who was unexpectedly diagnosed with gastroenteritis.

Incidence and Risk Factors Associated with Microbial Colonization of Burn Wounds: An Observational Study.

Microbial colonization of burn wounds leads to infection, which is a major cause of morbidity/mortality, prolonged admission, and cost. This study aims to investigate the incidence of positive burn wound colonization and its associated risk factors in a provincial referral center within a single-payer system. We performed a retrospective review of all adult (≥18 years) patients admitted to a single, tertiary burn center, with a primary burn diagnosis between January 2011 and 2021.

Clinicopathological heterogeneity and complexity of polymicrobial brain abscesses.

Polymicrobial brain abscess (PBA) is a complex infection caused by two or more pathogens and a life-threatening condition with diagnostic and therapeutic challenges. We retrospectively identified PBAs in 31 patients (24 males and 7 females) and examined their clinical, radiological and pathological characteristics. These characteristics of PBAs were compared with those of monomicrobial BAs (MBAs) in a previously reported cohort of 113 patients in our institution.

A 10-year Retrospective Review of Patient-to-Patient Transmitted Pathogens in Culture-Positive Burn Wounds at a Tertiary Burn Center.

Burn wound infection can progress to sepsis and is a significant source of morbidity and mortality. Prevalence of multidrug-resistant organisms are high in burn patients; these organisms can be transmitted between patients leading to poor outcomes. To characterize patient-to-patient transmission of pathogens causing burn wound colonization at a single tertiary hospital burn center in Hamilton, Canada from 2011 to 2020.

The Impact of Surgical Wait Time and Hospital Stay on the Incidence of Burn Wound Infection and Related Complications at a Single Tertiary Hospital Centre: A 10-Year Experience.

Admitted patients with burn injuries require prompt treatment and shorter hospital stays to avoid hospital-acquired infections and associated complications. This study aimed to determine the impact of time to the first surgery, and total length of hospital stay on the incidence of BWI and associated complications in adult patients with moderate burn injuries at a single tertiary hospital burn center. A retrospective chart review identified burn patients admitted to the Burn Unit between January 2011 and January 2021.

Polymicrobial brain abscesses: A complex condition with diagnostic and therapeutic challenges.

Brain abscesses (BA) are focal parenchymal infections that remain life-threatening conditions. Polymicrobial BAs (PBAs) are complex coinfections of bacteria or bacterial and nonbacterial pathogens such as fungi or parasites, with diagnostic and therapeutic challenges. In this article, we comprehensively review the prevalence, pathogenesis, clinical manifestations, and microbiological, histopathological, and radiological features of PBAs, as well as treatment and prognosis.

Retrospective Review of the Clinical Outcomes of Surgically Managed Patients with Intracranial Abscesses: A Single-Center Review.

Objective: This study analyzed patient, radiologic, and clinical factors associated with operative brain abscesses and patients' functional outcomes.

Methods: A retrospective analysis was conducted of neurosurgical cases of brain abscesses from 2009 to 2019 at a Canadian center. Functional outcome was recorded as Modified Rankin Scale score and Extended Glasgow Outcome Scale score.

Purposeful microbiology comment added to urine cultures with increases orders for follow-up blood cultures.

Introduction: Patients with bacteriuria (SABU) often have underlying invasive disease, including bacteremia (SAB). It has been proposed that most patients with SABU should have a blood culture done to rule out SAB. A preliminary audit suggested that our local hospitals had a low rate of follow-up blood culture orders for patients with SABU.

Local audit of empiric antibiotic therapy in bacteremia: A retrospective cohort study.

Background: It is unclear if a local audit would be useful in providing guidance on how to improve local practice of empiric antibiotic therapy. We performed an audit of antibiotic therapy in bacteremia to evaluate the proportion and risk factors for inadequate empiric antibiotic coverage.

Methods: This retrospective cohort study included patients with positive blood cultures across 3 hospitals in Hamilton, Ontario, Canada during October of 2019.

Short-Course Antimicrobial Therapy for Pediatric Community-Acquired Pneumonia: The SAFER Randomized Clinical Trial.

Importance: Community-acquired pneumonia (CAP) is a common occurrence in childhood; consequently, evidence-based recommendations for its treatment are required.

Objective: To determine whether 5 days of high-dose amoxicillin for CAP was associated with noninferior rates of clinical cure compared with 10 days of high-dose amoxicillin.

Design, Setting, And Participants: The SAFER (Short-Course Antimicrobial Therapy for Pediatric Respiratory Infections) study was a 2-center, parallel-group, noninferiority randomized clinical trial consisting of a single-center pilot study from December 1, 2012, to March 31, 2014, and the follow-up main study from August 1, 2016, to December 31, 2019 at the emergency departments of McMaster Children's Hospital and the Children's Hospital of Eastern Ontario.

Review of high dose vancomycin in the treatment of infection.

Background: Guidelines recommend oral vancomycin as first-line therapy for infection. Guideline recommendations vary regarding dosing of vancomycin. Our aim was to summarize the current evidence on the efficacy and adverse effects of high dose oral and vancomycin retention enema (>500 mg/day) for the treatment of infection.

Screening for and decolonization of Staphylococcus aureus carriers before total joint replacement is associated with lower S aureus prosthetic joint infection rates.

Background: Prosthetic joint infections (PJI) can be devastating postoperative complications after total joint replacement (TJR). The role of decolonization of Staphylococcus aureus carriers prior to surgery still remains unclear, and the most recent guidelines do not state a formal recommendation for such strategy. Our purpose was to seek further evidence supporting preoperative screening and S aureus decolonization in patients undergoing TJR.

The use of whole body diffusion-weighted post-mortem magnetic resonance imaging in timing of perinatal deaths.

Objectives: Diffusion-weighted MRI provides information regarding body water movement following death, which may be an imaging marker of post-mortem interval (time since death; PMI) or maceration (degree of tissue degradation during intra-uterine retention) in perinatal deaths. Our aim was to evaluate the relationship between maceration, PMI and body organ apparent diffusion coefficient (ADC) values in a cohort of subjects across a wide gestational range.

Materials: Whole body post-mortem MRI with diffusion-weighted imaging (DWI) sequences were performed at 1.

Short-course antimicrobial therapy for paediatric respiratory infections (SAFER): study protocol for a randomized controlled trial.

Background: Community-acquired pneumonia (CAP) is commonly diagnosed in children. The Infectious Disease Society of America guidelines recommend 10 days of high-dose amoxicillin for the treatment of non-severe CAP but 5-day "short course" therapy may be just as effective. Randomized trials in adults have already demonstrated non-inferiority of 5-day short-course treatment for adults hospitalized with severe CAP and for adults with mild CAP treated as outpatients.

Management and outcomes in patients with Staphylococcus aureus bacteremia after implementation of mandatory infectious diseases consult: a before/after study.

Background: Infectious disease (ID) consultations have been shown to increase adherence to guidelines and decrease mortality for patients with Staphylococcus aureus bacteremia (SAB). Here, we assessed the impact of a mandatory ID consultation policy for SAB.

Methods: We retrospectively reviewed all consecutive adult patients with SAB at two tertiary care teaching hospitals in Hamilton, ON, Canada.

A Controlled Quasi-Experimental Study of an Educational Intervention to Reduce the Unnecessary Use of Antimicrobials For Asymptomatic Bacteriuria.

Background: Asymptomatic bacteriuria (ABU) should only be treated in cases of pregnancy or in-patients undergoing urologic procedures; however, unnecessary treatment of ABU is common in clinical practice.

Objective: To identify risk factors for unnecessary treatment and to assess the impact of an educational intervention focused on these risk factors on treatment of ABU.

Design: Quasi-experimental study with a control group.

Self-disinfecting sink drains reduce the Pseudomonas aeruginosa bioburden in a neonatal intensive care unit.

Aim: Water in sink drains is a known source of gram-negative bacteria. We aimed to evaluate the impact of self-disinfecting sink drains on the emission of aerosolised bacteria and on Pseudomonas aeruginosa acquisition among neonates.

Methods: Aerosol bacterial growth and patient Pseudomonas aeruginosa acquisition rates were measured at baseline (Phase One), for 13 months after sinks were relocated or redesigned during refurbishment (Phase Two) and for 13 months after introducing self-disinfecting sink drains (Phase Three).