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  1. Article ; Online: Pseudomonas aeruginosa

    Kula, Brittany E / Hudson, Darren / Sligl, Wendy I

    Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada

    2020  Volume 5, Issue 3, Page(s) 130–138

    Abstract: Background: Pseudomonas aeruginosa: Methods: ICU patients with PA were identified and classified as colonized or infected. Infected patients were reviewed for source, patient characteristics, antimicrobial susceptibilities, appropriateness of empiric ...

    Abstract Background: Pseudomonas aeruginosa
    Methods: ICU patients with PA were identified and classified as colonized or infected. Infected patients were reviewed for source, patient characteristics, antimicrobial susceptibilities, appropriateness of empiric antimicrobial therapy, and 30-day mortality. Independent predictors of mortality were identified using multivariable logistic regression.
    Results: One hundred forty (71%) patients with PA were infected. Mean patient age was 55 (SD 18) years; 62% were male. Admission categories included medical (71%), surgical (20%), and trauma or neurological (9%). Mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 (SD 10). One hundred twenty-six (90%) patients were mechanically ventilated, 102 (73%) required vasopressors, and 27 (19%) received renal replacement; 32 (23%) died within 30 days. Infection was nosocomial in 101 (72%) cases. Sources were respiratory (66%), skin-soft tissue (11%), urinary (10%), blood (5%), surgical (5%), gastrointestinal (2%), or unknown (1%). Twenty (14%) isolates were multi-drug resistant; 6 (4%) were extensively drug resistant. Empiric antimicrobial therapy was effective in 97 (69%) cases. Liver disease (adjusted OR [aOR] 6.2, 95% CI 1.5 to 25.7;
    Conclusions: PA infection in ICU is most commonly respiratory and associated with substantial mortality. Existing malignancy, liver disease, and higher APACHE II score were independently associated with mortality.
    Language English
    Publishing date 2020-10-11
    Publishing country Canada
    Document type Journal Article
    ISSN 2371-0888
    ISSN (online) 2371-0888
    DOI 10.3138/jammi-2020-0003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Invasive mould disease in fatal COVID-19: a systematic review of autopsies.

    Kula, Brittany E / Clancy, Cornelius J / Hong Nguyen, M / Schwartz, Ilan S

    The Lancet. Microbe

    2021  Volume 2, Issue 8, Page(s) e405–e414

    Abstract: Invasive mould disease (IMD) might affect up to a third of critically ill patients with COVID-19. COVID-19-associated pulmonary aspergillosis (CAPA) is typically diagnosed on the basis of a combination of non-specific clinical, radiographical, and ... ...

    Abstract Invasive mould disease (IMD) might affect up to a third of critically ill patients with COVID-19. COVID-19-associated pulmonary aspergillosis (CAPA) is typically diagnosed on the basis of a combination of non-specific clinical, radiographical, and mycological findings, but whether most cases represent invasive disease is unresolved. We systematically reviewed autopsy series of three or more decedents with COVID-19 for evidence of IMD. We searched PubMed, Web of Science, OVID (Embase), and medRxiv for studies in English or French published from Jan 1, 2019, to Sept 26, 2020. We identified 1070 references, of which 50 studies met the criteria. These studies described autopsies from 677 decedents, with individual-level data for 443 decedents. The median age was 70·0 years (IQR 57·0-79·0). Of decedents with individual-level data, 133 (30%) had diabetes, 97 (22%) had pre-existing lung disease, and 27 (6%) had immunocompromising conditions. Of 548 decedents with such data, 320 (58%) received invasive mechanical ventilation; among 140 decedents for whom this was known, ventilation was for a median of 9·0 days (IQR 5·0-20·0). Treatment included immunomodulation in 60 decedents and antifungals in 50 decedents. Autopsy-proven IMD occurred in 11 (2%) of 677 decedents, including eight CAPA, two unspecified IMD, and one disseminated mucormycosis. Among 320 decedents who received mechanical ventilation, six (2%) had IMD. We conclude that IMD, including CAPA, is an uncommon autopsy finding in COVID-19.
    MeSH term(s) Aged ; Autopsy ; COVID-19/epidemiology ; Humans ; Pulmonary Aspergillosis/complications ; Respiration, Artificial ; SARS-CoV-2
    Language English
    Publishing date 2021-06-23
    Publishing country England
    Document type Journal Article ; Review ; Systematic Review
    ISSN 2666-5247
    ISSN (online) 2666-5247
    DOI 10.1016/S2666-5247(21)00091-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Defining COVID-19-associated pulmonary aspergillosis: systematic review and meta-analysis.

    Kariyawasam, Ruwandi M / Dingle, Tanis C / Kula, Brittany E / Vandermeer, Ben / Sligl, Wendy I / Schwartz, Ilan S

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2022  Volume 28, Issue 7, Page(s) 920–927

    Abstract: Background: Pulmonary aspergillosis may complicate coronavirus disease 2019 (COVID-19) and contribute to excess mortality in intensive care unit (ICU) patients. The disease is poorly understood, in part due to discordant definitions across studies.: ... ...

    Abstract Background: Pulmonary aspergillosis may complicate coronavirus disease 2019 (COVID-19) and contribute to excess mortality in intensive care unit (ICU) patients. The disease is poorly understood, in part due to discordant definitions across studies.
    Objectives: We sought to review the prevalence, diagnosis, treatment, and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA) and compare research definitions.
    Data sources: PubMed, Embase, Web of Science, and MedRxiv were searched from inception to October 12, 2021.
    Study eligibility criteria: ICU cohort studies and CAPA case series including ≥3 patients were included.
    Participants: Adult patients in ICUs with COVID-19.
    Interventions: Patients were reclassified according to four research definitions. We assessed risk of bias with an adaptation of the Joanna Briggs Institute cohort checklist tool for systematic reviews.
    Methods: We calculated CAPA prevalence using the Freeman-Tukey random effects method. Correlations between definitions were assessed with Spearman's rank test. Associations between antifungals and outcome were assessed with random effects meta-analysis.
    Results: Fifty-one studies were included. Among 3297 COVID-19 patients in ICU cohort studies, 313 were diagnosed with CAPA (prevalence 10%; 95% CI 8%-13%). Two hundred seventy-seven patients had patient-level data allowing reclassification. Definitions had limited correlation with one another (ρ = 0.268-0.447; p < 0.001), with the exception of Koehler and Verweij (ρ = 0.893; p < 0.001); 33.9% of patients reported to have CAPA did not fulfill any research definitions. Patients were diagnosed after a median of 8 days (interquartile range 5-14) in ICUs. Tracheobronchitis occurred in 3% of patients examined with bronchoscopy. The mortality rate was high (59.2%). Applying CAPA research definitions did not strengthen the association between mould-active antifungals and survival.
    Conclusions: The reported prevalence of CAPA is significant but may be exaggerated by nonstandard definitions.
    MeSH term(s) Adult ; Antifungal Agents/therapeutic use ; COVID-19/complications ; COVID-19/epidemiology ; Critical Care ; Humans ; Intensive Care Units ; Pulmonary Aspergillosis/complications ; Pulmonary Aspergillosis/diagnosis ; Pulmonary Aspergillosis/epidemiology
    Chemical Substances Antifungal Agents
    Language English
    Publishing date 2022-02-10
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2022.01.027
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4541: Show issues Location:
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    Zs.MO 284: Show issues

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  4. Article ; Online: COVID-19 Associated Pulmonary Aspergillosis: Systematic Review and Patient-Level Meta-Analysis

    Kariyawasam, Ruwandi M. / Dingle, Tanis C. / Kula, Brittany E. / Sligl, Wendy I. / Schwartz, Ilan S.

    medRxiv

    Abstract: Rationale Pulmonary aspergillosis may complicate COVID-19 and contribute to excess mortality in intensive care unit (ICU) patients. The incidence is unclear because of discordant definitions across studies. Objective We sought to review the incidence, ... ...

    Abstract Rationale Pulmonary aspergillosis may complicate COVID-19 and contribute to excess mortality in intensive care unit (ICU) patients. The incidence is unclear because of discordant definitions across studies. Objective We sought to review the incidence, diagnosis, treatment, and outcomes of COVID-19-associated pulmonary aspergillosis (CAPA), and compare research definitions. Methods We systematically reviewed the literature for ICU cohort studies and case series including ≥3 patients with CAPA. We calculated pooled incidence. Patients with sufficient clinical details were reclassified according to 4 standardized definitions (Verweij, White, Koehler, and Bassetti). Measurements Correlations between definitions were assessed with Spearmans rank test. Associations between antifungals and outcome were assessed with Fishers Exact test. Main Results 38 studies (35 cohort studies and 3 case series) were included. Among 3,297 COVID-19 patients in ICU cohort studies, 313 were diagnosed with CAPA (pooled incidence 9.5%). 197 patients had patient-level data allowing reclassification. Definitions had limited correlation with one another (ρ=0.330 to 0.621, p<0.001). 38.6% of patients reported to have CAPA did not fulfill any research definitions. Patients were diagnosed after a median of 9 days (interquartile range 5-14) in ICUs. Tracheobronchitis occured in 5.3% of patients examined with bronchoscopy. The mortality rate (50.0%) was high, irrespective of antifungal use (p=0.28); this remained true even when the analysis was restricted to patients meeting standardized definitions for CAPA. Conclusions The reported incidence of CAPA is exaggerated by use of non-standard definitions. Further research should focus on identifying patients likely to benefit from antifungals.
    Keywords covid19
    Language English
    Publishing date 2021-05-24
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.05.21.21257626
    Database COVID19

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  5. Article ; Online: A systematic review: can one prescribe carbapenems to patients with IgE-mediated allergy to penicillins or cephalosporins?

    Kula, Brittany / Djordjevic, Gordana / Robinson, Joan L

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2014  Volume 59, Issue 8, Page(s) 1113–1122

    Abstract: ... as all have a beta lactam ring. However, the true incidence of immunoglobulin (Ig)E-mediated cross-reactivity ...

    Abstract Background: Cross-reactivity between penicillins or cephalosporins and carbapenems is anticipated as all have a beta lactam ring. However, the true incidence of immunoglobulin (Ig)E-mediated cross-reactivity is not known.
    Methods: A systematic review was conducted to collect and combine all published data on children and adults reported to have a clinical history of IgE-mediated hypersensitivity to a penicillin and/or cephalosporin who were subsequently given a carbapenem. Reactions were classified as proven, suspected, or possible IgE-mediated and non-IgE-mediated.
    Results: Ten studies and 12 case reports describing 854 participants fit the study criteria. For patients with previous proven, suspected, or possible IgE-mediated penicillin reactions (N = 838), the incidence of any type of suspected hypersensitivity reaction to a carbapenem was 36/838 (4.3%; 95% confidence interval [CI], 3.1%-5.9%) and the incidence of proven (1/838), suspected (0/838), or possible (19/838) IgE-mediated reactions was 20/838 (2.4%; 95% CI, 1.6%-3.7%). Of the subset of patients with positive penicillin skin tests (n = 295), only 1 had a hypersensitivity reaction (0.3%; 95% CI, .06%-1.9%), and this was a possible IgE-mediated reaction. For patients with previous proven, suspected, or possible IgE-mediated cephalosporin reactions (N = 12), the incidence of any type of hypersensitivity reaction to a carbapenem was 3/12 (25%); this included 2 non-IgE-mediated reactions and 1 possible IgE-mediated reaction.
    Conclusions: The cross-reactivity between penicillins and carbapenems for IgE-mediated reactions is very low, but caution is still advised. Cross-reactivity rates may be higher between cephalosporins and carbapenems; however, minimal data are available.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/drug therapy ; Carbapenems/adverse effects ; Carbapenems/therapeutic use ; Cephalosporins/adverse effects ; Cephalosporins/therapeutic use ; Child ; Child, Preschool ; Cross Reactions ; Drug Hypersensitivity ; Humans ; Immunoglobulin E/blood ; Male ; Middle Aged ; Penicillins/adverse effects ; Penicillins/therapeutic use ; Young Adult
    Chemical Substances Anti-Bacterial Agents ; Carbapenems ; Cephalosporins ; Penicillins ; Immunoglobulin E (37341-29-0)
    Language English
    Publishing date 2014-10-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciu587
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    Zs.A 1505: Show issues Location:
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    Zs.MO 480: Show issues

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  6. Article ; Online: Depression and suicidality among Hispanics with epilepsy: Findings from the Managing Epilepsy Well (MEW) Network integrated database.

    O'Kula, Susanna S / Briggs, Farren B S / Brownrigg, Brittany / Sarna, Kaylee / Rosales, Omar / Shegog, Ross / Fraser, Robert T / Johnson, Erica K / Quarells, Rakale C / Friedman, Daniel / Sajatovic, Martha / Spruill, Tanya M

    Epilepsy & behavior : E&B

    2021  Volume 125, Page(s) 108388

    Abstract: Objective: Although psychiatric disorders are more common among people with epilepsy,: Methods: This cross-sectional analysis of pooled data from ten studies used the Patient Health Questionnaire-9: Results: Of 559 participants, 49.6% (n = 277) ... ...

    Abstract Objective: Although psychiatric disorders are more common among people with epilepsy,
    Methods: This cross-sectional analysis of pooled data from ten studies used the Patient Health Questionnaire-9
    Results: Of 559 participants, 49.6% (n = 277) were Hispanic. Elevated depressive symptoms were endorsed by 38.1% (n = 213) of all participants (32.5% of Hispanics); suicidal ideation was endorsed by 18.4% (n = 103) of all participants (16.3% of Hispanics). After adjustment for sociodemographic and health attributes, Hispanic PWE had a 44% lower prevalence of elevated depressive symptoms (OR = 0.56, CI 0.37-0.84, p = 0.0056) compared to non-Hispanics but similar rates of suicidal ideation (OR = 0.84, CI 0.45-1.58, p = 0.59). Acculturation measures were available for 256 (92.4%) of Hispanic PWE: language preference was Spanish for 62.9%, 46.1% were foreign-born. Spanish-speaking Hispanics were less likely than English-speaking Hispanics to report elevated depressive symptoms (OR = 0.43, CI 0.19-0.97, p = 0.041); however, Hispanics who reported fair or poor health status had a four-fold higher depression prevalence compared to those who reported excellent or very good health status [reference group] (OR = 4.44, CI 1.50-13.18, p = 0.0071). Of the Hispanics who provided prior 30-day seizure data, ≥1 monthly seizure was independently associated with higher depression prevalence (OR = 3.11, CI 1.29-7.45, p = 0.01). Being foreign-born was not associated with elevated depressive symptoms or suicidal ideation prevalence.
    Conclusions: In a large, geographically diverse sample of PWE, elevated depressive symptoms were significantly lower in Hispanics compared to non-Hispanics. Spanish language preference was associated with a lower prevalence of elevated depressive symptoms among Hispanic PWE. Future studies should include acculturation data to better screen for depression and suicidal ideation risk and optimize interventions for Hispanic PWE.
    MeSH term(s) Adult ; Cross-Sectional Studies ; Depression/epidemiology ; Epilepsy/epidemiology ; Humans ; Suicidal Ideation ; Suicide
    Language English
    Publishing date 2021-11-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2010587-3
    ISSN 1525-5069 ; 1525-5050
    ISSN (online) 1525-5069
    ISSN 1525-5050
    DOI 10.1016/j.yebeh.2021.108388
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    Zs.A 5289: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  7. Article ; Online: Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES)

    Vincent Issac Lau / Sumeet Dhanoa / Harleen Cheema / Kimberley Lewis / Patrick Geeraert / David Lu / Benjamin Merrick / Aaron Vander Leek / Meghan Sebastianski / Brittany Kula / Dipayan Chaudhuri / Arnav Agarwal / Daniel J Niven / Kirsten M Fiest / Henry T Stelfox / Danny J Zuege / Oleksa G Rewa / Sean M Bagshaw

    PLoS ONE, Vol 17, Iss 6, p e

    A systematic review and meta-analysis.

    2022  Volume 0269871

    Abstract: Background As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the ...

    Abstract Background As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs. Methods We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology. Results Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty). Conclusions There was a significant increase in mortality during the COVID pandemic ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 310
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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