Browsing by Author "Laupland, Kevin"

Now showing 1 - 8 of 8
  • Thumbnail Image
    ItemOpen Access
    A Mathematical Model For Optimal Admission Screening For Methicillin Resistant Staphylococcus aureus In Acute Care Facilities
    (2016-01-26) Simmonds, Kimberley Anne; Henderson, Elizabeth; Laupland, Kevin; Joffe, Mark; Svenson, Larry; Dean, Stafford; Li, Michael
    Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common healthcare associated infections (HAIs) worldwide. It has both an economic and personal cost to the healthcare system and infected individuals. Admission screening for MRSA is one method to detect MRSA entering the acute care system. Screening combined with isolation is currently a common method for preventing MRSA transmission in Alberta acute care facilities. There remains uncertainty about the best methods to screening patients for MRSA. Universal screening is the testing of all patients admitted to the hospital, regardless of their risk of MRSA colonization; conversely targeted screening only tests a selected patient population considered at greatest risk for MRSA colonization. Mathematical models for infectious diseases, such as MRSA, are very useful for predicting outcomes with varying scenarios. The purpose of this project was to develop and validate a deterministic differential equations model for MRSA transmission to determine the optimal screening method for the detection of MRSA infected individuals entering acute care facilities. Based on the local epidemiology used to develop this model, the conclusions drawn from the model are that targeted screening of 70-90% of high-risk patients will reduce unidentified-infected MRSA positive individuals. However, this Alberta model that shows a targeted screening program for high-risk individuals with horizontal measures to reduce the hospital transmission rate is the most effective way to reduce MRSA in Alberta acute care facilities.
  • Thumbnail Image
    ItemOpen Access
    A Microbiological Explanation for the Obesity Pandemic?
    (2014-01-01) Valiquette, Louis; Sirard, Stéphanie; Laupland, Kevin
  • Thumbnail Image
    ItemOpen Access
    Community-Associated Methicillin-Resistant Staphylococcus aureus Necrotizing Pneumonia without Evidence of Antecedent Viral Upper Respiratory Infection
    (2014-01-01) Toro, Cristina Moran; Janvier, Jack; Zhang, Kunyan; Fonseca, Kevin; Gregson, Dan; Church, Deirdre; Laupland, Kevin; Rabin, Harvey; Elsayed, Sameer; Conly, John
    BACKGROUND: USA300 community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) strains causing necrotizing pneumonia have been reported in association with antecedent viral upper respiratory tract infections (URI).METHODS: A case series of necrotizing pneumonia presenting as a primary or coprimary infection, secondary to CA-MRSA without evidence of antecedent viral URI, is presented. Cases were identified through the infectious diseases consultation service records. Clinical and radiographic data were collected by chart review and electronic records. MRSA strains were isolated from sputum, bronchoalveolar lavage, pleural fluid or blood cultures and confirmed using standard laboratory procedures. MRSA strains were characterized by susceptibility testing, pulsed-field gel electrophoresis, spa typing, agr typing and multilocus sequence typing. Testing for respiratory viruses was performed by appropriate serological testing of banked sera, or nucleic acid testing of nasopharyngeal or bronchoalveloar lavage specimens.RESULTS: Ten patients who presented or copresented with CA necrotizing pneumonia secondary to CA-MRSA from April 2004 to October 2011 were identified. The median length of stay was 22.5 days. Mortality was 20.0%. Classical risk factors for CA-MRSA were identified in seven of 10 (70.0%) cases. Chest tube placement occurred in seven of 10 patients with empyema. None of the patients had historical evidence of antecedent URI. In eight of 10 patients, serological or nucleic acid testing testing revealed no evidence of acute viral coinfection. Eight strains were CMRSA-10 (USA300). The remaining two strains were a USA300 genetically related strain and a USA1100 strain.CONCLUSION: Pneumonia secondary to CA-MRSA can occur in the absence of an antecedent URI. Infections due to CA-MRSA are associated with significant morbidity and mortality. Clinicians need to have an awareness of this clinical entity, particularly in patients who are in risk groups that predispose to exposure to this bacterium.
  • Thumbnail Image
    ItemOpen Access
    Guess Who’s Coming to Dinner? Emerging Foodborne Zoonoses
    (2010-01-01) Fisman, David N; Laupland, Kevin
  • Thumbnail Image
    ItemOpen Access
    Incidence, risk factors, and outcomes of Fusobacterium species bacteremia
    (BioMed Central, 2013-06-05) Afra, Kevin; Laupland, Kevin; Leal, Jenine; Lloyd, Tracie; Gregson, Daniel B.
  • Thumbnail Image
    ItemOpen Access
    Prevalence of USA300 Colonization or Infection and Associated Variables During an Outbreak of Community-Associated Methicillin-Resistant Staphylococcus aureus in a Marginalized Urban Population
    (2007-01-01) Gilbert, Mark; MacDonald, Judy; Louie, Marie; Gregson, Dan; Zhang, Kunyan; Elsayed, Sameer; Laupland, Kevin; Nielsen, Diane; Wheeler, Virginia; Lye, Tara; Conly, John
    BACKGROUND: In 2004, an outbreak of the USA300 strain of methicillin-resistant Staphylococcus aureus (MRSA) was identified in persons with histories of homelessness, illicit drug use or incarceration in the Calgary Health Region (Calgary, Alberta). A prevalence study was conducted to test the hypotheses for factors associated with USA300 colonization or infection.METHODS: Participants were recruited at sites accessed by this marginalized population. Health care staff administered a questionnaire and collected crack pipes and nasal, axillary and skin infection swabs. Pipes and swabs were cultured according to standard techniques. MRSA isolates were further characterized by polymerase chain reaction (mecA, Panton-Valentine leukocidin and Staphylococcal cassette chromosome mec) and typing methods (pulsed-field gel electrophoresis, staphylococcal protein A typing and multilocus sequence typing). Colonization or infection was determined by having any one of nasal, axillary, skin infection or pipe swabs positive for USA300. Colonized participants had one or more nasal, axillary or pipe swab positive for USA300; infected participants had one or more skin infection swab positive for USA300.RESULTS: The prevalence of USA300 colonization or infection among 271 participants was 5.5% (range 3.1% to 9.0%). USA300 cases were more likely to report manipulation of skin infections (OR 9.55; 95% CI 2.74 to 33.26); use of crack pipes was not significant despite identification of the USA300 strain on two of four crack pipes tested. USA300 cases were more likely to report drug use between sex trade workers and clients (OR 5.86; 95% CI 1.63 to 21.00), and with casual sex partners (OR 5.40; 95% CI 1.64 to 17.78).CONCLUSION: Ongoing efforts to promote the appropriate treatment of skin infections in this population are warranted. The association of USA300 colonization or infection and drug use with sexual partners suggest a role for sexual transmission of the USA300 strain of MRSA.
  • Thumbnail Image
    ItemOpen Access
    The Time of Cholera
    (2011-01-01) Fisman, David N; Laupland, Kevin
  • Thumbnail Image
    ItemOpen Access
    Utilization of Colistin for Treatment of Multidrug-Resistant Pseudomonas aeruginosa
    (2008-01-01) Sabuda, Deana M; Laupland, Kevin; Pitout, Johann; Dalton, Bruce; Rabin, Harvey; Louie, Thomas; Conly, John
    BACKGROUND: Colistin is uncommonly used in clinical practice; however, the emergence of multidrug-resistant organisms has rekindled interest in this potentially toxic therapeutic option. The present study describes the authors’ experience with colistin in the management of patients who were infected with metallo-beta-lactamase (MBL)-producing Pseudomonas aeruginosa within the Calgary Health Region (Calgary, Alberta).METHOD: Adult patients who received colistimethate sodium (colistin) between January 2000 and December 2005 were identified via pharmacy records, and their charts were reviewed retrospectively. Patients with cystic fibrosis were excluded. Patient demographics, clinical course and relevant laboratory data were extracted.RESULTS: Twenty-eight courses of colistin were received by 22 patients. The majority of these treatments were directed at MBL-producing Pseudomonas. One-half of the patients received nebulized colistin. Intravenous (IV) colistin was administered to 12 patients for a mean ± SD of 14.7±13.8 days (range 3.7 to 46 days). The highest IV dose used was 125 mg every 6 h or 6 mg/kg/day. Eight of 12 patients (67%) treated with IV colistin responded either fully or partially. Two patients received IV colistin as outpatients. Adverse effects considered to be due to colistin included drug fever, nephrotoxicity and neurotoxicity. Five of nine patients (56%) who had complete data available for evaluation had at least a doubling of creatinine levels from baseline.CONCLUSION: Patients in the present study received both IV and nebulized colistin for multidrug-resistant P aeruginosa. The use of IV colistin was associated with a favourable response, but mild nephrotoxicity occurred in two-third of patients. It was concluded that colistin may be a useful drug when choices are limited.