Frequent screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic populations using antigen-based point-of-care tests (APOCTs) is occurring globally with limited ...clinical performance data. The positive predictive value (PPV) of two APOCTs used in the asymptomatic screening of SARS-CoV-2 among health care workers (HCWs) at continuing care (CC) sites across AB, Canada, was evaluated. Between 22 February and 2 May 2021, CC sites implemented SARS-CoV-2 voluntary screening of their asymptomatic HCWs. On-site testing with Abbott Panbio or BD Veritor occurred on a weekly or twice-weekly basis. Positive APOCTs were confirmed with a real-time reverse transcriptase PCR (rRT-PCR) reference method. A total of 71,847 APOCTs (17,689 Veritor and 54,158 Panbio) were performed among 369 CC sites. Eighty-seven (0.12%) APOCTs were positive, of which 39 (0.05%) were confirmed as true positives using rRT-PCR. Use of the Veritor and Panbio resulted in 76.6% and 30.0% false-positive detection, respectively (
< 0.001). This corresponded to PPVs of 23.4 and 70.0% for the Veritor and Panbio, respectively. Frequent screening of SARS-CoV-2 among asymptomatic HCWs in CC, using APOCTs, resulted in a very low detection rate and a high rate of detection of false positives. Careful assessment of the risks versus benefits of APOCT programs and the prevalence of infection in this population needs to be thoroughly considered before implementation.
•Post-marketing surveillance of sotrovimab in Canada is limited.•Sotrovimab was not associated with improved outcomes.•Study results were consistent across different analytic methodologies.•Study ...findings need to be confirmed in other Canadian provinces.
Post-marketing surveillance of sotrovimab's effect during implementation in the Canadian population is limited.
The study used a propensity score–matched retrospective cohort design. Follow-up began between the periods of December 15, 2021 and April 30 2022. The study assessed any severe outcome defined as all-cause hospital admission or mortality within 30 days of a confirmed COVID-19–positive test. Covariate-adjusted odds ratios between sotrovimab treatment and the severe outcome was conducted using logistic regression.
There were 22,289 individuals meeting the treatment criteria for sotrovimab. There were 1603 treated and 6299 untreated individuals included in the analysis. The outcome occurrence in the study was 5.49% (treated) and 4.21% (untreated), with a median time from diagnosis to treatment of 1.00 days (interquartile range 2.00 days). In the propensity-matched cohort, sotrovimab was not associated with lower odds of a severe outcome (odds ratio 1.20, 95% confidence interval 0.91-1.58), adjusting for confounding variables.
After adjusting for confounding variables, sotrovimab treatment was not associated with lower odds of a severe outcome within 30-days of COVID-19–positive date.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Methicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic bacterial organism resistant to first line antibiotics. Acquisition of MRSA is often classified as either healthcare-associated ...or community-acquired. It has been shown that both healthcare-associated and community-acquired infections contribute to the spread of MRSA within healthcare facilities. The objective of this study was to estimate the incremental inpatient cost and length of stay for individuals colonized or infected with MRSA. Common analytical methods were compared to ensure the quality of the estimate generated. This study was performed at Alberta Ministry of Health (Edmonton, Alberta), with access to clinical MRSA data collected at two Edmonton hospitals, and ministerial administrative data holdings.
A retrospective cohort study of patients with MRSA was identified using a provincial infection prevention and control database. A coarsened exact matching algorithm, and two regression models (semilogarithmic ordinary least squares model and log linked generalized linear model) were evaluated. A MRSA-free cohort from the same facilities and care units was identified for the matched method; all records were used for the regression models. Records span from January 1, 2011 to December 31, 2015, for individuals 18 or older at discharge.
Of the models evaluated, the generalized linear model was found to perform the best. Based on this model, the incremental inpatient costs associated with hospital-acquired cases were the most costly at $31,686 (14,169 - 60,158) and $47,016 (23,125 - 86,332) for colonization and infection, respectively. Community-acquired MRSA cases also represent a significant burden, with incremental inpatient costs of $7397 (2924 - 13,180) and $14,847 (8445 - 23,207) for colonization and infection, respectively. All costs are adjusted to 2016 Canadian dollars. Incremental length of stay followed a similar pattern, where hospital-acquired infections had the longest incremental stays of 35.2 (16.3-69.5) days and community-acquired colonization had the shortest incremental stays of 3.0 (0.6-6.3) days.
MRSA, and in particular, hospital-acquired MRSA, places a significant but preventable cost burden on the Alberta healthcare system. Estimates of cost and length of stay varied by the method of analysis and source of infection, highlighting the importance of selecting the most appropriate method.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Erysipelothrix rhusiopathiae is a zoonotic pathogen that causes erysipeloid and is most frequently associated with exposure to domestic swine. Infection of native and prosthetic joints is a rarely ...reported manifestation.
We describe a case of E. rhusiopathiae prosthetic joint infection in a woman with a history of exposure to wild animals in the Canadian Arctic. Patient management involved a 1-stage surgical revision exchange with an antibiotic impregnated cement spacer and 6 weeks of intravenous penicillin G followed by 6 weeks of oral amoxicillin. Ten previously reported cases of E. rhusiopathiae joint infection are reviewed. Recent increases in mortality due to infection with this organism among host animal populations in the Canadian Arctic have generated concern regarding a potential increase in human infections. However, whole genome sequencing (WGS) of the organism was unable to identify a zoonotic origin for this case.
Consideration should be given to E. rhusiopathiae as a cause of joint infections if the appropriate epidemiologic and host risk factors exist. Expanded use of WGS in other potential animal hosts and environmental sources may provide important epidemiologic information in determining the source of human infections.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Canadian Consensus Development Conference on Surveillance and Screening for Antimicrobial-Resistant Organisms (AROs) was sponsored by the Alberta Ministry of Health to provide evidence to update ...policies for ARO screening in acute care settings. A rigorous evidence-based literature review completed before the conference concluded that that neither universal nor targeted screening of patients was associated with a reduction in hospital-acquired ARO colonization, infection, morbidity, or mortality. Leading international clinicians, scientists, academics, policy makers, and administrators presented current evidence and clinical experience, focusing on whether and how hospitals should screen patients for AROs as part of broader ARO control strategies. An unbiased and independent "jury" with a broad base of expertise from complementary disciplines considered the evidence and released a consensus statement of 22 recommendations. Policy highlights included developing an integrated "One Health" strategy, fully resourcing basic infection control practices, not performing universal screening, and focusing original research to determine what works.
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BFBNIB, NUK, PNG, UL, UM, UPUK
•Examines excess mortality during COVID-19 by age group in a population of 4.4m.•Excess mortality follows waves of acute COVID-19 infection.•Younger age groups are over-represented in the mortality ...data.•Deaths from substance abuse are markedly higher in this time frame, particularly in young males.
To determine if there was excess mortality in Alberta, Canada during the pandemic. We sought to confirm if excess mortality affected all age groups equally and determine what proportion of excess deaths is directly related to COVID-19, and non-pharmaceutical drug poisoning.
The weekly all-cause data were used to estimate excess mortality were modeled against the pre-pandemic period (January 2015 to February 2020). Age-adjusted weekly mortality rates for March 2020 to Dec 2021 were compared to the previous 5 years.
From March 2020 to Dec 2021 there was an 11% excess mortality corresponding to an average of 265 monthly excess deaths with a maximum of over 30%. COVID-19 related deaths (n=3202) account for 54.9 % of the total excess deaths (n=5833) that occurred in the 22 months.
The increase in all cause -excess deaths was proportionately higher, and in significantly greater numbers, in the younger age groups. Statistically significant increases in monthly drug poisoning deaths occurred from March 2020 to April 2021 with a total of 1819 deaths. Excess 825 drug poisoning deaths representing 25.4 % of total all-cause excess mortality affected mostly those age 25-60. 54.9 % of all excess deaths is directly related to COVID-19 and 25.4% are drug poisoning related excess deaths.
There was statistically significant increase in all-cause mortality. Although older adults are more likely to die of COVID-19, there was massive increase in non-COVID-19 related mortality among the youth. These should be factored in public policy decisions on epidemic/pandemic management.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The aim of this study was to investigate the physical determinants of weightlifting competition performance based on Isometric Mid-Thigh Pull (IMTP) and Countermovement Jump (CMJ) force-time ...variables, in a cross-sectional and longitudinal analysis. Ten British advanced international female weightlifters' competition results and neuromuscular assessment data collected as part of the British Weight Lifting World Class Programme were utilised for the purpose of this study. All data were averaged for two consecutive 1-year periods. The cross-sectional analysis utilised the second year of data, whereas the longitudinal analysis assessed the mean change between the two years. The cross-sectional analysis results reveal IMTP Net Isometric Peak Force (PF) and CMJ Peak Power (PP) predict 94.2%, 95.1% and 91.8% of the variance in Total, Snatch and Clean & Jerk competition performance, respectively (p = <0.5). The longitudinal analysis results revealed that ∆IMTP PF was the only predicting factor of longitudinal change in weightlifting competition performance predicting 41.5%, 41.7% and 42.5% of ∆Total, ∆Snatch and ∆Clean & Jerk, respectively (p = <0.5). The assessments and equations may be utilised by coaches or sports scientists to inform the prescription of training and help predict competition performance.
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BFBNIB, FSPLJ, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
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