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Huletsky A, Loo VG, Longtin Y, Longtin J, Trottier S, Tremblay CL, Gilca R, Lavallée C, Brochu É, Bérubé È, Bastien M, Bernier M, Gagnon M, Frenette J, Bestman-Smith J, Deschênes L, Bergeron MG. Comparison of rectal swabs and fecal samples for the detection of Clostridioides difficile infections with a new in-house PCR assay. Microbiol Spectr 2024:e0022524. [PMID: 38687067 DOI: 10.1128/spectrum.00225-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
The detection of Clostridioides difficile infections (CDI) relies on testing the stool of patients by toxin antigen detection or PCR methods. Although PCR and antigenic methods have significantly reduced the time to results, delays in stool collection can significantly add to the turnaround time. The use of rectal swabs to detect C. difficile could considerably reduce the time to diagnosis of CDI. We developed a new rapid PCR assay for the detection of C. difficile and evaluated this PCR assay on both stool and rectal swab specimens. We recruited a total of 623 patients suspected of C. difficile infection. Stool samples and rectal swabs were collected from each patient and tested by our PCR assay. Stool samples were also tested by the cell cytotoxicity neutralization assay (CCNA) as a reference. The PCR assay detected C. difficile in 60 stool specimens and 61 rectal swabs for the 64 patients whose stool samples were positive for C. difficile by CCNA. The PCR assay detected an additional 35 and 36 stool and rectal swab specimens positive for C. difficile, respectively, for sensitivity with stools and rectal swabs of 93.8% and 95.3%, specificity of 93.7% and 93.6%, positive predictive values of 63.2% and 62.9%, and negative predictive values of 99.2% and 99.4%. Detection of C. difficile using PCR on stools or rectal swabs yielded reliable and similar results. The use of PCR tests on rectal swabs could reduce turnaround time for CDI detection, thus improving CDI management and control of C. difficile transmission. IMPORTANCE Clostridioides difficile infection (CDI) is the leading cause of healthcare-associated diarrhea, resulting in high morbidity, mortality, and economic burden. In clinical laboratories, CDI testing is currently performed on stool samples collected from patients with diarrhea. However, the diagnosis of CDI can be delayed by the time required to collect stool samples. Barriers to sample collection could be overcome by using a rectal swab instead of a stool sample. Our study showed that CDI can be identified rapidly and reliably by a new PCR assay developed in our laboratory on both stool and rectal swab specimens. The use of PCR tests on rectal swabs could reduce the time for the detection of CDI and improve the management of this infection. It should also provide a useful alternative for infection-control practitioners to better control the spread of C. difficile.
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Affiliation(s)
- Ann Huletsky
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Vivian G Loo
- Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, Montréal, Canada
- Faculty of Medicine, McGill University, Montréal, Canada
| | - Yves Longtin
- Faculty of Medicine, McGill University, Montréal, Canada
- Sir Mortimer B. Davis Jewish General Hospital, Montréal, Canada
| | - Jean Longtin
- Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Sylvie Trottier
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Cécile L Tremblay
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Canada
- Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Canada
| | - Rodica Gilca
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec City, Canada
- Département de risque biologique et de la santé au travail, Institut national de santé publique du Québec, Québec City, Canada
| | - Christian Lavallée
- Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Canada
- Service de maladies infectieuses et de microbiologie, Département de médecine spécialisée, Hôpital Maisonneuve-Rosemont - CIUSSS de l'Est-de-l'Ile-de-Montréal, Montréal, Canada
- Département clinique de médecine de laboratoire, Centre hospitalier de l'Université de Montréal, Montréal, Canada
| | - Éliel Brochu
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Ève Bérubé
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Martine Bastien
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Marthe Bernier
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Martin Gagnon
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Johanne Frenette
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Julie Bestman-Smith
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Service de microbiologie-infectiologie, Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Louise Deschênes
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Service de microbiologie-infectiologie, Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
| | - Michel G Bergeron
- Centre de recherche en infectiologie de l'Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
- Axe maladies infectieuses et immunitaires, Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Québec City, Canada
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Melançon E, Brosseau M, Bartoli A, Labbé AC, Lavallée C, Marchand-Senécal X, Wang HT. Outcomes of hospital-acquired SARS-CoV-2 infection in the Canadian first wave epicentre: a retrospective cohort study. CMAJ Open 2022; 10:E74-E81. [PMID: 35105684 PMCID: PMC8812720 DOI: 10.9778/cmajo.20210055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND During the first wave of the COVID-19 pandemic, a substantial number of Quebec hospitals were hit by hospital-acquired (HA) SARS-CoV-2 infections. Our objective was to assess whether mortality is higher in HA cases than in non-hospital-acquired (NHA) cases and determine the prevalence of HA-SARS-CoV-2 infection in our hospital. METHODS This retrospective single-centre cohort study included all adults (≥ 18 yr) who had COVID-19, admitted to Hôpital Maisonneuve-Rosemont (Montréal, Canada) from Mar. 1 to June 30, 2020. We collected data on demographic characteristics, comorbidities, treatment, admission to the intensive care unit (ICU) and mechanical ventilation requirements from electronic health records. We adjudicated hospital acquisition based on the timing of symptom onset, and polymerase chain reaction testing for and exposures to SARS-CoV-2. To evaluate the association between HA-SARS-CoV-2 infection and in-hospital mortality, we computed a multivariable logistic regression analysis including known risk factors for death in patients with COVID-19 as covariates. RESULTS Among 697 patients with SARS-CoV-2 infection, 253 (36.3%) were classified as HA. The mortality rate was higher in the HA group than in the NHA group (38.2% v. 26.4%, p = 0.001), while the rates of ICU admission (8.3% v. 19.1%, p = 0.001) and requirement for mechanical ventilation (3.6% v. 13.0%, p = 0.001) were lower. Multivariable logistic regression analysis showed that HA-SARS-CoV-2 infection in patients younger than 75 years is an independent risk factor for death (odds ratio 2.78, 95% confidence interval 1.44-5.38). INTERPRETATION Our results show that HA-SARS-CoV-2 infection in younger patients was associated with higher mortality. Future studies need to evaluate relevant patient-centred long-term outcomes in this population.
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Affiliation(s)
- Eve Melançon
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Marc Brosseau
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Anthony Bartoli
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Annie-Claude Labbé
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Christian Lavallée
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Xavier Marchand-Senécal
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Han Ting Wang
- Pulmonary Division (Melançon, Brosseau), Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal; Department of Medicine (Melançon, Brosseau, Bartoli, Wang), Faculty of Medicine, Université de Montréal; Critical Care Division (Brosseau, Wang), Internal Medicine Division (Bartoli), and Microbiology and Infectious Disease Division (Labbé, Lavallée, Marchand-Senécal), Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal; Department of Microbiology, Infectious Diseases and Immunology (Labbé, Lavallée, Marchand-Senécal), Faculty of Medicine, Université de Montréal, Montréal, Que.
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Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ 2021; 193:E1868-E1877. [PMID: 34903591 PMCID: PMC8677578 DOI: 10.1503/cmaj.202783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.
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Affiliation(s)
- Nicholas Brousseau
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que.
| | - Laurianne Morin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Manale Ouakki
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Patrice Savard
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Caroline Quach
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Yves Longtin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Matthew P Cheng
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Alex Carignan
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon F Dufresne
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Jean-Michel Leduc
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Christian Lavallée
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Nicolas Gauthier
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Julie Bestman-Smith
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Maria-Jesus Arrieta
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Magued Ishak
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon Lévesque
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Philippe Martin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Gaston De Serres
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
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Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ 2021. [PMID: 34903591 DOI: 10.1503/cmaj.202783/tab-related-content] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.
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Affiliation(s)
- Nicholas Brousseau
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que.
| | - Laurianne Morin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Manale Ouakki
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Patrice Savard
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Caroline Quach
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Yves Longtin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Matthew P Cheng
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Alex Carignan
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon F Dufresne
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Jean-Michel Leduc
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Christian Lavallée
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Nicolas Gauthier
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Julie Bestman-Smith
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Maria-Jesus Arrieta
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Magued Ishak
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon Lévesque
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Philippe Martin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Gaston De Serres
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
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Gobeille Paré S, Bestman-Smith J, Fafard J, Doualla-Bell F, Jacob-Wagner M, Lavallée C, Charest H, Beauchemin S, Coutlée F, Dumaresq J, Busque L, St-Hilaire M, Lépine G, Boucher V, Desforges M, Goupil-Sormany I, Labbé AC. Natural spring water gargle samples as an alternative to nasopharyngeal swabs for SARS-CoV-2 detection using a laboratory-developed test. J Med Virol 2021; 94:985-993. [PMID: 34672374 PMCID: PMC8661969 DOI: 10.1002/jmv.27407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/28/2021] [Accepted: 10/18/2021] [Indexed: 01/23/2023]
Abstract
The objective of this study was to validate the use of spring water gargle (SWG) as an alternative to oral and nasopharyngeal swab (ONPS) for SARS‐CoV‐2 detection with a laboratory‐developed test. Healthcare workers and adults from the general population, presenting to one of two COVID‐19 screening clinics in Montréal and Québec City, were prospectively recruited to provide a gargle sample in addition to the standard ONPS. The paired specimens were analyzed using thermal lysis followed by a laboratory‐developed nucleic acid amplification test (LD‐NAAT) to detect SARS‐CoV‐2, and comparative performance analysis was performed. An individual was considered infected if a positive result was obtained on either sample. A total of 1297 adult participants were recruited. Invalid results (n = 18) were excluded from the analysis. SARS‐CoV‐2 was detected in 144/1279 (11.3%) participants: 126 from both samples, 15 only from ONPS, and 3 only from SWG. Overall, the sensitivity was 97.9% (95% CI: 93.7–99.3) for ONPS and 89.6% (95% CI: 83.4–93.6; p = 0.005) for SWG. The mean ONPS cycle threshold (Ct) value was significantly lower for the concordant paired samples as compared to discordant ones (22.9 vs. 32.1; p < 0.001). In conclusion, using an LD‐NAAT with thermal lysis, SWG is a less sensitive sampling method than the ONPS. However, the higher acceptability of SWG might enable a higher rate of detection from a population‐based perspective. Nonetheless, in patients with a high clinical suspicion of COVID‐19, a repeated analysis with ONPS should be considered. The sensitivity of SWG using NAAT preceded by chemical extraction should be evaluated. Using a laboratory‐developed NAAT preceded by thermal lysis, the overall percent agreement between spring water gargle (SWG) and oral combined with nasopharyngeal swab (ONPS), sampled at the same time among 1297 participants, is excellent (98.6%). Although the SARS‐CoV‐2 NAAT from SWG is globally less sensitive than from ONPS (89.6% vs. 97.9%), the difference is markedly less in individuals symptomatic for <3 days (2.7%; p=NS) than in those whose symptoms started ≥7 days before testing (35.7%; p= 0.005).
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Affiliation(s)
- Sarah Gobeille Paré
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Julie Bestman-Smith
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, Québec, Canada.,Département de microbiologie et d'infectiologie du Centre hospitalier universitaire (CHU) de Québec, Québec, Québec, Canada
| | - Judith Fafard
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec, Québec, Canada.,Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Florence Doualla-Bell
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec, Québec, Canada
| | - Mariève Jacob-Wagner
- Département de microbiologie et d'infectiologie du Centre hospitalier universitaire (CHU) de Québec, Québec, Québec, Canada
| | - Christian Lavallée
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Service de maladies infectieuses, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Hugues Charest
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec, Québec, Canada.,Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Stéphanie Beauchemin
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - François Coutlée
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Jeannot Dumaresq
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, Québec, Canada.,Département de microbiologie et d'Infectiologie, CISSS de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Lambert Busque
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Manon St-Hilaire
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Guylaine Lépine
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Valérie Boucher
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Marc Desforges
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département clinique de médecine de laboratoire, CHU Ste-Justine, Montréal, Québec, Canada
| | - Isabelle Goupil-Sormany
- Direction de la vigie sanitaire, Ministère de la Santé et des Services sociaux du Québec, Québec, Québec, Canada
| | - Annie-Claude Labbé
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Service de maladies infectieuses, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
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6
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Labbé A, Benoit P, Gobeille Paré S, Coutlée F, Lévesque S, Bestman‐Smith J, Dumaresq J, Lavallée C, Houle C, Martin P, Mak A, Gervais P, Langevin S, Jacob‐Wagner M, Gagnon S, St‐Hilaire M, Lussier N, Yechouron A, Roy D, Roger M, Fafard J. Comparison of saliva with oral and nasopharyngeal swabs for SARS-CoV-2 detection on various commercial and laboratory-developed assays. J Med Virol 2021; 93:5333-5338. [PMID: 33851739 PMCID: PMC8251198 DOI: 10.1002/jmv.27026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/05/2022]
Abstract
The accurate laboratory detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a crucial element in the fight against coronavirus disease 2019 (COVID-19). Reverse transcription-polymerase chain reaction testing on combined oral and nasopharyngeal swab (ONPS) suffers from several limitations, including the need for qualified personnel, the discomfort caused by invasive nasopharyngeal sample collection, and the possibility of swab and transport media shortage. Testing on saliva would represent an advancement. The aim of this study was to compare the concordance between saliva samples and ONPS for the detection of SARS-CoV-2 on various commercial and laboratory-developed tests (LDT). Individuals were recruited from eight institutions in Quebec, Canada, if they had SARS-CoV-2 RNA detected on a recently collected ONPS, and accepted to provide another ONPS, paired with saliva. Assays available in the different laboratories (Abbott RealTime SARS-CoV-2, Cobas® SARS-CoV-2, Simplexa™ COVID-19 Direct, Allplex™ 2019-nCoV, RIDA®GENE SARS-CoV-2, and an LDT preceded by three different extraction methods) were used to determine the concordance between saliva and ONPS results. Overall, 320 tests were run from a total of 125 saliva and ONPS sample pairs. All assays yielded similar sensitivity when saliva was compared to ONPS, with the exception of one LDT (67% vs. 93%). The mean difference in cycle threshold (∆C t ) was generally (but not significantly) in favor of the ONPS for all nucleic acid amplification tests. The maximum mean ∆C t was 2.0, while individual ∆C t varied importantly from -17.5 to 12.4. Saliva seems to be associated with sensitivity similar to ONPS for the detection of SARS-CoV-2 by various assays.
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Affiliation(s)
- Annie‐Claude Labbé
- Service de maladies infectieuses et de microbiologie, Département de médecine spécialiséeHôpital Maisonneuve‐Rosemont ‐ CIUSSS de l'Est‐de‐l'Ile‐de‐MontréalMontréalQuébecCanada
- Département de microbiologie, infectiologie et immunologieUniversité de MontréalMontréalQuébecCanada
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
| | - Patrick Benoit
- Département de microbiologie, infectiologie et immunologieUniversité de MontréalMontréalQuébecCanada
| | - Sarah Gobeille Paré
- Service de microbiologie‐infectiologieCentre Hospitalier Universitaire de Québec – Université LavalQuébecQuébecCanada
| | - François Coutlée
- Département de microbiologie, infectiologie et immunologieUniversité de MontréalMontréalQuébecCanada
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
| | - Simon Lévesque
- Service de microbiologieCentre Hospitalier Universitaire de Sherbrooke ‐ CIUSSS de l'EstrieSherbrookeQuébecCanada
- Département de microbiologie et infectiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Julie Bestman‐Smith
- Service de microbiologie‐infectiologieCentre Hospitalier Universitaire de Québec – Université LavalQuébecQuébecCanada
| | - Jeannot Dumaresq
- Département des laboratoiresHôpital Hôtel‐Dieu de Lévis ‐ CISSS de Chaudière‐AppalachesLévisQuébecCanada
| | - Christian Lavallée
- Service de maladies infectieuses et de microbiologie, Département de médecine spécialiséeHôpital Maisonneuve‐Rosemont ‐ CIUSSS de l'Est‐de‐l'Ile‐de‐MontréalMontréalQuébecCanada
- Département de microbiologie, infectiologie et immunologieUniversité de MontréalMontréalQuébecCanada
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
| | - Claudia Houle
- Service de microbiologie‐infectiologie, Département de médecine spécialiséeCentre hospitalier affilié universitaire régional ‐ CISSS de la Mauricie‐Centre‐du‐QuébecTrois‐RivièresQuébecCanada
| | - Philippe Martin
- Service de microbiologieCentre Hospitalier Universitaire de Sherbrooke ‐ CIUSSS de l'EstrieSherbrookeQuébecCanada
- Département de microbiologie et infectiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Anton Mak
- Département de médecine de laboratoireHôpital Charles Lemoyne ‐ CISSS Montérégie‐CentreGreenfield ParkQuébecCanada
| | - Philippe Gervais
- Département des laboratoiresInstitut Universitaire de Cardiologie et de Pneumologie de QuébecQuébecQuébecCanada
| | - Stéphanie Langevin
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
- Service de microbiologie‐infectiologie, Département de médecine spécialiséeCIUSSS du Centre‐Sud de MontréalMontréalQuébecCanada
| | - Mariève Jacob‐Wagner
- Service de microbiologie‐infectiologieCentre Hospitalier Universitaire de Québec – Université LavalQuébecQuébecCanada
| | - Simon Gagnon
- Département de microbiologie, infectiologie et immunologieUniversité de MontréalMontréalQuébecCanada
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
| | - Manon St‐Hilaire
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
| | - Nathalie Lussier
- Département de médecine de laboratoireHôpital Charles Lemoyne ‐ CISSS Montérégie‐CentreGreenfield ParkQuébecCanada
| | - Ariane Yechouron
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
- Service de microbiologie‐infectiologie, Département de médecine spécialiséeCIUSSS du Centre‐Sud de MontréalMontréalQuébecCanada
| | - David Roy
- Laboratoire de Santé Publique du QuébecInstitut national de santé publique du QuébecSte‐Anne‐de‐BellevueQuébecCanada
| | - Michel Roger
- Département de microbiologie, infectiologie et immunologieUniversité de MontréalMontréalQuébecCanada
- Département clinique de médecine de laboratoireCentre Hospitalier de l'Université de MontréalMontréalQuébecCanada
- Laboratoire de Santé Publique du QuébecInstitut national de santé publique du QuébecSte‐Anne‐de‐BellevueQuébecCanada
| | - Judith Fafard
- Laboratoire de Santé Publique du QuébecInstitut national de santé publique du QuébecSte‐Anne‐de‐BellevueQuébecCanada
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Benoit P, Labbé AC, Lalancette L, Gagnon S, Bonneau E, Lavallée C, Roger M, Fafard J, Dumaresq J, Beauchemin S, Coutlée F. Comparison of SARS-CoV-2 detection with the Cobas® 6800/8800 system on gargle samples using two sample processing methods with combined oropharyngeal/nasopharyngeal swab. J Med Virol 2021; 93:6837-6840. [PMID: 34324212 PMCID: PMC8426914 DOI: 10.1002/jmv.27245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/27/2021] [Indexed: 01/30/2023]
Abstract
Background Gargle samples have been proposed as a noninvasive method for detection of SARS‐CoV‐2 RNA. The clinical performance of gargle specimens diluted in Cobas® PCR Media and in Cobas® Omni Lysis Reagent was compared to oropharyngeal/nasopharyngeal swab (ONPS) for the detection of SARS‐CoV‐2 RNA. Study Design Participants were recruited prospectively in two COVID‐19 screening clinics. In addition to the ONPS, participants gargled with 5 ml of natural spring water split in the laboratory as follows: 1 ml was added to 4.3 ml of polymerase chain reaction (PCR) media and 400 μl was added to 200 μl of lysis buffer. Testing was performed with the Cobas® SARS‐CoV‐2 test on the Cobas® 6800 or 8800 platforms. Results Overall, 134/647 (20.7%) participants were considered infected because the ONPS or at least one gargle test was positive. ONPS had, respectively, a sensitivity of 96.3% (95% confidence interval [CI]: 91.3–98.5); both gargle processing methods were slightly less but equally sensitive (90.3% [95% CI: 83.9–94.3]). When ONPS and gargle specimens were both positive, the mean cycle threshold (Ct) was significantly higher for gargles, suggesting lower viral loads. Conclusion Gargle specimens directly added in PCR Media provide a similar clinical sensitivity to chemical lysis, both having a slightly, not significantly, lower sensitivity to ONPS.
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Affiliation(s)
- Patrick Benoit
- Département de microbiologie, Infectiologie et Immunologie, Université de Montréal, Québec, Canada
| | - Annie-Claude Labbé
- Département de microbiologie, Infectiologie et Immunologie, Université de Montréal, Québec, Canada.,Service d'infectiologie, Département de médecine, Hôpital Maisonneuve-Rosemont-CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Linda Lalancette
- Département de Microbiologie et d'Infectiologie, Centre Hospitalier de St-Eustache, St-Eustache, Québec, Canada
| | - Simon Gagnon
- Service de biologie moléculaire, Département clinique de Médecine de laboratoire, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Eric Bonneau
- Département de Microbiologie et d'Infectiologie, Centre Hospitalier de St-Eustache, St-Eustache, Québec, Canada
| | - Christian Lavallée
- Département de microbiologie, Infectiologie et Immunologie, Université de Montréal, Québec, Canada.,Service d'infectiologie, Département de médecine, Hôpital Maisonneuve-Rosemont-CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Michel Roger
- Département de microbiologie, Infectiologie et Immunologie, Université de Montréal, Québec, Canada.,Service de biologie moléculaire, Département clinique de Médecine de laboratoire, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Ste-Anne-de-Bellevue, Québec, Canada
| | - Judith Fafard
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Ste-Anne-de-Bellevue, Québec, Canada
| | - Jeannot Dumaresq
- Département de Microbiologie et d'Infectiologie, CISSS de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Stéphanie Beauchemin
- Service d'infectiologie, Département de médecine, Hôpital Maisonneuve-Rosemont-CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - François Coutlée
- Département de microbiologie, Infectiologie et Immunologie, Université de Montréal, Québec, Canada.,Service de biologie moléculaire, Département clinique de Médecine de laboratoire, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
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8
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Tardif JC, Bouabdallaoui N, L'Allier PL, Gaudet D, Shah B, Pillinger MH, Lopez-Sendon J, da Luz P, Verret L, Audet S, Dupuis J, Denault A, Pelletier M, Tessier PA, Samson S, Fortin D, Tardif JD, Busseuil D, Goulet E, Lacoste C, Dubois A, Joshi AY, Waters DD, Hsue P, Lepor NE, Lesage F, Sainturet N, Roy-Clavel E, Bassevitch Z, Orfanos A, Stamatescu G, Grégoire JC, Busque L, Lavallée C, Hétu PO, Paquette JS, Deftereos SG, Levesque S, Cossette M, Nozza A, Chabot-Blanchet M, Dubé MP, Guertin MC, Boivin G. Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial. Lancet Respir Med 2021. [PMID: 34051877 DOI: 10.1101/2021.01.26.21250494] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence suggests a role for excessive inflammation in COVID-19 complications. Colchicine is an oral anti-inflammatory medication beneficial in gout, pericarditis, and coronary disease. We aimed to investigate the effect of colchicine on the composite of COVID-19-related death or hospital admission. METHODS The present study is a phase 3, randomised, double-blind, adaptive, placebo-controlled, multicentre trial. The study was done in Brazil, Canada, Greece, South Africa, Spain, and the USA, and was led by the Montreal Heart Institute. Patients with COVID-19 diagnosed by PCR testing or clinical criteria who were not being treated in hospital were eligible if they were at least 40 years old and had at least one high-risk characteristic. The randomisation list was computer-generated by an unmasked biostatistician, and masked randomisation was centralised and done electronically through an automated interactive web-response system. The allocation sequence was unstratified and used a 1:1 ratio with a blocking schema and block sizes of six. Patients were randomly assigned to receive orally administered colchicine (0·5 mg twice per day for 3 days and then once per day for 27 days thereafter) or matching placebo. The primary efficacy endpoint was the composite of death or hospital admission for COVID-19. Vital status at the end of the study was available for 97·9% of patients. The analyses were done according to the intention-to-treat principle. The COLCORONA trial is registered with ClinicalTrials.gov (NCT04322682) and is now closed to new participants. FINDINGS Trial enrolment began in March 23, 2020, and was completed in Dec 22, 2020. A total of 4488 patients (53·9% women; median age 54·0 years, IQR 47·0-61·0) were enrolled and 2235 patients were randomly assigned to colchicine and 2253 to placebo. The primary endpoint occurred in 104 (4·7%) of 2235 patients in the colchicine group and 131 (5·8%) of 2253 patients in the placebo group (odds ratio [OR] 0·79, 95·1% CI 0·61-1·03; p=0·081). Among the 4159 patients with PCR-confirmed COVID-19, the primary endpoint occurred in 96 (4·6%) of 2075 patients in the colchicine group and 126 (6·0%) of 2084 patients in the placebo group (OR 0·75, 0·57-0·99; p=0·042). Serious adverse events were reported in 108 (4·9%) of 2195 patients in the colchicine group and 139 (6·3%) of 2217 patients in the placebo group (p=0·051); pneumonia occurred in 63 (2·9%) of 2195 patients in the colchicine group and 92 (4·1%) of 2217 patients in the placebo group (p=0·021). Diarrhoea was reported in 300 (13·7%) of 2195 patients in the colchicine group and 161 (7·3%) of 2217 patients in the placebo group (p<0·0001). INTERPRETATION In community-treated patients including those without a mandatory diagnostic test, the effect of colchicine on COVID-19-related clinical events was not statistically significant. Among patients with PCR-confirmed COVID-19, colchicine led to a lower rate of the composite of death or hospital admission than placebo. Given the absence of orally administered therapies to prevent COVID-19 complications in community-treated patients and the benefit of colchicine in patients with PCR-proven COVID-19, this safe and inexpensive anti-inflammatory agent could be considered for use in those at risk of complications. Notwithstanding these considerations, replication in other studies of PCR-positive community-treated patients is recommended. FUNDING The Government of Quebec, the Bill & Melinda Gates Foundation, the National Heart, Lung, and Blood Institute of the US National Institutes of Health, the Montreal Heart Institute Foundation, the NYU Grossman School of Medicine, the Rudin Family Foundation, and philanthropist Sophie Desmarais.
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Affiliation(s)
| | | | | | - Daniel Gaudet
- Ecogene-21, Université de Montréal, Montreal, QC, Canada; Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Binita Shah
- New York University Grossman School of Medicine, New York, NY, USA
| | | | | | - Protasio da Luz
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Lucie Verret
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Sylvia Audet
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - André Denault
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Martin Pelletier
- Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
| | - Philippe A Tessier
- Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
| | - Sarah Samson
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Denis Fortin
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | - David Busseuil
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Elisabeth Goulet
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Chantal Lacoste
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Anick Dubois
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | | | | | - Norman E Lepor
- Cedars-Sinai Heart Institute, Geffen School of Medicine-UCLA, Los Angeles, CA, USA
| | - Frédéric Lesage
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Nicolas Sainturet
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Eve Roy-Clavel
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Zohar Bassevitch
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Andreas Orfanos
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | | | - Jean C Grégoire
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Lambert Busque
- Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada
| | - Christian Lavallée
- Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada
| | | | | | - Spyridon G Deftereos
- Second Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sylvie Levesque
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Mariève Cossette
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Anna Nozza
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | | | - Marie-Pierre Dubé
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | - Guy Boivin
- Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
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9
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Desjardins M, Lefebvre B, Lavallée C, Labbé AC, Mauffrey F, Martin I, Longtin J, Fortin C. Gradient diffusion susceptibility testing for Neisseria gonorrhoeae: an accurate alternative to agar dilution in high-MIC strains? Access Microbiol 2020; 2:acmi000116. [PMID: 32974579 PMCID: PMC7494190 DOI: 10.1099/acmi.0.000116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/24/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction The correlation of antimicrobial susceptibility testing (AST) between agar dilution and gradient diffusion for Neisseria gonorrhoeae is not well established, especially in strains with high MICs. Aim The objective of this study was to evaluate the accuracy of gradient diffusion for N. gonorrhoeae. Methods Fifty strains of N. gonorrhoeae, all tested by the agar dilution method according to CLSI methods and confirmed to be genetically distinct using molecular typing (NG-MAST), were selected. Isolates with high MICs were targeted. Gradient diffusion was performed for ceftriaxone (CRO), cefixime (CFX), azithromycin (AZT), tetracycline (TET) and fosfomycin (FOS) using two different commercial antimicrobial strips on different culture media (a non-commercial GC agar base with 1 % defined growth supplement and two commercial media). The performance of agar gradient diffusion was assessed based on accuracy, using essential and category agreements (EA and CA). Results Essential and categorical agreement were over 90 % for CRO, CFX and AZT on the two commercial agar media tested. Category disagreements were seen for CFX and AZT, mostly just very major errors. For TET, EA ranged from 80 to 96 % and CA ranged from 38 to 76 %, most of the misclassifications being minor errors. Finally, EA for FOS ranged between 80 and 98 %. Conclusion Gradient diffusion is an accurate and acceptable alternative for CRO, CFX and AZT. Caution is advised when MICs are reported by gradient diffusion approach breakpoints because of the possibility of very major errors. The use of gradient diffusion is limited for TET because of the high rate of minor errors.
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Affiliation(s)
- Michaël Desjardins
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | | | - Christian Lavallée
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Hôpital Maisonneuve-Rosemont, Montréal, Canada
| | - Annie-Claude Labbé
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Hôpital Maisonneuve-Rosemont, Montréal, Canada
| | | | - Irene Martin
- National Microbiology Laboratory, Winnipeg, Canada
| | - Jean Longtin
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Laboratoire de santé publique du Québec, Montréal, Canada
| | - Claude Fortin
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
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10
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Chakravarti A, Soualhine H, Sharma M, Rivest P, Poirier L, Lavallée C. Indigenous Transmission of Mycobacterium africanum in Canada: A Case Series and Cluster Analysis. Open Forum Infect Dis 2019; 6:ofz088. [PMID: 30949534 PMCID: PMC6441568 DOI: 10.1093/ofid/ofz088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/04/2019] [Indexed: 11/15/2022] Open
Abstract
Mycobacterium africanum is an important cause of human tuberculosis and is found almost exclusively in West Africa. We identified a cluster of patients in Montreal, Canada, with M africanum disease that share identical genotypic signatures by mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and a putative epidemiological link, thus providing evidence of possible local transmission of M africanum in Montreal over a 10-year period.
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Affiliation(s)
- Arpita Chakravarti
- Department of Microbiology and Adult Infectious Diseases, Centre Hospitalier de l’Université de Montréal, Canada
| | - Hafid Soualhine
- National Reference Centre for Mycobacteriology, Public Health Agency of Canada, Winnipeg
| | - Meenu Sharma
- National Reference Centre for Mycobacteriology, Public Health Agency of Canada, Winnipeg
| | - Paul Rivest
- Direction de Santé Publique, Centre Intégré Universitaire de Soins et de Services Sociaux du Centre-Sud-de-l’Île-de-Montréal, Canada
| | - Louise Poirier
- Department of Microbiology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Christian Lavallée
- Department of Microbiology and Adult Infectious Diseases, Maisonneuve-Rosemont Hospital, Montreal, Canada
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11
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Ambaraghassi G, Béliveau C, Labbé AC, Lavallée C. Relevance or performance: potential savings associated with verification of prior results before performing microbiology analysis. Diagn Microbiol Infect Dis 2018; 93:136-139. [PMID: 30293678 DOI: 10.1016/j.diagmicrobio.2018.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE In an era of rising healthcare expenditures, it is critical to find ways to decrease cost. The objective of this study is to evaluate the number of repeated tests and the associated cost savings in a university-affiliated hospital. METHODS The following 7 microbiology analysis were assessed for nonrepeat testing: HCV antibody, HBV core antibody, CMV IgG, rubella IgG, Treponema pallidum antibodies, Clostridioides difficile toxin detection, and vancomycin-resistant enterococci PCR. Presence of a prior positive result leads to the cancellation of subsequent orders. RESULTS Percentages of not repeated test ranged from 0.1% to 21.4%. Rubella IgG had the highest proportion of unnecessary repeat testing. Total cost savings were estimated at $33,627 for 2016. CONCLUSION Unnecessary repeated microbiologic test can account for a non-negligible part of total volume test. Use of an automated software to detect unnecessary repeated microbiologic test through laboratory information system can generate important savings.
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Affiliation(s)
- Georges Ambaraghassi
- Division of Infectious Diseases and Medical Microbiology, Department of Medical Biology, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
| | - Claire Béliveau
- Division of Infectious Diseases and Medical Microbiology, Department of Medical Biology, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Annie-Claude Labbé
- Division of Infectious Diseases and Medical Microbiology, Department of Medical Biology, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Christian Lavallée
- Division of Infectious Diseases and Medical Microbiology, Department of Medical Biology, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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12
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Lavallée C, Labbé AC, Talbot JD, Alonso CD, Marr KA, Cohen S, Laverdière M, Dufresne SF. Risk factors for the development of Clostridium difficile infection in adult allogeneic hematopoietic stem cell transplant recipients: A single-center study in Québec, Canada. Transpl Infect Dis 2017; 19. [PMID: 27943498 DOI: 10.1111/tid.12648] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 09/01/2016] [Accepted: 09/12/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Clostridium difficile infection (CDI) is a significant complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our primary objective was to determine risk factors for the development of CDI during the first year following allo-HSCT. METHODS A matched case-control study nested in a cohort of allo-HSCT at a single hospital in Montréal, Québec, Canada, was conducted from 2002 through 2011. RESULTS Sixty-five of 760 patients who underwent allo-HSCT between 2002 and 2011 developed CDI, representing an incidence of 8.6%. We selected 123 controls matched for year of transplant for risk factor analyses. In the multivariable analysis, receipt of trimethoprim-sulfamethoxazole (TMP-SMX) prior to transplantation (adjusted odds ratio [aOR] 0.07, 95% confidence interval [CI] 0.02-0.27), mucositis (aOR 5.90, 95% CI 2.08-16.72), and reactivation of cytomegalovirus (CMV) (aOR 6.17, 95% CI 2.17-17.57) and of other Herpesviridae viruses (aOR 3.04, 95% CI 1.13-8.16) were the variables that remained statistically associated with CDI. High-risk antibiotic use in the late post-transplant period (aOR 7.63, 95% CI 2.14-27.22) was associated with development of late CDI. CONCLUSION This study revealed reactivation of CMV and other Herpesviridae viruses as novel risk factors for CDI. Administration of TMP-SMX prior to transplantation was independently associated with a decreased risk of CDI. Early and late CDI after HSCT may have distinct risk factors.
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Affiliation(s)
- Christian Lavallée
- Department of Infectious Diseases and Medical Microbiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
| | - Annie-Claude Labbé
- Department of Infectious Diseases and Medical Microbiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
| | - Jean-Daniel Talbot
- Department of Infectious Diseases and Medical Microbiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
| | - Carolyn D Alonso
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kieren A Marr
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sandra Cohen
- Division of Hematology, Department of Medicine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
| | - Michel Laverdière
- Department of Infectious Diseases and Medical Microbiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
| | - Simon Frédéric Dufresne
- Department of Infectious Diseases and Medical Microbiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
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Delisle G, Quach C, Domingo MC, Boudreault AA, Gourdeau M, Bernatchez H, Lavallée C. Escherichia coli antimicrobial susceptibility profile and cumulative antibiogram to guide empirical treatment of uncomplicated urinary tract infections in women in the province of Québec, 2010-15. J Antimicrob Chemother 2016; 71:3562-3567. [PMID: 27494927 DOI: 10.1093/jac/dkw302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/22/2016] [Accepted: 06/24/2016] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Empirical treatment of uncomplicated urinary tract infections (UTIs) in women should be based on local susceptibility data. We aimed to generate regional and provincial cumulative antibiograms combining data from different laboratory information systems and determine the impact of basic patient characteristics on susceptibility results. METHODS All positive urine samples for Escherichia coli obtained from women aged 18-65 years old in outpatient settings between 1 April 2010 and 31 March 2015 from four hospitals in Quebec, Canada, were included. The cumulative antibiogram for ciprofloxacin, nitrofurantoin and trimethoprim/sulfamethoxazole was calculated. A clinically significant difference in susceptibility profile was defined as factor(s) that lowered the susceptibility proportion below 80%. RESULTS A total of 36 293 positive urine cultures were analysed. In the last year of the study, the proportion of susceptibility for ciprofloxacin, nitrofurantoin and trimethoprim/sulfamethoxazole was 90.3%, 95.4% and 81.9%, respectively. The susceptibility proportion was <80% for trimethoprim/sulfamethoxazole in the Montreal region (73.4%; 95% CI 71.1%-75.9%), whereas it remained >80% for the other regions. A significant decrease in susceptibility with time was identified for ciprofloxacin (92.1%-90.3%, P < 0.001) and nitrofurantoin (97.1%-95.4%, P < 0.001). Increasing age, recent hospitalization and site of collection were associated with an increase in resistance for certain antibiotics. CONCLUSIONS Overall, all first-line antimicrobials remain acceptable choices for empirical treatment of uncomplicated UTIs in women in Quebec. The regional variability in susceptibility data within a single province emphasizes the importance of local susceptibility data to inform the development of empirical treatment guidelines for UTIs.
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Affiliation(s)
- Gaelle Delisle
- Research Institute, McGill University Health Centre, McGill University, 1001 Boulevard Décarie, Montréal, Québec H4A 3J1, Canada
| | - Caroline Quach
- Research Institute, McGill University Health Centre, McGill University, 1001 Boulevard Décarie, Montréal, Québec H4A 3J1, Canada.,Epidemiology, Biostatistics & Occupational Health, McGill University, 1001 Boulevard Décarie, Montréal, Québec H4A 3J1, Canada
| | - Marc-Christian Domingo
- Institut national de santé publique du Québec, 20045 Chemin Ste-Marie, Sainte-Anne-de-Bellevue, Québec H9X 3R5, Canada.,Département de microbiologie-infectiologie et d'immunologie, Université Laval, 2325 Rue de l'Université, Ville de Québec, Québec G1V 0A6, Canada
| | - Alexandre A Boudreault
- Département de microbiologie-infectiologie et d'immunologie, Université Laval, 2325 Rue de l'Université, Ville de Québec, Québec G1V 0A6, Canada.,CHU de Québec, Université Laval, 11 Côte du Palais, Ville de Québec, Québec G1R 2J6, Canada
| | - Marie Gourdeau
- Département de microbiologie-infectiologie et d'immunologie, Université Laval, 2325 Rue de l'Université, Ville de Québec, Québec G1V 0A6, Canada.,CHU de Québec, Université Laval, 11 Côte du Palais, Ville de Québec, Québec G1R 2J6, Canada
| | - Harold Bernatchez
- CISSS Bas-St-Laurent, 150 Avenue Rouleau, Rimouski, Québec G5L 5T1, Canada
| | - Christian Lavallée
- CIUSSS de l'Est-de-l'Île-de-Montréal, Université de Montréal, 5415 Boulevard l'Assomption, Montréal, Québec H1T 2M4, Canada
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14
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Boileau M, Ferreira J, Ahmad I, Lavallée C, Qvarnstrom Y, Dufresne SF. Successful Treatment of Disseminated Anncaliia algerae Microsporidial Infection With Combination Fumagillin and Albendazole. Open Forum Infect Dis 2016; 3:ofw158. [PMID: 27704013 PMCID: PMC5047403 DOI: 10.1093/ofid/ofw158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/19/2016] [Indexed: 11/23/2022] Open
Abstract
Anncaliia algerae myositis is a life-threatening, emerging microsporidiosis among immunocompromised hosts. We report a case of disseminated A algerae infection in a man previously treated with alemtuzumab. Due to failure of albendazole-based therapy, fumagillin was added as a novel approach to management, with a good clinical response and patient survival.
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Affiliation(s)
| | | | | | - Christian Lavallée
- Infectious Diseases and Medical Microbiology , Hôpital Maisonneuve-Rosemont, Université de Montréal , Canada
| | - Yvonne Qvarnstrom
- Division of Parasitic Diseases and Malaria , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Simon F Dufresne
- Infectious Diseases and Medical Microbiology , Hôpital Maisonneuve-Rosemont, Université de Montréal , Canada
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15
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Awissi DK, Beauchamp A, Hébert E, Lavigne V, Munoz DL, Lebrun G, Savoie M, Fagnan M, Amyot J, Tétreault N, Robitaille R, Varin F, Lavallée C, Pichette V, Leblanc M. Pharmacokinetics of an extended 4-hour infusion of piperacillin-tazobactam in critically ill patients undergoing continuous renal replacement therapy. Pharmacotherapy 2016; 35:600-7. [PMID: 26095008 DOI: 10.1002/phar.1604] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
STUDY OBJECTIVE To evaluate the pharmacokinetic and pharmacodynamic profiles of piperacillin-tazobactam administered as a 4-hour infusion in critically ill patients undergoing continuous renal replacement therapy (CRRT). DESIGN Prospective, observational, pharmacokinetic study. SETTING Intensive care unit of a tertiary care hospital in Montréal, Canada. PATIENTS Twenty critically ill adults who were undergoing continuous venovenous hemodiafiltration and receiving a 4-hour infusion of piperacillin 4 g-tazobactam 0.5 g every 8 hours for a documented or suspected infection. INTERVENTION Blood samples were collected every hour over an 8-hour dosing interval. Prefilter and postfilter blood samples, and effluent and urine samples were also collected. MEASUREMENTS AND MAIN RESULTS The primary outcome was the proportion of patients who achieved an unbound piperacillin plasma concentration above a target minimum inhibitory concentration (MIC) of 64 mg/L (MIC that inhibits 90% of isolates for Pseudomonas aeruginosa) for at least 50% of the dosing interval; 18 (90%) of the 20 patients achieved this outcome. In all patients, the free piperacillin concentrations were above the Pseudomonas aeruginosa breakpoint of 16 mg/L for the entire time interval. Regarding piperacillin pharmacokinetic parameters, the median (interquartile range) minimum unbound plasma concentration was 65.15 mg/L (51.30-89.30), maximum unbound plasma concentration was 141.3 mg/L (116.75-173.90), sieving coefficient was 0.809 (0.738-0.938), total clearance was 65.82 ml/minute (53.79-102.87), and renal clearance was 0.16 ml/minute (0.05-3.04). The median CRRT dose was 32.0 ml/kg/h (25.0-39.8). CONCLUSIONS Administration of a 4-hour infusion of piperacillin-tazobactam was associated with a favorable pharmacodynamic profile in patients undergoing CRRT. Concentrations associated with maximal activity were attained in our patients.
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Affiliation(s)
- Don-Kelena Awissi
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Annie Beauchamp
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Elisabeth Hébert
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Viviane Lavigne
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Danya Lucia Munoz
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Geneviève Lebrun
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Michel Savoie
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Mylène Fagnan
- Pharmacy Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Julie Amyot
- Biochemistry Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Nicolas Tétreault
- Biochemistry Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Robert Robitaille
- Biochemistry Department, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - France Varin
- Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada
| | - Christian Lavallée
- Department of Infectious Diseases and Medical Microbioloy, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Vincent Pichette
- Department of Nephrology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Martine Leblanc
- Department of Nephrology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada.,Intensive Care Unit, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
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16
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Talbot JD, Dufresne P, Moonjely SS, Vinh DC, Pelletier R, Lavallée C, Tremblay C, Dufresne SF. Clinical and Molecular Epidemiology of Histoplasma capsulatum in Quebec, Canada. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Hanessian S, Vakiti RR, Chattopadhyay AK, Dorich S, Lavallée C. Probing functional diversity in pactamycin toward antibiotic, antitumor, and antiprotozoal activity. Bioorg Med Chem 2013; 21:1775-86. [DOI: 10.1016/j.bmc.2013.01.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 01/15/2013] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
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18
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Leduc JM, Dufresne SF, Lavallée C, Nigen S, Labbé AC, Poirier L. Mycobacterium celatum skin infection with sporotrichoid spread in an HIV-negative immunocompromised man. J Am Acad Dermatol 2012; 66:e247-9. [PMID: 22583731 DOI: 10.1016/j.jaad.2011.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 06/19/2011] [Accepted: 06/22/2011] [Indexed: 10/28/2022]
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19
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Lavallée C, Laufer B, Pépin J, Mitchell A, Dubé S, Labbé AC. Fatal Clostridium difficile enteritis caused by the BI/NAP1/027 strain: a case series of ileal C. difficile infections. Clin Microbiol Infect 2009; 15:1093-9. [PMID: 19681954 DOI: 10.1111/j.1469-0691.2009.03004.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Clostridium difficile generally causes diarrhoea and colitis. Small-bowel infections are considered to be rare. Twelve cases of ileal C. difficile infections are presented, including the first reported case proven to be caused by the hypervirulent BI/NAP1/027 strain. This case series suggests that small bowel involvement in C. difficile infections may be more frequent than previously thought.
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Affiliation(s)
- C Lavallée
- Département de Microbiologie, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
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20
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Lavallée C, Carmel M, Utracki LA, Szabo JP, Keough IA, Favis BD. Thermal and viscoelastic behavior of polyurethane/polyvinylchloride blends. POLYM ENG SCI 2004. [DOI: 10.1002/pen.760322210] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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21
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Gonzalez-Nunez R, Favis BD, Carreau PJ, Lavallée C. Factors influencing the formation of elongated morphologies in immiscible polymer blends during melt processing. POLYM ENG SCI 2004. [DOI: 10.1002/pen.760331310] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Ovetchkine P, Tapiéro B, Lebel MH, Lavallée C, Lamarre V, Lafferière C. 51 Epidemiology, Serotypes Distribution and Antibiotic Susceptibility of Streptococcus Pneumoniae Strains Associated with Invasive Pneumococcal Diseases in a Pediatric Tertiary Care Center in Montreal. Paediatr Child Health 2004. [DOI: 10.1093/pch/9.suppl_a.34aa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Using the data from a number of the surveys conducted over the last 10 years by Santé Québec, this study examines the health characteristics of two populations of Aboriginal women of northern Quebec compared to those of women in the rest of the province. The northern populations had a larger proportion of young women. Aboriginal women have heavier family responsibilities than other Quebec women. Inuit women had a much higher prevalence of smoking and drug use. Alcohol consumption was less frequent in northern women, but the quantity consumed was higher compared to other Quebec women. Cree women tended to be more obese, had higher levels of blood glucose and lower levels of cholesterol. Inuit women tended to have lower rates of hypertension and higher rates of declared hearing problems and mental disorders. The similarities and differences observed among these three populations of women can assist decision-makers in setting priorities with regards to maintaining and improving their health.
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Affiliation(s)
- C Lavallée
- Santé Québec Division, Institut de la statistique du Québec, Montreal.
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24
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Lavallée C, Thibodeau L. [Cloning, expression and characterization of HIV-1 gp60 partially or completely deleted in the V3 loop]. C R Acad Sci III 1996; 319:983-90. [PMID: 9033843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In order to better understand the role of the immunodominant V3 loop in the type-specific immune response and also to determine if this sequence has a role in AIDS pathogenesis, notably in the induction of apoptosis in CD4+ cells, we have introduced 2 modifications in the env gene from pNL4-3: a partial deletion in the V3 loop, keeping only the conserved tip of the loop GPGRAF consensus sequence (env delta V3-GPGRAF) and, secondly, a complete deletion of V3 sequence plus 43 nucleotides in C3 (env delta V3+). These constructions as well as the non-modified env gene, were cloned and expressed in a baculovirus system. Western blot analysis has shown that both modified env gene products reacted with a reference anti-HIV-1 serum to the same extent as the non-modified gp 160. However, in contrast to the non-modified env-protein and to env delta V3-GPGRAF, the env delta V3+ protein failed to bind to CD4 molecule, although V3 is not directly involved in receptor binding. These modified and non-modified recombinant proteins will be very useful to determine the potential of the partially or totally V3-deleted gp 160 to induce broadly reactive neutralizing antibodies and also to determine if V3 has a role in certain aspects of HIV-induced pathogenesis, notably apoptosis.
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Affiliation(s)
- C Lavallée
- Laboratoire de recherche sur le sida, virologie, Institut Armand-Frappier, Laval, Canada
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25
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Bernard L, Lavallée C, Gray-Donald K, Delisle H. Overweight in Cree schoolchildren and adolescents associated with diet, low physical activity, and high television viewing. J Am Diet Assoc 1995; 95:800-2. [PMID: 7797812 DOI: 10.1016/s0002-8223(95)00221-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- L Bernard
- Public Health Unit, Montréal General Hospital, Quebec, Canada
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Lavallée C, Yao XJ, Ladha A, Göttlinger H, Haseltine WA, Cohen EA. Requirement of the Pr55gag precursor for incorporation of the Vpr product into human immunodeficiency virus type 1 viral particles. J Virol 1994; 68:1926-34. [PMID: 8107252 PMCID: PMC236654 DOI: 10.1128/jvi.68.3.1926-1934.1994] [Citation(s) in RCA: 105] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The human immunodeficiency virus type 1 (HIV-1) particles consists of two molecules of genomic RNA as well as molecules originating from gag, pol, and env products, all synthesized as precursor proteins. The 96-amino-acid Vpr protein, the only virion-associated HIV-1 regulatory protein, is not part of the virus polyprotein precursors, and its incorporation into virus particles must occur by way of an interaction with a component normally found in virions. To investigate the mechanism of incorporation of Vpr into the HIV-1 virion, Vpr- proviral DNA constructs harboring mutations or deletions in specific virion-associated gene products were cotransfected with Vpr expressor plasmids in COS cells. Virus released from the transfected cells was tested for the presence of Vpr by immunoprecipitation with Vpr-specific antibodies. The results of these experiments show that Vpr is trans-incorporated into virions but at a lower efficiency than when Vpr is expressed from a proviral construct. The minimal viral genetic information necessary for Vpr incorporation was a deleted provirus encoding only the pr55gag polyprotein precursor. Incorporation of Vpr requires the expression but not the processing of gag products and is independent of pol and env expression. Direct interaction of Vpr with the Pr55gag precursor protein was demonstrated by coprecipitation experiments with gag product-specific antibodies. Overall, these results indicate that HIV-1 Vpr is incorporated into the nascent virion through an interaction with the Gag precursor polyprotein and demonstrate a novel mechanism by which viral protein can be incorporated into virus particles.
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Affiliation(s)
- C Lavallée
- Département de Microbiologie et Immunologie, Faculté de Médecine, Université de Montréal, Quebec, Canada
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Brassard P, Robinson E, Lavallée C. Prevalence of diabetes mellitus among the James Bay Cree of northern Quebec. CMAJ 1993; 149:303-7. [PMID: 8339176 PMCID: PMC1485497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To determine the prevalence of diabetes mellitus among the James Bay Cree in northern Quebec. DESIGN Chart survey of physician-diagnosed cases of diabetes. The biochemical criteria of the World Health Organization were used to confirm the diagnoses. SETTING Eight James Bay Cree communities: six remote and two rural. SUBJECTS All James Bay Cree with diabetes whose names were in a chronic disease registry or on a diabetes clinic list kept at each community clinic. OUTCOME MEASURES Prevalence rates, both crude and standardized to the 1986 Canadian population, were estimated by sex, age group and type of diabetes. RESULTS A total of 235 cases of diabetes were confirmed, for a crude prevalence of 2.7%. The age-standardized rate of non-insulin-dependent diabetes mellitus was 6.6% among people 20 years and over. The prevalence increased as the latitude decreased. CONCLUSIONS Our crude prevalence resembles that in similar native linguistic and cultural groups elsewhere in Canada. Diabetes is becoming an important disease in the Cree population of Quebec. A better understanding of the sociocultural changes in this population is necessary.
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Affiliation(s)
- P Brassard
- Department of Community Health, Montreal General Hospital, Que
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Lavallée C, Guyon L. The Santé Québec Cree and Inuit Surveys, Québec, Canada. Arctic Med Res 1993; 52:26-9. [PMID: 8466581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- C Lavallée
- Northern Québec Module, Department of Community Health, Montréal General Hospital, Canada
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30
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Woerly S, Lavallée C, Marchand R. Intracerebral implantation of ionic synthetic hydrogels: effect of polar substrata on astrocytosis and axons. J Neural Transplant Plast 1992; 3:21-34. [PMID: 1571396 PMCID: PMC2565137 DOI: 10.1155/np.1992.21] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In previous studies, hyperporous synthetic hydrogels of poly(glyceryl methacrylate) or p(GMA), containing bioadhesive substrates of collagen, were implanted into rat cerebral tissue in order to provide systems of oriented guidance channels for directing the growth of the scar and axons /28/. In the present study, ionic p(GMA)-collagen hydrogels containing polar chemical groups, either basic amino groups or acidic carboxyl groups, were evaluated for their tolerance and their effects on the brain scarring response and axonal reactivity after long-term implantation in the cerebral cortex. In all animals, the implants were well tolerated. Although both types of gels influenced the astroglial reaction near the bioimplant, hydrogels carrying carboxyl groups had the strongest influence on the elongation, the direction and the organization of astrocytic processes so that a glial matrix could form in regions of the gel. Extracellular material (e.g. reticulin) was also deposited into the gels carrying carboxyl groups. Although cortical nerve fibers in the surrounding tissue showed a regenerative response, extending onto or into the matrices, this behavior seemed to depend more on the organization of the astrocytic scar imposed by the gel than on the type of gel. We conclude that matrices carrying negatively charged groups influence favorably the astrocytosis and the deposition of connective tissue, and that this approach represents a new avenue in attempting to modulate the brain scar formation.
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Affiliation(s)
- S Woerly
- Centre de recherche en neurobiologie, Hôpital de l'Enfant Jésus, Université Laval, Québec, Canada
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Lavallée C, James CA, Robinson EJ. Evaluation of a community health representative program among the Cree of northern Quebec. Can J Public Health 1991; 82:181-4. [PMID: 1884312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The James Bay Cree Community Health Representative (CHR) program was implemented in 1984 to train persons from the Cree population of northern Quebec to act as health care advocates and educators, as intermediaries between the Cree population, health services and local organizations, and as participants in assessing health needs. A formative evaluation was initiated which included quantitative analysis of the daily tasks of CHRs and a qualitative component based on documentary research, observation and semi-structured interviews. The evaluation revealed that CHRs actively participated in the ongoing community health programs mainly through health education; the people interviewed showed a high level of satisfaction. However, direct supervision, sufficient continuing education for the CHRs and better integration into health care teams are long-term goals which need to be emphasized in the program.
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Affiliation(s)
- C Lavallée
- Department of Community Health, Montreal General Hospital, Quebec, Canada
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Woerly S, Marchand R, Lavallée C. Interactions of copolymeric poly(glyceryl methacrylate)-collagen hydrogels with neural tissue: effects of structure and polar groups. Biomaterials 1991; 12:197-203. [PMID: 1878454 DOI: 10.1016/0142-9612(91)90200-t] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In a previous study we developed copolymeric glyceryl methacrylate-collagen hydrogels for implantation in surgical lesions of the rat brain. Such materials provide porous matrices that can serve as support systems for oriented growth of scar tissue and axonal growth. In the present work, we have investigated the effect of structural modifications (studied by mercury porosimetry) of polymeric matrices and the effect of polar groups on the response of the brain tissue. The findings show that the fractional porosity and the pore size distribution of matrices are critical for tissue ingrowth and that negative charges, i.e. carboxylic acid groups, incorporated in the polymer have a strong influence on reactive astrocytosis.
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Affiliation(s)
- S Woerly
- Centre de recherche en neurobiologie, Hopital de l Enfant-Jésus, Québec, Canada
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Lavallée C, Robinson E. Physical activity, smoking and overweight among the Cree of eastern James Bay. Arctic Med Res 1991; Suppl:770-3. [PMID: 1365296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Affiliation(s)
- C Lavallée
- Department of Community Health, Montreal General Hospital
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Lavallée C, Cornejo H, James C, Robinson E. The eastern Cree bush-kit program evaluation; its usefulness. Arctic Med Res 1990; 49:189-94. [PMID: 2278598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In 1982 the Cree Board of Health and Social Services of James Bay in northern Quebec created the bush-kit program to provide hunters and trappers with the technical skills to handle medical problems in the bush. A formative evaluation of the program revealed a decrease in calls and in medical evacuations from the bush and high levels of satisfaction among the participants, health professionals and community leaders. However, specific service accessibility problems were identified at the time of the evaluation as indicated by participation rates of only 50% of the targeted hunters and trappers. These findings as well as discussions with bush-kit administrators led to subsequent improvements in the program and an increased participation rate the following year.
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Affiliation(s)
- C Lavallée
- Department of Community Health, Montreal General Hospital, Canada
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Abstract
Various poly (2-hydroxyethyl methacrylate)-collagen and poly (glyceryl methacrylate)-collagen composite hydrogels with varying porosities and cross-linking densities were implanted into the cortex of adult rat brains to provide mechanical guiding substrates for wound healing and tissue ingrowth. The hydrogels were well tolerated by the neural tissue. After 2 and 3 month, hyper- and macroporous hydrogels (poly(glyceryl methacrylate)) with interconnected channel systems were penetrated by neural tissue and elements of extracellular matrices, with differences in the degree and the topographic patterning of tissue ingrowth according to the type of samples. These differences were ascribed to the geometry, size of the pore interconnections and the mechanical properties of the polymers. Hyper- and microporous hydrogels (poly(2-hydroxyethyl methacrylate)) and hydrogels without collagen were not penetrated by the host tissue. The compatibility of the polymers with the neural tissue was also tested in vitro. This study suggests a new approach to repair brain lesions consisting of loss of tissue volume.
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Affiliation(s)
- S Woerly
- Laboratoire de Neurobiologie, Hôpital de l'Enfant-Jésus et Université Laval, Québec, Canada
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Hamelin C, Lavallée C, Belloncik S. A simplified method for the characterization of nuclear polyhedrosis virus genomes. FEMS Microbiol Lett 1989; 51:233-7. [PMID: 2550318 DOI: 10.1016/0378-1097(89)90515-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A simplified restriction endonuclease analysis procedure is described which allows the characterization of baculovirus DNA obtained directly from a single larvae without purification of virus. This rapid method was used to demonstrate the genomic stability of nuclear polyhedrosis viruses (NPVs) from Agrotis segetum, Euxoa messoria and Mamestra brassicae after several passages in Euxoa scandens.
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Affiliation(s)
- C Hamelin
- Centre de Recherche en Virologie, Institut Armand-Frappier, Québec, Canada
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Arella M, Lavallée C, Belloncik S, Furuichi Y. Molecular cloning and characterization of cytoplasmic polyhedrosis virus polyhedrin and a viable deletion mutant gene. J Virol 1988; 62:211-7. [PMID: 3275433 PMCID: PMC250521 DOI: 10.1128/jvi.62.1.211-217.1988] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The double-stranded RNA genome of Bombyx mori cytoplasmic polyhedrosis virus (CPV) was converted to double-stranded DNA and cloned into plasmid pBR322. The complete nucleotide sequence of cloned genome segment 10, which encodes virus polyhedrin polypeptide, was determined. The CPV polyhedrin gene consists of 942 based pairs and possesses a long open reading frame that codes for a polypeptide of 248 amino acids (molecular weight, 28,500), consistent with an apparent molecular weight of 28,000 previously determined for purified polyhedrin. No sequence homology was found between CPV polyhedrin and polyhedrins from several nuclear polyhedrosis viruses. In addition to the polyhedrin gene, we completed the sequence analysis of a small deletion mutant gene derived from the polyhedrin gene. This mutant gene consists of two subset domains of the polyhedrin gene, i.e., the 5'-terminal 121 base pairs and the 3'-terminal 200 base pairs. An in vitro transcription demonstrated that the small mutant gene is transcribed by virion-associated RNA polymerases. These data confirm the importance of CPV terminal sequences in virus genome replication.
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Affiliation(s)
- M Arella
- Department of Virology, Institut Armand-Frappier, University of Quebec, Montreal, Canada
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Lapointe JR, Lavallée C, Meilleur R, Bourget C. Roxithromycin alone and in combination with sulphamethoxazole against Haemophilus influenzae. J Antimicrob Chemother 1987; 20 Suppl B:21-9. [PMID: 3501425 DOI: 10.1093/jac/20.suppl_b.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Haemophilus influenzae is only moderately susceptible to erythromycin but previous studies in vitro and in vivo have shown that it is fully susceptible when erythromycin is combined with sulphonamides. The purpose of this study was to evaluate whether the activity of the new macrolide antibiotic roxithromycin was improved after combination with sulphamethoxazole. One hundred and eighty fresh clinical isolates of Haemophilus influenzae, comprising 74 ampicillin-susceptible, beta-lactamase negative, and 106 ampicillin-resistant, beta-lactamase positive, strains, were tested for their susceptibility to erythromycin, roxithromycin, sulphamethoxazole, erythromycin-sulphamethoxazole and roxithromycin-sulphamethoxazole in a fixed ratio of 1:19. Bacteriostatic and bactericidal synergy was found between roxithromycin and sulphamethoxazole more commonly than between erythromycin and sulphamethoxazole. Antagonism, was less common between roxithromycin and sulphamethoxazole than erythromycin and sulphamethoxazole. These results suggest that the in-vitro activity of roxithromycin is improved by combination with sulphamethoxazole, making this combination more attractive in the oral therapy of infections due to H. influenzae.
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Affiliation(s)
- J R Lapointe
- Pediatric Research Center, Hôpital Ste-Justine, Montréal, Québec, Canada
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Lapointe JR, Lavallée C. Antibiotic interaction of amoxycillin and clavulanic acid against 132 beta-lactamase positive Haemophilus isolates: a comparison with some other oral agents. J Antimicrob Chemother 1987; 19:49-58. [PMID: 3494009 DOI: 10.1093/jac/19.1.49] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We studied the specific beta-lactamase inhibitory activity of clavulanic acid in association with amoxycillin against 132 beta-lactamase producing Haemophilus isolates. Inhibitory synergy between amoxycillin and clavulanic acid (ratio 2:1) was found in 131/132, partial synergy or antagonism in none; bactericidal synergy was found in 124/131, partial synergy in 4 and antagonism in 1. In comparison, inhibitory synergy between trimethoprim and sulphamethoxazole (ratio 1:19) was found in only 39/104 beta-lactamase positive strains, partial synergy in 42 and antagonism in 3 and bactericidal synergy in 18/104, partial synergy in 8 and antagonism in 3. The amoxycillin-clavulanic acid combination expressed significantly (P less than 0.001) more frequent synergy, at both inhibitory and bactericidal levels, than the trimethoprim-sulphamethoxazole combination. The synergy of amoxycillin-clavulanic acid resulted in a significant decrease of MIC90 (greater than or equal to 32.0-2.0 mg/l) and MBC90 (greater than or equal to 32.0-4.0 mg/l) of amoxycillin; the synergy of trimethoprim-sulphamethoxazole resulted in a significant decrease of MIC90 (8.0-2.0 mg/l) of trimethoprim but did not change MBC90. The amoxycillin-clavulanic acid combination was also more active than cefaclor or erythromycin alone against the 132 beta-lactamase producing strains.
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Lapointe JR, Lavallée C, Michaud A, Chicoine L, Joncas JH. In vitro comparison of ampicillin-chloramphenicol and ampicillin-cefotaxime against 284 Haemophilus isolates. Antimicrob Agents Chemother 1986; 29:594-7. [PMID: 3486630 PMCID: PMC180448 DOI: 10.1128/aac.29.4.594] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Since November 1982 at the Sainte-Justine Hospital in Montreal, ampicillin and cefotaxime were used in association as initial treatment (greater than or equal to 48 h) for childhood bacterial meningitis. In this report is described the in vitro interaction of the new regimen in comparison with that of the previous ampicillin-chloramphenicol combination against 284 Haemophilus isolates. Among the 156 ampicillin-susceptible, beta-lactamase-negative isolates, synergy was detected in 13 with ampicillin-cefotaxime, and antagonism was detected in only 1; in contrast, synergy was found in only 2 strains with ampicillin-chloramphenicol, and antagonism was found in 15. These differences were statistically significant (P less than 0.01). Such significant differences were not observed among the 128 ampicillin-resistant, beta-lactamase-positive Haemophilus isolates. The synergy of ampicillin-cefotaxime did not contribute to a decrease of the MIC of cefotaxime for 90% of isolates tested, whereas the antagonism of ampicillin-chloramphenicol did not contribute to increase the MIC of ampicillin for 90% of isolates tested.
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Belloncik S, Lavallée C, Hamelin C. Relative pathogenicity of nuclear polyhedrosis viruses from Mamestra brassicae, Euxoa messoria, Agrotis segetum, Autographa california, and Heliothis spp. for larvae of Euxoa scandens (Lepidoptera:Noctuidae). J Invertebr Pathol 1986. [DOI: 10.1016/0022-2011(86)90157-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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