Emergence of and risk factors for ciprofloxacin-gentamicin-resistant Escherichia coli urinary tract infections in a region of Quebec

BACKGROUND: An increased incidence of urinary tract infections (UTIs) caused by ciprofloxacin-gentamicin-resistant Escherichia coli (CiGREC) has been observed in a tertiary care centre in Sherbrooke, Quebec. The risk factors for such infections remained unclear

Impact of methicillin resistant Staphylococcus aureus contact isolation units on medical care.

BACKGROUND: Patient isolation using contact precautions has gained widespread use to halt MRSA transmission, however supportive data is scarce and concerns regarding patient safety and satisfaction have been raised. At our institution, MRSA patients are isolated on a dedicated ward (cohort isolation), rather than in separate rooms. Our objectives were (1) to determine the proportion of bedside medical visits to patients on an isolation ward, (2) to quantify complications in those patients and (3) to determine if those complications are related to isolation and if they can be prevented. METHODS: This retrospective case-control study was performed on the two sites of a tertiary teaching hospital in Sherbrooke, QC, Canada. We matched MRSA patients with an admission diagnosis of heart failure or chronic obstructive pulmonary disease to similar non-isolated controls. The proportion of bedside visits was ascertained through the number of progress notes with subjective elements or with a physical examination. Complications were sought through an extensive file review, and events were analysed according to Baker's CAES causality and preventability scales. RESULTS: Overall, 111 patient pairs were analysed (35 with heart failure and 76 with COPD). Isolated patients received less bedside visits (subjective notes/1,000 patient-days: 849.6 vs. 983.3, p = 0,001). Attending physicians (454.5 vs. 451.4, p = 0,02) and residents (347.0 vs. 416.9, p = 0.01) are responsible for this discrepancy, while medical students appear to visit isolated and non-isolated patients equally (116.5 vs. 114.9, p = 0.90). Isolated patients showed a tendency towards longer stay and more preventable complications, although no difference in the total number of complications was observed. CONCLUSION: Isolated patients have less documented care that suggests less bedside visits from the medical staff, which could hamper the therapeutical relationship. Further studies are needed to explain this finding

Opt-out universal HCV and HIV screening in a Canadian emergency room: a cross-sectional study

International audienceObjectives To determine the prevalence of undiagnosed hepatitis C virus (HCV) and HIV cases in a population sample tested in the emergency room (ER) and to evaluate linkage-to-care.Setting Canadian university hospital.Participants Adults born after 1945 who consulted at ER for any condition and on any shift were included. Patients unable to opt-out were excluded.Interventions ER nurse confirmed patients’ eligibility and provided them with the option to opt-out. A physician met patients with a new diagnosis. Linkage-to-care was assessed 3 months postdiagnosis. Patients newly diagnosed with HCV were considered linked if they had an HCV RNA test, genotype, liver fibrosis evaluation, and if indicated, treatment prescription. Patients newly diagnosed with HIV were considered linked to care if they had an HIV serology confirmation test, viral load, CD4 cell count and started antiretroviral therapy.Primary and secondary outcome measures Primary objective: to determine the prevalence (overall and undiagnosed cases) of HIV and HCV among the patients who consult the ER. Secondary objectives: to determine the proportion of patients who opt-out, assess the adherence of emergency staff to the offer of testing, determine the proportion of patients linked to care at 3 months.Results Among 6350 eligible patients informed of the screening programme, 62.1% of patients were tested for at least one virus (HIV: 3905; HCV: 3910). 25% patients opted-out, 12% were not tested for organisational reasons, 0.3% (18) patients were HCV-HIV coinfected. Overall prevalence of HCV and HIV cases were 1.9% and 1.2%, respectively. Prevalence of new cases was 0.23% (95% CI 0.12% 0.45%) for HCV and 0.05% (95% CI 0.01% to 0.20%) for HIV. Among the new cases, only two HCV-infected and one HIV-infected patients were linked-to-care 3 months postdiagnosis.Conclusions Identification of new cases of HCV and HIV through universal screening at the ER and linkage-to-care were both low

sj-docx-1-smo-10.1177_20503121231166638 – Supplemental material for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury

Supplemental material, sj-docx-1-smo-10.1177_20503121231166638 for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury by Christophe Alarie, Isabelle Gagnon, Lily Trang Thao Huynh, Karine Doucet, Adèle Pichette-Auray, Cassandre Hinse-Joly and Bonnie Swaine in SAGE Open Medicine</p

sj-docx-3-smo-10.1177_20503121231166638 – Supplemental material for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury

Supplemental material, sj-docx-3-smo-10.1177_20503121231166638 for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury by Christophe Alarie, Isabelle Gagnon, Lily Trang Thao Huynh, Karine Doucet, Adèle Pichette-Auray, Cassandre Hinse-Joly and Bonnie Swaine in SAGE Open Medicine</p

sj-docx-4-smo-10.1177_20503121231166638 – Supplemental material for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury

Supplemental material, sj-docx-4-smo-10.1177_20503121231166638 for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury by Christophe Alarie, Isabelle Gagnon, Lily Trang Thao Huynh, Karine Doucet, Adèle Pichette-Auray, Cassandre Hinse-Joly and Bonnie Swaine in SAGE Open Medicine</p

sj-docx-2-smo-10.1177_20503121231166638 – Supplemental material for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury

Supplemental material, sj-docx-2-smo-10.1177_20503121231166638 for SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury by Christophe Alarie, Isabelle Gagnon, Lily Trang Thao Huynh, Karine Doucet, Adèle Pichette-Auray, Cassandre Hinse-Joly and Bonnie Swaine in SAGE Open Medicine</p

Assessment of Bedside Visits.

<p>Assessment of Bedside Visits.</p

Patients Characteristics.

<p>COPD : Chronic Pulmonary Obstructive Disease.</p