Publications by authors named "Jennifer M Grant"

Background: We aimed to evaluate the impact of health care vaccine mandates on vaccine uptake and infection risk in a cohort of Canadian health care workers (HCWs).

Methods: We conduct interrupted time series analysis through a regression discontinuity in time approach to estimate the immediate and delayed impact of the mandate. Multilevel mixed effect modeling fitted with restricted maximum likelihood was used to estimate impact on infection risk.

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Background: Acyclovir has an important role in the treatment of viral central nervous system (CNS) infection, especially herpes simplex virus (HSV)-1 encephalitis. It is therefore used broadly as empiric therapy for many patients who present to the hospital with symptoms of a possible neurologic infection. We sought to review our practices in acyclovir prescribing, deprescribing, and associated investigations for the clinical syndromes it treats.

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The COVID-19 pandemic highlighted hurdles for healthcare delivery and personnel globally. Vaccination has been an important tool for preventing severe illness and death in healthcare workers (HCWs) as well as the public at large. However, vaccination has resulted in some HCWs requiring time off work post-vaccination to recover from adverse events.

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Article Synopsis
  • The study addresses the uncertainty regarding the best treatment for penicillin-susceptible Staphylococcus aureus (PSSA) infections and concerns about testing reliability for detecting some resistant strains.
  • Researchers sent PSSA isolates to 34 labs across multiple countries to evaluate the performance of two different susceptibility testing methods (CLSI and EUCAST) using blaZ PCR as a reference.
  • Results showed that the EUCAST method had better accuracy and lower error rates compared to the CLSI method, highlighting the need to consider that most clinically relevant PSSA isolates do not have genetic elements indicating resistance, making treatment decisions complex.
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Introduction: Healthcare workers (HCWs) play a critical role in responding to the COVID-19 pandemic. Early in the pandemic, urban centres were hit hardest globally; rural areas gradually became more impacted. We compared COVID-19 infection and vaccine uptake in HCWs living in urban versus rural locations within, and between, two health regions in British Columbia (BC), Canada.

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Background: People with immune dysfunction are at higher risk of severe outcomes from COVID-19 infection, but relatively little epidemiologic information is available for mostly vaccinated population in the Omicron era. This population-based study compared relative risk of breakthrough COVID-19 hospitalisation among vaccinated people identified as clinically extremely vulnerable (CEV) vs non-CEV individuals before treatment became more widely available.

Methods: COVID-19 cases and hospitalisations reported to the British Columbia Centre for Disease Control (BCCDC) between January 7, 2022 and March 14, 2022 were linked with data on their vaccination and CEV status.

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Background: The burden of severe disease and death due to SARS-CoV-2 (COVID-19) pandemic among healthcare workers (HCWs) worldwide has been substantial. Masking is a critical control measure to effectively protect HCWs from respiratory infectious diseases, yet for COVID-19, masking policies have varied considerably across jurisdictions. As Omicron variants began to be predominant, the value of switching from a permissive approach based on a point of care risk assessment (PCRA) to a rigid masking policy needed to be assessed.

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Background: We evaluated measures to protect healthcare workers (HCWs) in Vancouver, Canada, where variants of concern (VOC) went from <1% VOC in February 2021 to >92% in mid-May. Canada has amongst the longest periods between vaccine doses worldwide, despite Vancouver having the highest P.1 variant rate outside Brazil.

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Background: Cefazolin surgical prophylaxis is associated with better patient outcomes; however, its use in penicillin-allergic patients is controversial. We evaluated the safety of cefazolin as surgical prophylaxis in penicillin-allergic patients, including those with anaphylaxis histories.

Methods: We conducted a pre and postintervention quality improvement evaluation of an institution-wide policy change at a tertiary-care hospital, before (October 2017-January 2018), during (February 2018-September 2018), and after (October 2018-October 2019) transition to routine cefazolin prophylaxis for penicillin-allergic patients, including those with anaphylaxis histories but excluding severe delayed reactions (eg, Stevens-Johnson syndrome).

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Article Synopsis
  • The Accelerate Pheno system (AXDX) offers quick identification of pathogens (90 minutes) and antimicrobial susceptibility testing (AST; around 7 hours) from positive blood cultures, which could enhance antibiotic treatment timing.
  • In a study of 158 blood culture specimens, AXDX results were found to be available significantly faster (11.9 hours for ID and 27.7 hours for AST) compared to the standard care, with a high percentage of accurate results.
  • Clinicians could have implemented interventions up to 39 hours sooner using AXDX data, highlighting its potential to improve patient outcomes through timely and informed antibiotic adjustments.
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Background: Antimicrobial resistance is a growing threat to the world's ability to prevent and treat infections. Links between quantitative antibiotic use and the emergence of bacterial resistance are well documented. This study presents benchmark antimicrobial use (AMU) rates for inpatient adult populations in acute-care hospitals across Canada.

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Article Synopsis
  • Multidrug-resistant strains of Klebsiella pneumoniae and Escherichia coli carrying the NDM-1 gene were identified in a Canadian patient who traveled from India.
  • The NDM-1 gene is located on similar types of plasmids known as incompatibility group A/C.
  • The presence of NDM-1 in North America raises significant public health risks due to its resistance to multiple antibiotics.
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We report the first case of atovaquone/proguanil treatment failure in severe Plasmodium falciparum malaria acquired by a non-immune traveller to the Indian subcontinent. Recrudescent infection was complicated by neurological involvement 14 days after directly observed therapy with atovaquone/proguanil. Sequence analysis of the plasmodial cytochrome b gene confirmed a contribution of atovaquone resistance to treatment failure.

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The accepted standard for treatment of zygomycetes is amphotericin B and surgical debridement, however recent data suggest that combined treatment modalities may be optimal. Newer anti-fungal agents show success in vitro and in animal models. We present the case of a 10-year-old boy with invasive Rhizopus microsporus var.

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