Metagenomic analysis after selective culture enrichment of hospital and community wastewater enhances antimicrobial resistance gene detection.

Antimicrobial resistance is an accelerating threat to global health. Wastewater-based surveillance (WBS) enables objective, inclusive, and comprehensive assessments of population-level antimicrobial resistance; however, it is limited in its ability to detect rare antibiotic resistance genes (ARG). We compared traditional high-depth metagenomic sequencing of raw wastewater with lower-depth sequencing following semi-selective culture enrichment for gram negatives for rare ARGs in wastewater from two tertiary-care hospitals and two nearby urban neighborhoods.

Consistent trends from different methods for monitoring SARS-CoV-2 in urban wastewater during a 29-month longitudinal study.

Rigorous method development and validation to detect and quantify SARS-CoV-2 RNA in wastewater has led to important advances in community disease surveillance using quantitative molecular biology tools. Despite this progress, agreement on standardized workflows for this important public health objective has been elusive. Multiple studies have compared different protocols but have been limited by short periods of observation or low numbers of test sites.

Candidemia Treatment is Improved by Infectious Disease Consultation: A Population-Based Cohort Study.

Introduction: 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.

Time to replace the oral glucose tolerance test for cystic fibrosis related diabetes first-step screening? Establishing glycemic tools relevant to cystic fibrosis.

Introduction: As the life expectancy of people with cystic fibrosis (CF) increases, complications related to CF, such as CF-related diabetes (CFRD), are of great concern. Oral glucose tolerance test (OGTT) is the current gold standard test to screen for CFRD, which is associated with reduced lung function and body mass index (BMI). However, this is a cumbersome test with poor adherence, and emerging evidence suggests that HbA1c or serum fructosamine might be viable alternative screening tools.

Trends in Medicare versus Medicaid spending on CFTR modulator therapy - an economic evaluation.

The introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators has changed the landscape of therapy for persons with cystic fibrosis. However, the steep cost of targeted therapy poses significant financial burden for individuals and health systems. We aimed to determine the trends in Medicare and Medicaid spending on CFTR modulators between the years 2015 and 2022 through retrospective analysis of the Medicare and Medicaid claims data.

Cytomegalovirus serostatus among people with HIV, characterizing the prevalence, risk factors, and association with immune recovery.

Introduction: Cytomegalovirus (CMV) infection is common among people with HIV (PWH), and may be associated with negative outcomes. We aimed to identify the seroprevalence of CMV between 01 January 1998 and 01 June 2022 among PWH accessing care at the Southern Alberta Clinic (SAC) and the associated risk factors. We also aimed to assess the impact of CMV seropositivity on CD4+ T-cells and CD4+/CD8+ ratio recovery among PWH who maintain HIV viral suppression.

Genomic analysis of the liverpool epidemic strain of pseudomonas aeruginosa infecting persons with cystic fibrosis reveals likely Canadian origins.

Introduction: The Liverpool Epidemic Strain (LES) of Pseudomonas aeruginosa is one of several known strains to be transmissible between persons with cystic fibrosis (CF) (pwCF) and the only known strain to have infected large proportions of CF populations on two continents. Despite its prevalence, efforts to understand its spread have proven elusive.

Methods: We leveraged a prospective collection of P.

Longitudinal monitoring of sewershed resistomes in socioeconomically diverse urban neighborhoods.

Background: Understanding factors associated with antimicrobial resistance (AMR) distribution across populations is a necessary step in planning mitigation measures. While associations between AMR and socioeconomic-status (SES), including employment and education have been increasingly recognized in low- and middle-income settings, connections are less clear in high-income countries where SES remains an important influence on other health outcomes.

Methods: We explored the relationship between SES and AMR in Calgary, Canada using spatially-resolved wastewater-based surveillance of resistomes detected by metagenomics across eight socio-economically diverse urban neighborhoods.

Clinical epidemiology and impact of Haemophilus influenzae airway infections in adults with cystic fibrosis.

Background: Haemophilus influenzae is prevalent within the airways of persons with cystic fibrosis (pwCF). H. influenzae is often associated with pulmonary exacerbations (PEx) in pediatric cohorts, but in adults, studies have yielded conflicting reports around the impact(s) on clinical outcomes such as lung function decline.

Combined medical-interventional approaches for the management of complex fungal balls: a case series as a viable alternative in non-surgical patients.

Intracavitary pulmonary aspergilloma is a persistent and life-threatening infection that carries a mortality rate of up to 15%. It occurs when Aspergillus species gain entry to an existing lung cavity. In the absence of definitive treatment, patients may succumb to severe complications such as massive hemoptysis, cachexia, or secondary infections.

The airway microbiome of persons with cystic fibrosis correlates with acquisition and microbiological outcomes of incident infection.

Rationale: Chronic infection with in persons with cystic fibrosis (pwCF) has been linked to an increased risk of pulmonary exacerbations and lung function decline. We sought to establish whether baseline sputum microbiome associates with risk of incident infection and persistence in pwCF.

Methods: pwCF experiencing incident infections attending the Calgary Adult CF Clinic from 2010-2018 were compared with -negative sex, age (+/-2 years), and birth-cohort-matched controls.

Porcine-derived pancreatic enzyme replacement therapy may be linked to chronic hepatitis E virus infection in cystic fibrosis lung transplant recipients.

Objectives: In high-income countries hepatitis E virus (HEV) is an uncommonly diagnosed porcine-derived zoonoses. After identifying disproportionate chronic HEV infections in persons with cystic fibrosis (pwCF) postlung transplant, we sought to understand its epidemiology and potential drivers.

Design: All pwCF post-transplant attending our regional CF centre were screened for HEV.

Evaluating Sinus Microbiology by Transplant Status in Persons With Cystic Fibrosis: A Matched Cohort Study.

Objective: Sinus disease is prevalent in persons with cystic fibrosis (PwCF) and may be a reservoir of airway infection in postlung transplant (pTx) patients. The microbial composition of cystic fibrosis sinuses and its associations with chronic rhinosinusitis (CRS) is relatively unexplored. We aimed to examine the sinus and lower airway microbiome and their associations with CRS in PwCF and pTxPwCF.

A Bayesian framework for modeling COVID-19 case numbers through longitudinal monitoring of SARS-CoV-2 RNA in wastewater.

Wastewater-based surveillance has become an important tool for research groups and public health agencies investigating and monitoring the COVID-19 pandemic and other public health emergencies including other pathogens and drug abuse. While there is an emerging body of evidence exploring the possibility of predicting COVID-19 infections from wastewater signals, there remain significant challenges for statistical modeling. Longitudinal observations of viral copies in municipal wastewater can be influenced by noisy datasets and missing values with irregular and sparse samplings.

Wastewater-based surveillance as a tool for public health action: SARS-CoV-2 and beyond.

Wastewater-based surveillance (WBS) has undergone dramatic advancement in the context of the coronavirus disease 2019 (COVID-19) pandemic. The power and potential of this platform technology were rapidly realized when it became evident that not only did WBS-measured SARS-CoV-2 RNA correlate strongly with COVID-19 clinical disease within monitored populations but also, in fact, it functioned as a leading indicator. Teams from across the globe rapidly innovated novel approaches by which wastewater could be collected from diverse sewersheds ranging from wastewater treatment plants (enabling community-level surveillance) to more granular locations including individual neighborhoods and high-risk buildings such as long-term care facilities (LTCF).

Elexacaftor-Tezacaftor-Ivacaftor in 2 cystic fibrosis adults homozygous for M1101K with end-stage lung disease.

Elexacaftor-tezacaftor-ivacaftor (ETI) therapy is shown to improve the health of individuals with cystic fibrosis (CF) who have the F508del variant. There are studies showing benefit with ETI for select rare CF variants. Limited data exists on the use of ETI in individuals with rare CF variants, particularly in those with advanced lung disease.

Prevalence and impact of human papillomavirus (HPV) in adults with cystic fibrosis: A self-reported cross-sectional Canadian survey.

Background: In persons with cystic fibrosis (pwCF), little is known about the prevalence or impact of HPV on quality of life and attitudes towards vaccination.

Methods: We conducted a national online survey of adult pwCF. We sought to determine the prevalence of self-reported HPV infection, disease-associated complications and effects on quality of life.

Campus node-based wastewater surveillance enables COVID-19 case localization and confirms lower SARS-CoV-2 burden relative to the surrounding community.

Wastewater-based surveillance (WBS) has been established as a powerful tool that can guide health policy at multiple levels of government. However, this approach has not been well assessed at more granular scales, including large work sites such as University campuses. Between August 2021 and April 2022, we explored the occurrence of SARS-CoV-2 RNA in wastewater using qPCR assays from multiple complimentary sewer catchments and residential buildings spanning the University of Calgary's campus and how this compared to levels from the municipal wastewater treatment plant servicing the campus.

natural history and evolution in the airways of adults with cystic fibrosis.

Introduction: is an opportunistic pathogen infecting persons with cystic fibrosis (pwCF) and portends a worse prognosis. Studies of infection dynamics have been limited by cohort size and follow-up. We investigated the natural history, transmission potential, and evolution of in a large Canadian cohort of 321 pwCF over a 37-year period.

Wastewater-based surveillance can be used to model COVID-19-associated workforce absenteeism.

Wastewater-based surveillance (WBS) of infectious diseases is a powerful tool for understanding community COVID-19 disease burden and informing public health policy. The potential of WBS for understanding COVID-19's impact in non-healthcare settings has not been explored to the same degree. Here we examined how SARS-CoV-2 measured from municipal wastewater treatment plants (WWTPs) correlates with workforce absenteeism.

Single nucleotide variants in populations from sputum correlate with baseline lung function and predict disease progression in individuals with cystic fibrosis.

The severity and progression of lung disease are highly variable across individuals with cystic fibrosis (CF) and are imperfectly predicted by mutations in the human gene CFTR, lung microbiome variation or other clinical factors. The opportunistic pathogen () dominates airway infections in most CF adults. Here we hypothesized that within-host genetic variation of populations would be associated with lung disease severity.

Incidence, susceptibility and outcomes of candidemia in adults living in Calgary, Alberta, Canada (2010-2018).

Background: Candidemia is increasing in frequency and is associated with high mortality. We sought to determine the burden of illness, the population it affects and its resistance profile in our region.

Methods: The Calgary Zone (CZ) provides all care for residents of Calgary and surrounding communities (~ 1.