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Sawatzky P, Lefebvre B, Diggle M, Hoang L, Wong J, Patel S, Van Caessele P, Minion J, Garceau R, Jeffrey S, Haldane D, Lourenco L, Gravel G, Mulvey M, Martin I. Antimicrobial susceptibilities of Neisseria gonorrhoeae in Canada, 2021. Can Commun Dis Rep 2023; 49:388-397. [PMID: 38463902 PMCID: PMC10919915 DOI: 10.14745/ccdr.v49i09a05] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background In Canada, gonorrhea is the second most prevalent bacterial sexually transmitted infection. The Gonococcal Antimicrobial Surveillance Programme (GASP - Canada), a passive surveillance system monitoring antimicrobial resistance in Neisseria gonorrhoeae in Canada since 1985, is the source for this summary of demographics, antimicrobial resistance and N. gonorrhoeae multi-antigen sequence typing (NG-MAST) of gonococcal isolates collected in Canada in 2021. Methods Provincial and territorial public health laboratories submitted N. gonorrhoeae cultures and data to the National Microbiology Laboratory in Winnipeg as part of the surveillance system. The antimicrobial resistance and molecular type of each isolate received were determined. Results In total, 3,439 N. gonorrhoeae cultures were received from laboratories across Canada in 2021, a 9.9% increase since 2020 (n=3,130). Decreased susceptibility to cefixime increased significantly (p<0.001) in 2021 (1.5%) compared to 2017 (0.6%). No significant change in decreased susceptibility to ceftriaxone was detected between 2017 and 2021 (0.6%) (p>0.001); however, one ceftriaxone-resistant isolate was identified. Azithromycin resistance decreased significantly (p<0.001) in 2021 (7.6%) compared to 2017 (11.7%); however, there was a significant increase (p<0.001) in the proportion of cultures with an azithromycin minimum inhibitory concentration of at least 1 mg/L (2017=22.2% to 2021=28.1%). In 2021, NG-MAST-19875 (15.3%) was the most prevalent sequence type in Canada; 20.3% of isolates with this sequence type were resistant to azithromycin. Conclusion The spread of antimicrobial-resistant gonorrhea is a significant public health concern. The continued regional and national surveillance of antimicrobial resistance in N. gonorrhoeae is essential in ensuring effective treatment therapies are recommended.
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Affiliation(s)
- Pamela Sawatzky
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
| | | | - Mathew Diggle
- Provincial Laboratory for Public Health, Edmonton, AB
| | - Linda Hoang
- BC Centre for Disease Control Public Health Laboratory, Vancouver, BC
| | - Jason Wong
- BC Centre for Disease Control Public Health Laboratory, Vancouver, BC
| | - Samir Patel
- Public Health Ontario Laboratory, Toronto, ON
| | | | | | - Richard Garceau
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, NB
| | - Sarah Jeffrey
- Government of Northwest Territories, Yellowknife, NT
| | - David Haldane
- Queen Elizabeth II Health Sciences Centre, Halifax, NS
| | - Lillian Lourenco
- Centre for Communicable Diseases and Infection Control Branch, Public Health Agency of Canada, Ottawa, ON
| | - Genevieve Gravel
- Centre for Communicable Diseases and Infection Control Branch, Public Health Agency of Canada, Ottawa, ON
| | - Michael Mulvey
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
| | - Irene Martin
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
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2
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Tsang RSW, Law DKS, Zhou J, Haldane D, Garceau R, Zahariadis G, Mead K, Alexander D. Characterization of invasive meningococcal disease case isolates in Atlantic Canada, 2014 to 2020: spatial-temporal variations of clones and predicted meningococcal B vaccine coverage. J Med Microbiol 2022; 71. [PMID: 36748536 DOI: 10.1099/jmm.0.001615] [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] [Indexed: 12/23/2022] Open
Abstract
Introduction. Invasive meningococcal disease (IMD) caused by Neisseria meningitidis may show temporal and geographical changes in both the epidemiology and the characteristics of the strains involved.Gap statement. A study that examined invasive N. meningitidis causing IMD in Atlantic Canada from 2009 to 2013 was published in 2014. Data from subsequent years have not been described.Aim. This study examined the molecular epidemiology of IMD in four Atlantic Provinces of Canada as well as potential serogroup B (MenB) vaccine coverage.Methods. Individual IMD case isolates recovered from 2014 to 2020 were analysed for serotype and serosubtype antigens as well as by whole-genome sequencing (WGS) for prediction of potential MenB vaccine coverage.Results. Of the 56 IMD isolates, 42, 8, 5 and 1 were MenB, serogroup Y, serogroup W (MenW) and serogroup C, respectively. Geographical differences in the distribution of MenB clones revealed concentration of sequence type (ST)-269 clonal complex (cc) and ST-60 cc in Newfoundland and Labrador, while ST-41/44 cc (particularly ST-154) was predominantly found in New Brunswick and Nova Scotia. Core genome multi-locus sequence typing (cgMLST) also separated the New Brunswick and Nova Scotia ST-154 isolates into two clusters, with differences in their nhba and penA alleles. Furthermore, cgMLST also separated the ST-269 cc isolates in Atlantic Canada into the ST-1611 and the ST-269/ST-8924 clusters, with the latter showing high similarity to the ST-269 that first emerged in the Province of Quebec. Genetic Meningococcal Antigen Typing System showed that 54.8 % of MenB were predicted to be covered by the MenB vaccine Bexsero, with a further 38.1 % potentially covered by virtue of the presence of genes that encoded factor H-binding protein variant 1 proteins. Meningococcal deduced vaccine antigen reactivity predicted from WGS data showed that 95.3 % of MenB were covered by Trumenba. Four cases of IMD due to MenW ST-11 cc were also identified, with the first case found in 2018.Conclusions. This study provided evidence concerning the dynamics of N. meningitidis strains causing IMD in Atlantic Canada, with both geographical and temporal differences found. MenB vaccine appeared to provide good coverage of MenB IMD, especially towards the predominant strain of ST-154.
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Affiliation(s)
- Raymond S W Tsang
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Dennis K S Law
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jianwei Zhou
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - David Haldane
- Nova Scotia Health Authority, Government of Nova Scotia, Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhouse University, Halifax, Nova Scotia, Canada
| | - Richard Garceau
- Communicable Disease Control Unit, Department of Health, Government of New Brunswick, Fredericton, New Brunswick, Canada
| | - George Zahariadis
- Provincial Public Health Laboratory, Eastern Health Microbiology Services, Government of Newfoundland and Labrador, St. John's, Newfoundland, Canada.,Department of Laboratory Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Kristen Mead
- Department of Health, Government of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - David Alexander
- Cadham Provincial Labortory, Government of Manitoba, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
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3
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Thorington R, Sawatzky P, Lefebvre B, Diggle M, Hoang L, Patel S, Van Caessele P, Minion J, Garceau R, Matheson M, Haldane D, Gravel G, Mulvey MR, Martin I. Antimicrobial susceptibilities of Neisseria gonorrhoeae in Canada, 2020. Can Commun Dis Rep 2022; 48:571-579. [PMID: 38298531 PMCID: PMC10829890 DOI: 10.14745/ccdr.v48i1112a10] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background The Gonococcal Antimicrobial Surveillance Programme is a passive surveillance system that has monitored antimicrobial resistance in Neisseria gonorrhoeae in Canada since the 1980s. This article summarizes the demographics, antimicrobial resistances and NG-MAST (N. gonorrhoeae multiantigen sequence typing) for cultures collected in 2020. Methods The National Microbiology Laboratory (NML) in Winnipeg received resistant N. gonorrhoeae cultures from provincial and territorial public health laboratories. Agar dilution was used to determine the minimum inhibitory concentrations to ten antimicrobials for all cultures received at NML, according to Clinical and Laboratory Standards Institute guidelines. The NG-MAST typing was also determined for each culture. Results A total of 3,130 N. gonorrhoeae cases were cultured across Canada in 2020; a 36% decrease from 2019 (n=4,859). The level of decreased susceptibility to cefixime increased significantly between 2016 and 2020 to 2.8% (p=0.0054). Decreased susceptibility to ceftriaxone declined significantly between 2016 (1.8%) and 2020 to 0.9% (p=0.001), and there was no significant change with azithromycin between 2016 (7.2%) and 2020 (6.1%). The proportion of cultures with an azithromycin minimum inhibitory concentrations of ≥1 mg/L increased significantly from 11.6% in 2016 to 15.3% in 2020 (p=0.0017). The most common NG-MAST type in Canada for 2020 was sequence type (ST)-11461, while ST-12302 was most commonly associated with azithromycin resistance and ST-16639 with cephalosporin decreased susceptibility. Conclusion Antimicrobial resistance in N. gonorrhoeae remains an important public health concern and continued surveillance is imperative to monitor trends to ensure the recommended therapies will be the most effective.
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Affiliation(s)
- Robyn Thorington
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
| | - Pamela Sawatzky
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
| | | | - Mathew Diggle
- Provincial Laboratory of Public Health Alberta, Edmonton, Alberta, Canada
| | - Linda Hoang
- British Columbia Centres for Disease Control Public Health Microbiology & Reference Laboratory, Vancouver, BC
| | - Samir Patel
- Public Health Ontario Laboratory, Toronto, ON
| | | | | | - Richard Garceau
- Dr. Georges L. Dumont University Hospital Centre, Moncton, NB
| | - Myrna Matheson
- Government of the Northwest Territories, Yellowknife, NT
| | - David Haldane
- Queen Elizabeth II Health Science Centre, Halifax, NS
| | - Genevieve Gravel
- Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control Branch, Public Health Agency of Canada, Ottawa, ON
| | - Michael R Mulvey
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
| | - Irene Martin
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, MB
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4
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Stein DR, Osiowy C, Gretchen A, Thorlacius L, Fudge D, Lang A, Sekirov I, Morshed M, Levett PN, Tran V, Kus JV, Gubbay J, Mohan V, Charlton C, Kanji JN, Tipples G, Serhir B, Therrien C, Roger M, Jiao L, Zahariadis G, Needle R, Gilbert L, Desnoyers G, Garceau R, Bouhtiauy I, Longtin J, El-Gabalawy N, Dibernardo A, Lindsay LR, Drebot M. Evaluation of commercial SARS-CoV-2 serological assays in Canadian public health laboratories. Diagn Microbiol Infect Dis 2021; 101:115412. [PMID: 34425450 PMCID: PMC8377389 DOI: 10.1016/j.diagmicrobio.2021.115412] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 01/22/2023]
Abstract
The COVID-19 pandemic has led to the influx of immunoassays for the detection of antibodies towards severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the global market. The Canadian Public Health Laboratory Network Serology Task Force undertook a nationwide evaluation of twelve laboratory and 6 point-of-care based commercial serological assays for the detection of SARS-CoV-2 antibodies. We determined that there was considerable variability in the performance of individual tests and that an orthogonal testing algorithm should be prioritized to maximize the accuracy and comparability of results across the country. The manual enzyme immunoassays and point-of-care tests evaluated had lower specificity and increased coefficients of variation compared to automated enzyme immunoassays platforms putting into question their utility for large-scale sero-surveillance. Overall, the data presented here provide a comprehensive approach for applying accurate serological assays for longitudinal sero-surveillance and vaccine trials while informing Canadian public health policy.
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Affiliation(s)
- Derek R Stein
- Cadham Provincial Laboratory, Serology and Parasitology, Winnipeg, Manitoba, Canada.
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ainsley Gretchen
- Cadham Provincial Laboratory, Serology and Parasitology, Winnipeg, Manitoba, Canada
| | | | - Denise Fudge
- Shared Health Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda Lang
- Roy Romanow Provincial Laboratory, Regina, Saskatchewan, Canada
| | - Inna Sekirov
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Muhammad Morshed
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Paul N Levett
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Vanessa Tran
- Public Health Ontario Laboratory, Toronto, Ontario Canada
| | - Julianne V Kus
- Public Health Ontario Laboratory, Toronto, Ontario Canada
| | | | - Vandana Mohan
- Public Health Ontario Laboratory, Toronto, Ontario Canada
| | - Carmen Charlton
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Li Ka Shing Institute of Virology, Edmonton, Alberta
| | - Jamil N Kanji
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada
| | - Graham Tipples
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada; Li Ka Shing Institute of Virology, Edmonton, Alberta
| | - Bouchra Serhir
- Laboratoire de santé publique du Quebec, Montreal, Quebec, Canada
| | | | - Michel Roger
- Laboratoire de santé publique du Quebec, Montreal, Quebec, Canada
| | - Lei Jiao
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - George Zahariadis
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - Robert Needle
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - Laura Gilbert
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. John's, Newfoundland and Labrador, Canada
| | - Guillaume Desnoyers
- New Brunswick Virology Reference Centre, CHU Dumont, Moncton, New Brunswick, Canada
| | - Richard Garceau
- New Brunswick Virology Reference Centre, CHU Dumont, Moncton, New Brunswick, Canada
| | | | - Jean Longtin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nadia El-Gabalawy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Antonia Dibernardo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - L Robbin Lindsay
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael Drebot
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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5
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LeBlanc JJ, Gubbay JB, Li Y, Needle R, Arneson SR, Marcino D, Charest H, Desnoyers G, Dust K, Fattouh R, Garceau R, German G, Hatchette TF, Kozak RA, Krajden M, Kuschak T, Lang ALS, Levett P, Mazzulli T, McDonald R, Mubareka S, Prystajecky N, Rutherford C, Smieja M, Yu Y, Zahariadis G, Zelyas N, Bastien N. Real-time PCR-based SARS-CoV-2 detection in Canadian laboratories. J Clin Virol 2020; 128:104433. [PMID: 32405254 PMCID: PMC7219382 DOI: 10.1016/j.jcv.2020.104433] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [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: 05/02/2020] [Accepted: 05/09/2020] [Indexed: 12/21/2022]
Abstract
With emergence of pandemic COVID-19, rapid and accurate diagnostic testing is essential. This study compared laboratory-developed tests (LDTs) used for the detection of SARS-CoV-2 in Canadian hospital and public health laboratories, and some commercially available real-time RT-PCR assays. Overall, analytical sensitivities were equivalent between LDTs and most commercially available methods.
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Affiliation(s)
- Jason J LeBlanc
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (NSHA), Room 404B, MacKenzie Building, 5788 University Avenue, Halifax, Nova Scotia B3H 1V8, Canada; Departments of Pathology, Medicine, and Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Jonathan B Gubbay
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Public Health Ontario Laboratories, Toronto, Ontario, Canada; Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yan Li
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Robert Needle
- Public Health and Microbiology Laboratory, St. John's, Newfoundland, Canada
| | - Sandra Radons Arneson
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Dionne Marcino
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Hugues Charest
- Laboratoire De Santé Publique Du Québec/INSPQ, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Guillaume Desnoyers
- Centre Hospitalier Universitaire Dr. Georges L. Dumont, Moncton, New-Brunswick, Canada
| | - Kerry Dust
- Cadham Provincial Laboratory, Winnipeg, Manitoba, Canada
| | - Ramzi Fattouh
- Department of Laboratory Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Richard Garceau
- Centre Hospitalier Universitaire Dr. Georges L. Dumont, Moncton, New-Brunswick, Canada
| | - Gregory German
- Queen Elizabeth Hospital, Charlottetown, Prince Edward Island, Canada
| | - Todd F Hatchette
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (NSHA), Room 404B, MacKenzie Building, 5788 University Avenue, Halifax, Nova Scotia B3H 1V8, Canada; Departments of Pathology, Medicine, and Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert A Kozak
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Mel Krajden
- Public Health Laboratory, British Columbia Centre for Disease Control (BCCDC), Vancouver, British Columbia, Canada
| | - Theodore Kuschak
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Amanda L S Lang
- Roy Romanow Provincial Laboratory (RRPL), Saskatchewan Health Authority (SHA), Regina, Saskatchewan, Canada
| | - Paul Levett
- Public Health Laboratory, British Columbia Centre for Disease Control (BCCDC), Vancouver, British Columbia, Canada
| | - Tony Mazzulli
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ryan McDonald
- Roy Romanow Provincial Laboratory (RRPL), Saskatchewan Health Authority (SHA), Regina, Saskatchewan, Canada
| | - Samira Mubareka
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Natalie Prystajecky
- Public Health Laboratory, British Columbia Centre for Disease Control (BCCDC), Vancouver, British Columbia, Canada
| | | | - Marek Smieja
- St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Yang Yu
- Public Health and Microbiology Laboratory, St. John's, Newfoundland, Canada
| | - George Zahariadis
- Public Health and Microbiology Laboratory, St. John's, Newfoundland, Canada
| | - Nathan Zelyas
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (NSHA), Room 404B, MacKenzie Building, 5788 University Avenue, Halifax, Nova Scotia B3H 1V8, Canada; Provincial Laboratory for Public Health (ProvLab), Calgary, Alberta, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
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6
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Barkati S, Gottstein B, Mu Ller N, Sheitoyan-Pesant C, Metrakos P, Chen T, Garceau R, Libman MD, Ndao M, Yansouni CP. First Human Case of Metacestode Infection Caused by Versteria sp. in a Kidney Transplant Recipient. Clin Infect Dis 2020; 68:680-683. [PMID: 30212859 DOI: 10.1093/cid/ciy602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/25/2018] [Indexed: 11/13/2022] Open
Abstract
Cestodes are emerging agents of severe opportunistic infections among immunocompromised patients. We describe the first case of human infection, with the recently-proposed genus Versteria causing an invasive, tumor-like hepatic infection with regional and distant extension in a 53-year-old female kidney transplant recipient from Atlantic Canada.
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Affiliation(s)
- Sapha Barkati
- J.D. MacLean Centre for Tropical Diseases at McGill University.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Bruno Gottstein
- Institute of Parasitology, Vertsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland
| | - Norbert Mu Ller
- Institute of Parasitology, Vertsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland
| | | | - Peter Metrakos
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Tianyan Chen
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Richard Garceau
- Centre Hospitalier Universitaire Dr-Georges-L.-Dumont, Moncton, New-Brunswick
| | - Michael D Libman
- J.D. MacLean Centre for Tropical Diseases at McGill University.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Momar Ndao
- J.D. MacLean Centre for Tropical Diseases at McGill University.,National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Cedric P Yansouni
- J.D. MacLean Centre for Tropical Diseases at McGill University.,McGill University Health Centre, Montreal, Quebec, Canada
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7
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Tsang RSW, Shuel M, Ahmad T, Hayden K, Knox N, Van Domselaar G, Hoang L, Tyrrell GJ, Minion J, Van Caeseele P, Kus JV, Ulanova M, Lefebvre B, Haldane D, Garceau R, German G, Zahariadis G, Hanley B, Kandola K, Patterson M. Whole genome sequencing to study the phylogenetic structure of serotype a Haemophilus influenzae recovered from patients in Canada. Can J Microbiol 2019; 66:99-110. [PMID: 31661630 DOI: 10.1139/cjm-2019-0406] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the phylogenetic structure of serotype a Haemophilus influenzae (Hia) isolates recovered from patients in Canada. Hia isolates from 490 separate patients and an American Type Culture Collection (ATCC) strain were analyzed by multilocus sequence typing (MLST), with 18 different sequence types (STs) identified. Most (85.7%) Hia patient isolates were typed as ST-23 and another 12.7% belonged to 14 different STs with 6, 5, or 4 MLST gene loci related to ST-23 (ST-23 complex). Core genome single-nucleotide variation phylogeny (SNVPhyl) on whole genome sequence (WGS) data of 121 Hia patient isolates representing all identified STs and the ATCC strain revealed 2 phylogenetic populations, with all the ST-23 complex isolates within 1 population. The other phylogenetic population contained only the ATCC strain and 3 patient isolates. Concatenated hitABC sequences retrieved from WGS data and analyzed by MEGA (Molecular Evolutionary Genetic Analysis) alignment confirmed the phylogeny obtained by SNVPhyl. The sodC gene was found only in isolates in the minor phylogenetic population. The 2 phylogenetic populations of the Canadian Hia isolates are similar to the 2 clonal divisions described for serotype b H. influenzae. Combining MLST, core SNVPhyl, and hitABC gene sequence alignment showed that most (99.4%) Canadian Hia patient isolates belonged to 1 major phylogenetic population.
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Affiliation(s)
- Raymond S W Tsang
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michelle Shuel
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Tauqeer Ahmad
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Kristy Hayden
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Natalie Knox
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gary Van Domselaar
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Linda Hoang
- BC Public Health Microbiology and Reference Laboratory, Vancouver, British Columbia, Canada
| | | | - Jessica Minion
- Roy Romanow Provincial Laboratory, Regina, Saskatchewan, Canada
| | | | - Julianne V Kus
- Public Health Ontario, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Marina Ulanova
- Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Brigitte Lefebvre
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - David Haldane
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,Dalhousie University, Halifax, Nova Scotia, Canada
| | - Richard Garceau
- Communicable Disease Control Unit, Department of Health, Government of New Brunswick, Fredericton, New Brunswick, Canada
| | - Greg German
- Department of Health, Government of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - George Zahariadis
- Provincial Public Health Laboratory, Eastern Health Microbiology Services, St. John's, Newfoundland and Labrador, Canada.,Department of Laboratory Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Brendan Hanley
- Department of Health and Social Services, Government of Yukon, Whitehorse, Yukon, Canada
| | - Kami Kandola
- Department of Health and Social Services, Government of Northwest Territories, Yellowknife, Northwest Territories, Canada
| | - Michael Patterson
- Department of Health, Government of Nunavut, Iqaluit, Nunavut, Canada
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8
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Tsang RS, Hoang L, Tyrrell GJ, Minion J, Van Caeseele P, Kus JV, Lefebvre B, Haldane D, Garceau R, German G, Zahariadis G, Hanley B. Increase in ST-11 serogroup W Neisseria meningitidis invasive meningococcal disease in Canada, 2016-2018. Can Commun Dis Rep 2019; 45:164-169. [PMID: 31285709 PMCID: PMC6587698 DOI: 10.14745/ccdr.v45i06a04] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Many countries have experienced increases in invasive meningococcal disease (IMD) due to a serogroup W Neisseria meningitidis (MenW) strain of the multilocus sequence type (ST)-11 clonal complex (CC). MenW ST-11 was first reported in Ontario, Canada, in 2014. By 2016, this strain caused IMD in five provinces and was responsible for 18.8% of the IMD cases in Canada. OBJECTIVE To provide an update on invasive MenW disease in Canada including the strain characteristics, specimen source of isolates, age, sex and geographic distribution of cases. METHODS N. meningitidis from culture-positive IMD cases are routinely submitted to the National Microbiology Laboratory (NML) for serogroup, serotype, serosubtype and sequence type analysis. The data from January 1, 2016 to December 31, 2018 were analyzed by calculating the proportion of IMD cases caused by MenW compared with other serogroups. In addition, trends based on age, sex and geographic distribution of cases and specimen source of isolates were analyzed based on information on specimen requisition forms. RESULTS Over the 3-year period, 292 individual IMD case isolates were analyzed. The percentage of IMD case isolates typed as MenW more than doubled from 19% (n=15) to 44% (n=51) in 2018 when MenW became the most common serogroup, exceeded the number of MenB, MenC or MenY. In total, 93 MenW case isolates were identified, 91% (n=85) belonged to the ST-11 CC. The increase in MenW affected all age groups (but was most common in those older than 60) and both sexes, and occurred across the country but most prevalent in western Canada. The most common specimen source was blood. CONCLUSION In 2018, MenW was the most common serogroup for isolates received by the NML from culture-positive IMD cases in Canada. Over 90% of the MenW serogroup isolates belonged to the ST-11 CC. The quadrivalent ACWY meningococcal conjugate vaccine protects against IMD caused by strains in the A, C, W or Y serogroups and therefore may protect against IMD caused by the new MenW ST-11 strain; however, more research is needed. The emergence of variant strains highlight the importance of strain characterization in IMD surveillance and research.
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Affiliation(s)
- RS Tsang
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB
| | - L Hoang
- BC Public Health Microbiology and Reference Laboratory, Vancouver, BC
| | - GJ Tyrrell
- Provincial Laboratory for Public Health, Edmonton, AB
| | - J Minion
- Saskatchewan Disease Control Laboratory, Regina, SK
| | | | - JV Kus
- Public Health Ontario, Toronto, ON
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON
| | - B Lefebvre
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, QC
| | - D Haldane
- Nova Scotia Health Authority, Halifax, NS
- Dalhousie University, Halifax, NS
| | - R Garceau
- Communicable Disease Control Unit, Department of Health, Government of New Brunswick, Fredericton, NB
| | - G German
- Department of Health, Government of Prince Edward Island, Charlottetown, PE
| | - G Zahariadis
- Provincial Public Health Laboratory, Eastern Health Microbiology Services, St. John’s, NL
- Department of Laboratory Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL
| | - B Hanley
- Yukon Communicable Disease Control, Yukon Health and Social Services, Whitehorse, YT
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Lavoie S, Caswell D, Gill MJ, Kadkhoda K, Charlton CL, Levett PN, Hatchette T, Garceau R, Maregmen J, Mazzulli T, Needle R, Kadivar K, Kim J. Heterophilic interference in specimens yielding false-reactive results on the Abbott 4th generation ARCHITECT HIV Ag/Ab Combo assay. J Clin Virol 2018; 104:23-28. [PMID: 29704735 DOI: 10.1016/j.jcv.2018.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/06/2017] [Revised: 03/27/2018] [Accepted: 03/31/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND False-reactivity in HIV-negative specimens has been detected in HIV fourth-generation antigen/antibody or 'combo' assays which are able to detect both anti-HIV-1/HIV-2 antibodies and HIV-1 antigen. OBJECTIVES We sought to characterize these specimens and determine the effect of heterophilic interference. STUDY DESIGN Specimens previously testing as false-reactive on the Abbott ARCHITECT HIV Ag/Ab combo assay and re-tested on a different (Siemens ADVIA Centaur HIV Ag/Ab) assay. A subset of these specimens were also pre-treated with heterophilic blocking agents and re-tested on the Abbott assay. RESULTS Here we report that 95% (252/264) of clinical specimens that were repeatedly reactive on the Abbott ARCHITECT HIV Ag/Ab combo assay (S/Co range, 0.94-678) were negative when re-tested on a different fourth generation HIV combo assay (Siemens ADVIA Centaur HIV Ag/Ab). All 264 samples were subsequently confirmed to be HIV negative. On a small subset (57) of specimens with available volume, pre-treatment with two different reagents (HBT; Heterophilic Blocking Tube, NABT; Non-Specific Blocking Tube) designed to block heterophilic antibody interference either eliminated (HBT) or reduced (NABT) the false reactivity when re-tested on the ARCHITECT HIV Ag/Ab combo assay. CONCLUSIONS Our results suggest that the Abbott ARCHITECT HIV Ag/Ab combo assay can be prone to heterophilic antibody interference.
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Affiliation(s)
- S Lavoie
- National Laboratory for HIV Reference Services, National Microbiology Laboratory, Winnipeg, MB, Canada
| | - D Caswell
- Saskatchewan Disease Control Laboratory, Regina, SK, Canada
| | - M J Gill
- Southern Alberta HIV Clinic, Calgary, AB, Canada
| | - K Kadkhoda
- Cadham Provincial Public Health Laboratory, Winnipeg, MB, Canada
| | - C L Charlton
- Provincial Laboratory for Public Health, University of Alberta Hospital, Edmonton, AB, Canada
| | - P N Levett
- Saskatchewan Disease Control Laboratory, Regina, SK, Canada
| | - T Hatchette
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, NS, Canada
| | - R Garceau
- Centre Hospitalier Universitaire-Dr G. L. Dumont, Moncton, NB, Canada
| | - J Maregmen
- Public Health Ontario Toronto Laboratory, Toronto, ON, Canada
| | - T Mazzulli
- Public Health Ontario Toronto Laboratory, Toronto, ON, Canada
| | - R Needle
- Department of Laboratory Medicine Faculty of Medicine, Memorial University of Newfoundland, NL, Canada
| | - K Kadivar
- National Laboratory for HIV Reference Services, National Microbiology Laboratory, Winnipeg, MB, Canada
| | - J Kim
- National Laboratory for HIV Reference Services, National Microbiology Laboratory, Winnipeg, MB, Canada.
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10
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Martin I, Sawatzky P, Liu G, Allen V, Lefebvre B, Hoang L, Drews S, Horsman G, Wylie J, Haldane D, Garceau R, Ratnam S, Wong T, Archibald C, Mulvey MR. Decline in Decreased Cephalosporin Susceptibility and Increase in Azithromycin Resistance in Neisseria gonorrhoeae, Canada. Emerg Infect Dis 2016; 22:65-7. [PMID: 26689114 PMCID: PMC4696705 DOI: 10.3201/eid2201.151247] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Antimicrobial resistance profiles were determined for Neisseria gonorrhoeae strains isolated in Canada during 2010–2014. The proportion of isolates with decreased susceptibility to cephalosporins declined significantly between 2011 and 2014, whereas azithromycin resistance increased significantly during that period. Continued surveillance of antimicrobial drug susceptibilities is imperative to inform treatment guidelines.
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11
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Tsang RSW, Morshed M, Allen V, Chernesky MA, Fonseca K, Garceau R, Jayaraman GC, Kadkhoda K, Lee BE, Levett PN, Radons SM, Serhir B, Singh AE, Wong T. Canadian Public Health Laboratory Network national syphilis laboratory testing recommendations: INTRODUCTION. Can J Infect Dis Med Microbiol 2015; 26 Suppl A:4A-5A. [PMID: 25798164 PMCID: PMC4353978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/04/2014] [Indexed: 12/04/2022]
Affiliation(s)
| | - Raymond SW Tsang
- National Microbiology Laboratory, Winnipeg, Manitoba;,Correspondence: Dr Raymond Tsang, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2. Telephone 204-789-6020, fax 204-789-2018, e-mail
| | - Muhammad Morshed
- BC Public Health Microbiology and Reference Laboratory, and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia
| | - Vanessa Allen
- Ontario Agency for Health Protection and Promotion, Toronto
| | | | - Kevin Fonseca
- Alberta Provincial Laboratory for Public Health, Calgary, Alberta
| | | | - Gayatri C Jayaraman
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario
| | - Kamran Kadkhoda
- Cadham Provincial Laboratory, and Department of Medical Microbiology & Infectious Diseases and Department of Immunology, University of Manitoba, Winnipeg, Manitoba
| | - Bonita E Lee
- Division of Pediatric Infectious Diseases, University of Alberta, Edmonton, Alberta
| | - Paul N Levett
- Saskatchewan Disease Control Laboratory, Regina, Saskatchewan
| | - Sandra M Radons
- Canadian Public Health Laboratory Network, Winnipeg, Manitoba
| | - Bouchra Serhir
- Institut national de santé publique du Quebec-LSPQ, Sainte-Anne-de-Bellevue, Quebec
| | - Ameeta E Singh
- Division of Infectious Diseases, University of Alberta, Edmonton, Alberta
| | - Tom Wong
- Public Health Agency of Canada, Ottawa, Ontario
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12
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Martin I, Sawatzky P, Liu G, Allen V, Lefebvre B, Hoang L, Lovgren M, Haldane D, Caeseele PV, Horsman G, Garceau R, Ratnam S, Wong T, Gilmour M. Antimicrobial susceptibilities and distribution of sequence types of Neisseria gonorrhoeae isolates in Canada: 2010. Can J Microbiol 2013; 59:671-8. [PMID: 24102220 DOI: 10.1139/cjm-2013-0357] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The monitoring of antimicrobial susceptibilities in Neisseria gonorrhoeae isolates and characterization of N. gonorrhoeae multiantigen sequence types (NG-MAST, ST) provide important surveillance data as resistance rates continue to rise. A total of 2970 N. gonorrhoeae isolates were collected by Canadian provincial public health laboratories in 2010, and 1233 were submitted to the National Microbiology Laboratory for testing. The NG-MAST and minimum inhibitory concentration (MIC) by agar dilution were determined for each isolate. Of the 2970 isolates, 25.1% were resistant to penicillin, 34.6% resistant to tetracycline, 31.5% resistant to erythromycin, 35.9% resistant to ciprofloxacin, and 1.2% resistant to azithromycin. Decreased susceptibility to cefixime (MIC ≥ 0.25 mg/L) and ceftriaxone (MIC ≥ 0.125 mg/L) was identified in 3.2% and 7.3% of the isolates, respectively. The most common STs found in Canada were ST1407 (13.3%), ST3150 (11.3%), and ST3158 (9.0%), with 249 different STs identified among the isolates. Within the ST1407 group, 19.5% and 43.3% isolates have decreased susceptibility to cefixime and ceftriaxone, respectively. ST1407, the most prevalent NG-MAST in Canada in 2010, has been associated with high-level ceftriaxone MICs and with cefixime treatment failure cases worldwide. Identification and monitoring of STs and corresponding antimicrobial resistance profiles may be useful in surveillance programs and be used to inform public health actions.
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Affiliation(s)
- Irene Martin
- a Bacteriology and Enteric Diseases Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
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13
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Abstract
We describe 3 culture-proven cases of adenovirus serotype 14 infection in New Brunswick, Canada, during the summer of 2011. Strains isolated from severely ill patients were closely related to strains of a genomic variant, adenovirus 14p1, circulating in the United States and Ireland. Physicians in Canada should be aware of this emerging adenovirus.
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Affiliation(s)
- Gabriel Girouard
- Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton, New Brunswick, Canada.
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14
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Affiliation(s)
- Duncan Webster
- Department of Medicine, Saint John Regional Hospital, Saint John, NB.
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15
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Van Buynder PG, Dhaliwal JK, Van Buynder JL, Couturier C, Minville-Leblanc M, Garceau R, Tremblay FW. Protective effect of single-dose adjuvanted pandemic influenza vaccine in children. Influenza Other Respir Viruses 2011; 4:171-8. [PMID: 20629771 PMCID: PMC5964543 DOI: 10.1111/j.1750-2659.2010.00146.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Please cite this paper as: Van Buynder et al. (2010) Protective effect of single‐dose adjuvanted pandemic influenza vaccine in children. Influenza and Other Respiratory Viruses 4(4), 171–178. Background During the first wave of A/California/7/2009(H1N1) influenza, high rates of hospitalization in children under 5 years were seen in many countries. Subsequent policies for vaccinating children varied in both type of vaccine and number of doses. In Canada, children 36 months to <10 years received a single dose of 0·25 ml of the GSK adjuvanted vaccine (Arepanrix™) equivalent to 1·9 μg HA. Children 6 months to 35 months received two doses as did those 36–119 months with chronic medical conditions. Method We conducted a community‐based case–control vaccine effectiveness (VE) review of children under 10 years with influenza like illness who were tested for H1N1 infection at the central provincial laboratory. Laboratory‐confirmed influenza was the primary outcome, and vaccination status the primary exposure to assess VE after a single 0·25‐ml dose. Results If vaccination was designated to be effective after 14 days, no vaccinated child had laboratory‐confirmed influenza compared to 38% of controls. The VE of 100% was statistically significant for children <10 years of age and <5 years considered separately. If vaccination was considered effective after 10 days, VE dropped to 96% overall but was statistically significant and over 90% in all age subgroups, including those under 36 months. Conclusions A single 0·25‐ml dose of the GSK adjuvanted vaccine (Arepanrix™) protects children against laboratory‐confirmed pandemic influenza potentially avoiding any increased reactogenicity associated with second doses. Adjuvanted vaccines offer hope for improved seasonal vaccines in the future.
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Affiliation(s)
- P G Van Buynder
- New Brunswick Department of Health, Office of the Chief Medical Officer of Health (OCMOH), Fredericton, NB, Canada.
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16
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Garceau R, Leblanc D, Mallet M, Girouard G, Thibault L. P252 Herpes simplex type 1 is the leading cause of genital herpes in New Brunswick. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70471-6] [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: 11/16/2022]
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18
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Vinh DC, Garceau R, Martinez G, Wiebe D, Burdz T, Reimer A, Bernard K. Legionella jordanis lower respiratory tract infection: case report and review. J Clin Microbiol 2007; 45:2321-3. [PMID: 17494719 PMCID: PMC1932991 DOI: 10.1128/jcm.00314-07] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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: 11/20/2022] Open
Abstract
Legionella jordanis was first described in 1982 after isolation from environmental sources and is otherwise a very rare human pathogen. Here, we report the recovery of L. jordanis from a bronchoalveolar lavage specimen from a patient who presented with an indolent lower respiratory tract infection associated with constitutional symptoms. This case is the first culture-positive case of infection involving this species in Canada.
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Affiliation(s)
- Donald C Vinh
- Department of Medical Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
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Abstract
Prophylactic antibiotics were given postoperatively to a consecutive series of 74 patients who underwent vaginal hysterectomy. Antibiotics were administered in the immediate postoperative period. There was a highly significant decrease in febrile morbidity in the treated group compared to 190 control subjects having similar surgery but treated with antibiotics only on the appearance of fever and/or other signs of infection. There was a failure to relate the increased febrile morbidity in the control group to patient's age, menopausal state, type of catheterization, or to the type of operative procedure. The increased morbidity in the control group related only to the failure to use prophylactic antibiotics. The antibiotic-treated portion (58 per cent) of the control group had a longer period of hospitalization.
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