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Article ; Online: Genomic Epidemiology of Carbapenemase-Producing

Jamal, Alainna J / Mataseje, Laura F / Williams, Victoria / Leis, Jerome A / Tijet, Nathalie / Zittermann, Sandra / Melano, Roberto G / Mulvey, Michael R / Katz, Kevin / Allen, Vanessa G / McGeer, Allison J

Antimicrobial agents and chemotherapy

2021 Volume 65, Issue 8, Page(s) e0036021

Abstract: At a hospital system (H1) in Ontario, Canada, we investigated whether whole-genome sequencing (WGS) altered initial epidemiological interpretation of carbapenemase- ... ...

Abstract	At a hospital system (H1) in Ontario, Canada, we investigated whether whole-genome sequencing (WGS) altered initial epidemiological interpretation of carbapenemase-producing
MeSH term(s)	Bacterial Proteins/genetics ; Enterobacteriaceae Infections/epidemiology ; Genomics ; Hospitals ; Humans ; Ontario ; Travel ; Travel-Related Illness ; beta-Lactamases/genetics
Chemical Substances	Bacterial Proteins ; beta-Lactamases (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6)
Language	English
Publishing date	2021-07-16
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.00360-21
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Article ; Online: Epidemiology of healthcare-associated Pseudomonas aeruginosa in intensive care units: Are sink drains to blame?

Volling, Cheryl / Mataseje, Laura / Graña-Miraglia, Lucía / Hu, Xiaoyi / Anceva-Sami, Sofia / Coleman, Brenda L / Downing, Mark / Hota, Susy / Jamal, Alainna J / Johnstone, Jennie / Katz, Kevin / Leis, Jerome A / Li, Angel / Mahesh, Vinaya / Melano, Roberto / Muller, Matthew / Nayani, Sarah / Patel, Samir / Paterson, Aimee /

Pejkovska, Mare / Ricciuto, Daniel / Sultana, Asfia / Vikulova, Tamara / Zhong, Zoe / McGeer, Allison / Guttman, David S / Mulvey, Michael R

The Journal of hospital infection

2024

Abstract: Background: Pseudomonas aeruginosa (PA) is a common cause of healthcare-associated infections (PA-HAI) in the intensive care unit (ICU). We aimed to describe the epidemiology of PA-HAI in ICUs in Ontario, Canada, and determine whether we could identify ... ...

Abstract	Background: Pseudomonas aeruginosa (PA) is a common cause of healthcare-associated infections (PA-HAI) in the intensive care unit (ICU). We aimed to describe the epidemiology of PA-HAI in ICUs in Ontario, Canada, and determine whether we could identify episodes of sink-to-patient PA transmission. Methods: This was a prospective cohort study of patients in six ICUs from 2018-2019, with retrieval of PA clinical isolates, and PA-screening of antimicrobial resistant organism surveillance rectal swabs, and of sink drain, air, and faucet samples. All PA isolates underwent whole genome sequencing. PA-HAI was defined using US National Healthcare Safety Network criteria. ICU-acquired PA was defined as PA isolated from specimens obtained >48 hours after ICU admission in those with prior negative rectal swabs. Sink-to-patient PA transmission was defined as ICU-acquired PA with close genomic relationship to isolate(s) previously recovered from sinks in a room/bedspace occupied 3-14 days prior to the relevant patient isolate. Results: Over ten months, 72 PA-HAI occurred among 60/4263 admissions. The rate of PA-HAI was 2.40 per 1000 patient-ICU days; higher in patients who were PA-colonized on admission. PA-HAI was associated with longer stay (median 26 vs 3 days uninfected, p<0.001) and contributed to death in 22/60 cases (36.7%). Fifty-eight admissions with ICU-acquired PA were identified, contributing 35/72 (48.6%) PA-HAI. Four patients with five PA-HAI (6.9%) had closely related isolates previously recovered from their room/bedspace sinks. Conclusions: Nearly half of PA causing HAI appeared to be acquired in ICUs, and 7% of PA-HAI were associated with sink-to-patient transmission. Sinks may be an underrecognized reservoir for HAIs.
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2024.03.009
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Article ; Online: Standard versus combined chemical, mechanical, and heat decontamination of hospital drains harboring carbapenemase-producing organisms (CPOs): A randomized controlled trial.

Jamal, Alainna J / Pantelidis, Rajni / Sawicki, Rachael / Li, Angel X / Chiu, Wayne / Morrison, Deborah / Marshman, John / Baqi, Mahin / Richardson, David / McGeer, Allison J / Borgia, Sergio

Infection control and hospital epidemiology

2021 Volume 42, Issue 10, Page(s) 1275–1278

Abstract: We sought to determine whether combined chemical, mechanical, and heat cleaning was superior to standard cleaning for the decontamination of 32 sink and shower drains harboring carbapenemase-producing organisms (CPOs). Of 16 intervention drains, 10 (63%) ...

Abstract	We sought to determine whether combined chemical, mechanical, and heat cleaning was superior to standard cleaning for the decontamination of 32 sink and shower drains harboring carbapenemase-producing organisms (CPOs). Of 16 intervention drains, 10 (63%) were decontaminated until day 7 versus 1 (5%) of 16 comparator drains (P = .002). Intensive cleaning may be useful if administered repeatedly in drain-associated CPO outbreaks.
MeSH term(s)	Bacterial Proteins ; Decontamination/methods ; Hospitals ; Hot Temperature ; Random Allocation ; Water Supply ; beta-Lactamases
Chemical Substances	Bacterial Proteins ; beta-Lactamases (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6)
Language	English
Publishing date	2021-02-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.1384
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Article ; Online: Sensitivity of nasopharyngeal swabs and saliva for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Alainna J. Jamal / Mohammad Mohammad / Eric Coomes / Jeff Powis / Angel Li / Aimee Paterson / Sofia Anceva-Sami / Shiva Barati / Gloria Crowl / Amna Faheem / Lubna Farooqi / Saman Khan / Karren Prost / Susan Poutanen / Lily Yip / Zoe Zhong / Allison J McGeer / Samira Mubareka

Abstract: We enrolled 53 consecutive in-patients with COVID-19 at six hospitals in Toronto, Canada, and tested one nasopharyngeal swab/saliva sample pair from each patient for SARS-CoV-2. Overall, sensitivity was 89% for nasopharyngeal swabs and 77% for saliva (p= ... ...

Abstract	We enrolled 53 consecutive in-patients with COVID-19 at six hospitals in Toronto, Canada, and tested one nasopharyngeal swab/saliva sample pair from each patient for SARS-CoV-2. Overall, sensitivity was 89% for nasopharyngeal swabs and 77% for saliva (p=NS); difference in sensitivity was greatest for sample pairs collected later in illness.
Keywords	covid19
Publisher	medrxiv
Document type	Article ; Online
DOI	10.1101/2020.05.01.20081026
Database	COVID19

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Article ; Online: Development of a tool to assess evidence for causality in studies implicating sink drains as a reservoir for hospital-acquired gammaproteobacterial infection.

Volling, C / Thomas, S / Johnstone, J / Maltezou, H C / Mertz, D / Stuart, R / Jamal, Alainna J / Kandel, C / Ahangari, N / Coleman, B L / McGeer, A

The Journal of hospital infection

2020 Volume 106, Issue 3, Page(s) 454–464

Abstract: Background: Decades of studies document an association between Gammaproteobacteria in sink drains and hospital-acquired infections, but the evidence for causality is unclear.: Aim: We aimed to develop a tool to assess the quality of evidence for ... ...

Abstract	Background: Decades of studies document an association between Gammaproteobacteria in sink drains and hospital-acquired infections, but the evidence for causality is unclear. Aim: We aimed to develop a tool to assess the quality of evidence for causality in research studies that implicate sink drains as reservoirs for hospital-acquired Gammaproteobacterial infections. Methods: We used a modified Delphi process with recruited experts in hospital epidemiology to develop this tool from a pre-existing causal assessment application. Findings: Through four rounds of feedback and revision we developed the 'Modified CADDIS Tool for Causality Assessment of Sink Drains as a Reservoir for Hospital-Acquired Gammaproteobacterial Infection or Colonization'. In tests of tool application to published literature during development, mean percent agreement ranged from 46.7% to 87.5%, and the Gwet's AC1 statistic (adjusting for chance agreement) ranged from 0.13 to 1.0 (median 68.1). Areas of disagreement were felt to result from lack of a priori knowledge of causal pathways from sink drains to patients and uncertain influence of co-interventions to prevent organism acquisition. Modifications were made until consensus was achieved that further iterations would not improve the tool. When the tool was applied to 44 articles by two independent reviewers in an ongoing systematic review, percent agreement ranged from 93% to 98%, and the Gwet's AC1 statistic was 0.91-0.97. Conclusion: The modified causality tool was useful for evaluating studies that implicate sink drains as reservoirs for hospital-acquired infections and may help guide the conduct and reporting of future research.
MeSH term(s)	Causality ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Disease Reservoirs/microbiology ; Equipment Contamination/prevention & control ; Equipment Contamination/statistics & numerical data ; Equipment and Supplies, Hospital/microbiology ; Gammaproteobacteria ; Gram-Negative Bacterial Infections/prevention & control ; Gram-Negative Bacterial Infections/transmission ; Hospitals/statistics & numerical data ; Humans ; Infection Control/methods ; Software
Language	English
Publishing date	2020-09-06
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2020.08.024
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Article ; Online: Ku-gaa-gii pimitizi-win, the COVID-19 cohort study of people experiencing homelessness in Toronto, Canada

BMJ Open, Vol 12, Iss

a study protocol

2022 Volume 8

Abstract: Introduction Initial reports suggest people experiencing homelessness (PEH) are at high risk for SARS-CoV-2 infection and associated morbidity and mortality. However, there have been few longitudinal evaluations of the spread and impact of COVID-19 among ...

Abstract	Introduction Initial reports suggest people experiencing homelessness (PEH) are at high risk for SARS-CoV-2 infection and associated morbidity and mortality. However, there have been few longitudinal evaluations of the spread and impact of COVID-19 among PEH. This study will estimate the prevalence and incidence of COVID-19 infections in a cohort of PEH followed prospectively in Toronto, Canada. It will also examine associations between individual-level and shelter-level characteristics with COVID-19 infection, adverse health outcomes related to infection and vaccination. Finally, the data will be used to develop and parameterise a mathematical model to characterise SARS-CoV-2 transmission dynamics, and the transmission impact of interventions serving PEH.Design, methods and analysis Ku-gaa-gii pimitizi-win will follow a random sample of PEH from across Toronto (Canada) for 12 months. 736 participants were enrolled between June and September 2021, and will be followed up at 3-month intervals. At each interval, specimens (saliva, capillary blood) will be collected to determine active SARS-CoV-2 infection and serologic evidence of past infection and/or vaccination, and a detailed survey will gather self-reported information, including a detailed housing history. To examine the association between individual-level and shelter-level characteristics on COVID-19-related infection, adverse outcomes, and vaccination, shelter and healthcare administrative data will be linked to participant study data. Healthcare administrative data will also be used to examine long-term (up to 5 years) COVID-19-related outcomes among participants.Ethics and dissemination Ethical approval was obtained from the Unity Health Toronto and University of Toronto Health Sciences Research Ethics Boards (# 20-272). Ku-gaa-gii pimitizi-win was designed in collaboration with community and service provider partners and people having lived experience of homelessness. Findings will be reported to groups supporting Ku-gaa-gii pimitizi-win, Indigenous ...
Keywords	Medicine ; R
Subject code	170 ; 360
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Infection prevention and control practices related to carbapenemase-producing Enterobacteriaceae (CPE) in acute-care hospitals in Ontario, Canada.

Jamal, Alainna J / Garcia-Jeldes, Felipe / Baqi, Mahin / Borgia, Sergio / Johnstone, Jennie / Katz, Kevin / Kohler, Philipp / Muller, Matthew P / McGeer, Allison J

Infection control and hospital epidemiology

2019 Volume 40, Issue 9, Page(s) 1006–1012

Abstract: Objective: To determine infection prevention and control (IPAC) practices for carbapenemase-producing Enterobacteriaceae (CPE), an emerging threat, at acute-care hospitals in Ontario, Canada.: Design: A descriptive cross-sectional survey.: Methods!# ...

Abstract	Objective: To determine infection prevention and control (IPAC) practices for carbapenemase-producing Enterobacteriaceae (CPE), an emerging threat, at acute-care hospitals in Ontario, Canada. Design: A descriptive cross-sectional survey. Methods: We surveyed IPAC directors and managers at all acute-care hospitals in Ontario, Canada, to gather information on IPAC practices related to CPE, including admission screening, other patient screening, environmental testing, use of precautions to prevent transmission, and outbreak management. Results: Of 116 acute-care hospitals, 105 (91%) responded. Admission screening included patients previously colonized or infected with CPE (n = 64, 61%), patients recently hospitalized outside of Canada (Indian subcontinent, n = 62, 59%; other countries, n = 56, 53%), and patients recently hospitalized in Canada (n = 22, 21%). Fifty-one hospitals (49%) screened patients for colonization during an outbreak. Almost all hospitals (n = 101, 96%) used precautions to prevent transmission from patients with CPE colonization or infection; most hospitals (n = 54, 53%) continued precautions indefinitely. Few hospitals (n = 19, 18%) performed environmental cultures. Eight hospitals (8%) reported at least 1 outbreak, and 6 hospitals (6%) reported transmission from sink or shower drains to patients. Conclusions: Variability in practices may result from lack of evidence and challenges in updating guidelines as evidence emerges. A coordinated approach to slow the emergence of CPE should be considered in our population.
MeSH term(s)	Carbapenem-Resistant Enterobacteriaceae ; Cross-Sectional Studies ; Disease Outbreaks/prevention & control ; Enterobacteriaceae Infections/prevention & control ; Hospitals ; Humans ; Infection Control/methods ; Ontario ; Practice Patterns, Physicians' ; Surveys and Questionnaires
Language	English
Publishing date	2019-06-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2019.173
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Article ; Online: Sensitivity of Nasopharyngeal Swabs and Saliva for the Detection of Severe Acute Respiratory Syndrome Coronavirus 2.

Jamal, Alainna J / Mozafarihashjin, Mohammad / Coomes, Eric / Powis, Jeff / Li, Angel X / Paterson, Aimee / Anceva-Sami, Sofia / Barati, Shiva / Crowl, Gloria / Faheem, Amna / Farooqi, Lubna / Khan, Saman / Prost, Karren / Poutanen, Susan / Taylor, Maureen / Yip, Lily / Zhong, Xi Zoe / McGeer, Allison J / Mubareka, Samira

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

2020 Volume 72, Issue 6, Page(s) 1064–1066

Abstract: We enrolled 91 consecutive inpatients with COVID-19 at 6 hospitals in Toronto, Canada, and tested 1 nasopharyngeal swab/saliva sample pair from each patient using real-time RT-PCR for severe acute respiratory syndrome coronavirus 2. Sensitivity was 89% ... ...

Abstract	We enrolled 91 consecutive inpatients with COVID-19 at 6 hospitals in Toronto, Canada, and tested 1 nasopharyngeal swab/saliva sample pair from each patient using real-time RT-PCR for severe acute respiratory syndrome coronavirus 2. Sensitivity was 89% for nasopharyngeal swabs and 72% for saliva (P = .02). Difference in sensitivity was greatest for sample pairs collected later in illness.
MeSH term(s)	COVID-19 ; Canada ; Humans ; Nasopharynx ; Real-Time Polymerase Chain Reaction ; SARS-CoV-2 ; Saliva
Keywords	covid19
Language	English
Publishing date	2020-08-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa848
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Article ; Online: Sensitivity of midturbinate versus nasopharyngeal swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Infection control and hospital epidemiology

2020 Volume 42, Issue 8, Page(s) 1001–1003

Abstract: To compare sensitivity of specimens for COVID-19 diagnosis, we tested 151 nasopharyngeal/midturbinate swab pairs from 117 COVID-19 inpatients using reverse-transcriptase polymerase chain reaction (RT-PCR). Sensitivity was 94% for nasopharyngeal and 75% ... ...

Abstract	To compare sensitivity of specimens for COVID-19 diagnosis, we tested 151 nasopharyngeal/midturbinate swab pairs from 117 COVID-19 inpatients using reverse-transcriptase polymerase chain reaction (RT-PCR). Sensitivity was 94% for nasopharyngeal and 75% for midturbinate swabs (P = .0001). In 88 nasopharyngeal/midturbinate pairs with matched saliva, sensitivity was 86% for nasopharyngeal swabs and 88% for combined midturbinate swabs/saliva.
MeSH term(s)	COVID-19 ; COVID-19 Testing ; Humans ; Nasopharynx ; SARS-CoV-2 ; Saliva ; Specimen Handling
Keywords	covid19
Language	English
Publishing date	2020-11-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.1326
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Article: Are Sink Drainage Systems a Reservoir for Hospital-Acquired Gammaproteobacteria Colonization and Infection? A Systematic Review.

Open forum infectious diseases

2020 Volume 8, Issue 2, Page(s) ofaa590

Abstract: Increasing rates of antimicrobial-resistant organisms have focused attention on sink drainage systems as reservoirs for hospital-acquired Gammaproteobacteria colonization and infection. We aimed to assess the quality of evidence for transmission from ... ...

Abstract	Increasing rates of antimicrobial-resistant organisms have focused attention on sink drainage systems as reservoirs for hospital-acquired Gammaproteobacteria colonization and infection. We aimed to assess the quality of evidence for transmission from this reservoir. We searched 8 databases and identified 52 studies implicating sink drainage systems in acute care hospitals as a reservoir for Gammaproteobacterial colonization/infection. We used a causality tool to summarize the quality of evidence. Included studies provided evidence of co-occurrence of contaminated sink drainage systems and colonization/infection, temporal sequencing compatible with sink drainage reservoirs, some steps in potential causal pathways, and relatedness between bacteria from sink drainage systems and patients. Some studies provided convincing evidence of reduced risk of organism acquisition following interventions. No single study provided convincing evidence across all causality domains, and the attributable fraction of infections related to sink drainage systems remains unknown. These results may help to guide conduct and reporting in future studies.
Language	English
Publishing date	2020-12-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofaa590
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