Coping with stressful life disruptions due to long COVID: A qualitative study.

Background: Long COVID impacts people's physical health and cognition which immensely affects their psychosocial well-being. A larger study was conducted that explored the psychosocial impacts of Long COVID on individuals and caregivers. This paper focuses on the impact of these stressful disruptions on one's health and psychosocial well-being, and how individuals cope with them.

Clinical course of patients with bloodstream infections enrolled in the BALANCE clinical trial.

Objectives: There is a lack of data describing the longitudinal clinical trajectories of vital signs and laboratory tests in patients with bloodstream infection (BSI). The BALANCE trial, which randomly assigned patients with BSI to receive 7 or 14 days of antibiotic treatment, provided rich daily data to describe these trajectories.

Methods: As part of the BALANCE trial, we collected several daily parameters (temperature, heart rate, mean arterial pressure, systolic blood pressure, respiratory rate, WBC count, C-reactive protein, platelet count and SOFA score) until Day 14 of illness, discharge or death.

Incidence of Respiratory Syncytial Virus-Associated Hospitalization Among Adults in Ontario, Canada, 2017-2019.

Background: Respiratory syncytial virus (RSV) causes substantial morbidity and mortality among adults. Given recent RSV vaccine authorizations, data on groups at highest risk are needed to support vaccine program decision making.

Methods: We identified adults aged ≥ 18 years hospitalized with laboratory-confirmed RSV and hospitalizations with RSV-related diagnostic codes in Ontario, Canada (2017-2019).

Differentiation of COVID-19 from other types of viral pneumonia and severity scoring on baseline chest radiographs: Comparison of deep learning with multi-reader evaluation.

Chest X-ray (CXR) imaging plays a pivotal role in the diagnosis and prognosis of viral pneumonia. However, distinguishing COVID-19 CXRs from other viral infections remains challenging due to highly similar radiographic features. Most existing deep learning (DL) models focus on differentiating COVID-19 from community-acquired pneumonia (CAP) rather than other viral pneumonias and often overlook baseline CXRs, missing the critical window for early detection and intervention.

Clinical evaluation of adults undergoing elective surgery utilizing intraoperative incisional wound irrigation (CLEAN Wound): protocol for a randomised controlled trial.

Introduction: In moderate to high-risk surgical procedures, 15-25% of patients develop a postoperative surgical site infection. Intraoperative incisional wound irrigation has the potential to reduce surgical site infections, and additional randomised controlled trials are required to provide evidence of effectiveness.

Methods And Analysis: This protocol describes a pragmatic, adaptive, participant and adjudicator-blinded trial at 13 sites in Canada in up to 2500 participants.

Moving from intervention management to disease management for Clostridioides difficile infection: an economic evaluation exploring the impact of a systems approach to health technology assessment.

Objective: Our objective was to test the impact of assessing the cost-effectiveness of a hypothetical new preventative intervention in combination with a new treatment strategy and to compare this to the conventional approach which typically assesses a new preventative intervention independently from changes to the treatment strategy.

Methods: We used traditional cost-effectiveness methodology and Clostridiodes difficile infection as a case study to identify the optimal implementation strategy for a new vaccine assuming static downstream treatment interventions (conventional approach) vs. in combination with a new (more effective, more costly) treatment.

Trends in Oral Antibiotic Treatment in Patients Hospitalized with Diabetic Foot Osteomyelitis: A Single-Centre Experience.

Background: 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.

Concordance of Anosmia Between Household Members Affected by COVID-19 Infection.

Background: 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.

Methods: 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.

Spillover From an Intervention on Antibiotic Prescribing for Family Physicians: A Post Hoc Secondary Analysis of a Randomized Clinical Trial.

Importance: Antibiotic audit and feedback is effective at reducing antibiotic prescribing in primary care.

Objective: To evaluate the spillover of an audit-and-feedback intervention originally targeted at patients aged 65 years or older on a broader population of all age groups.

Design, Setting, And Participants: This is a post hoc secondary analysis of a randomized clinical trial that was conducted among primary care physicians in Ontario, Canada.

Exploring variability in antibiograms: a cross-sectional study.

Background: Antibiograms are important tools for guiding empirical antimicrobial prescribing and monitoring antimicrobial resistance (AMR); however, there are challenges to their implementation and interpretation in practice. Variable formatting may be a contributing factor. This study explores variability in antibiogram data presentation to identify opportunities for improvement.

Making sense of hierarchical composite endpoints in randomized clinical trials - a primer for infectious disease clinicians and researchers.

Hierarchical composite endpoints (HCEs), combining features of simple composite endpoints and conventional ordinal endpoints, are increasingly being used in infectious diseases research. However, many clinicians may be unfamiliar with these novel endpoints, including the variety of different target parameters that may be of interest and the methods that can be used to estimate them. In this review, we provide a conceptual overview of HCEs by defining them and providing examples from the infectious diseases literature.

Prehospital antibiotics and intravenous fluids for patients with sepsis: protocol for a 2×2 factorial randomised controlled trial.

Introduction: Prompt recognition and treatment of patients with sepsis improve survival. Patients transported to hospital with sepsis often do not receive treatment until they are assessed in emergency departments. Initiation of treatments by paramedics at the point of first contact may improve outcomes for these patients.

The Burden of Antimicrobial Resistant Bacteremia in Ontario: A Population-wide Analysis of Attributable Mortality from 110 Pathogen-Antibiotic Combinations.

Background: Reliable information on the burden of antimicrobial resistance (AMR) is necessary to confront the threat of antimicrobial resistance. We sought to examine the association between AMR and mortality across cultured bacterial bloodstream pathogens in the province of Ontario, Canada.

Methods: We used linked microbiology data from 114 hospital, community, and public health laboratories to develop a positive bacterial blood culture episode cohort, between January 2017 and December 2021, for the population of Ontario, Canada (population 14.

Cefazolin vs. antistaphylococcal penicillins for the treatment of methicillin-susceptible Staphylococcus aureus bacteraemia: a systematic review and meta-analysis.

Background: There is debate on whether cefazolin or antistaphylococcal penicillins should be the first-line treatment for methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia. Ongoing trials are investigating whether cefazolin is non-inferior to (flu)cloxacillin, but it remains uncertain whether these findings apply to other antistaphylococcal penicillins.

Objectives: We conducted a systematic review and meta-analysis comparing cefazolin with each of the individual antistaphylococcal penicillins for MSSA bacteraemia.

Reporting of sociodemographic characteristics of trial participants in infectious diseases clinical trials-a systematic review.

Background: Reporting of demographic characteristics in randomized clinical trials (RCTs) is recommended to facilitate assessment of generalizability to other populations. However, there is a lack of consensus as to what variables should be reported, and there are limited data describing current research practice.

Objectives: We aimed to evaluate reporting of sociodemographic characteristics of participants in infectious diseases RCTs and identify gaps in current practice.

Identifying heterogeneity of treatment effect for antibiotic duration in bloodstream infection: an exploratory post-hoc analysis of the BALANCE randomised clinical trial.

Background: The BALANCE trial demonstrated non-inferiority of 7 (vs 14) day antibiotic durations in patients with uncomplicated non- bacterial bloodstream infections (BSI). However, there may be patient subgroups who benefit from longer durations. We aimed to evaluate if bedside clinical decision rules could identify these subgroups.

Short versus longer duration antibiotic treatment for urinary tract infections in companion animals: a systematic review and meta-analysis.

Background: Unnecessarily prolonged antibiotic durations may contribute to the development of resistance in both humans and animals. Veterinarians need evidence supporting antibiotic treatment durations. This systematic review and meta-analysis aimed to compare the efficacy of shorter durations of antibiotic treatment to longer durations in treating urinary tract infections (UTIs) in dogs and cats.

Impact of Antibiotic Duration on Gut Microbiome Composition and Antimicrobial Resistance: A Substudy of the BALANCE Randomized Controlled Trial.

Background: Maintaining a diverse gut microbiome and minimizing antimicrobial resistance gene (ARG) carriage through reduced antibiotic utilization may decrease antimicrobial resistance. We compared gut microbiome disruption and ARG carriage following 7 or 14 days of antibiotics for treatment of bacteremia in a substudy of the BALANCE randomized controlled trial.

Methods: The BALANCE randomized controlled trial enrolled 3631 participants with bacteremia, who were randomized 1:1 to receive 7 or 14 days of antibiotics.

Seven vs Fourteen Days of Antibiotics for Gram-Negative Bloodstream Infection: A Systematic Review and Noninferiority Meta-Analysis.

Importance: Gram-negative bloodstream infections are a common cause of hospitalization. A 2-week duration of antibiotic therapy has been commonly used, but shorter durations may have similar outcomes.

Objectives: To assess whether 7 days of antibiotic therapy was noninferior to 14 days.

Patterns of outpatient antibiotic prescribing in older adults by social determinants of healthcare access: a population-based retrospective cohort study.

Objectives: Strategies to improve antibiotic use may exacerbate health inequities if they do not consider existing barriers to healthcare access. We examined associations between social determinants of healthcare access (SDOH) and antibiotic prescribing and variations in these associations pre- and post-COVID-19 emergence.

Methods: We conducted a retrospective cohort study of community-dwelling adults aged ≥66 years in Ontario, Canada, between March 2018 and March 2020 (pre-pandemic period) and March 2020 and March 2022 (pandemic period).

Impact of two antimicrobial susceptibility reporting strategies on treatment of bacteremia caused by low-risk AmpC inducible organisms.

In this retrospective study examining the treatment of low-risk AmpC-producing Enterobacterales bacteremia during two periods with different microbiology reporting strategies, reporting of ceftriaxone susceptibility was associated with a statistically significant decrease in carbapenem use as definitive therapy compared to when susceptibility was suppressed (21 vs 50%, < 0.0001).