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  1. Article ; Online: Evaluation of intravenous amoxicillin-clavulanate use in two Canadian hospitals.

    Wong, Maggie / Malhotra, Sangita / Afra, Kevin

    Antimicrobial stewardship & healthcare epidemiology : ASHE

    2024  Volume 4, Issue 1, Page(s) e24

    Abstract: We describe our experience with intravenous amoxicillin-clavulanate, which is new to the Canadian market. The majority of patients were successfully de-escalated from piperacillin-tazobactam or a carbapenem for respiratory infections or skin and soft ... ...

    Abstract We describe our experience with intravenous amoxicillin-clavulanate, which is new to the Canadian market. The majority of patients were successfully de-escalated from piperacillin-tazobactam or a carbapenem for respiratory infections or skin and soft tissue infections. Intravenous amoxicillin-clavulanate provides a good alternative in an era of rising
    Language English
    Publishing date 2024-02-14
    Publishing country England
    Document type Journal Article
    ISSN 2732-494X
    ISSN (online) 2732-494X
    DOI 10.1017/ash.2024.18
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  2. Article ; Online: Cardiac and vascular serious adverse events following tixagevimab-cilgavimab.

    Piszczek, Jolanta / Murthy, Srinivas / Afra, Kevin

    The Lancet. Respiratory medicine

    2022  Volume 11, Issue 1, Page(s) e5–e6

    MeSH term(s) Humans ; Antibodies, Monoclonal ; Risk Factors
    Chemical Substances tixagevimab ; cilgavimab (1KUR4BN70F) ; Antibodies, Monoclonal
    Language English
    Publishing date 2022-12-12
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(22)00452-0
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  3. Article ; Online: Point-counterpoint: The MERINO trial and what it should imply for future treatment of ESBL bacteremia.

    Grant, Jennifer / Afra, Kevin

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

    2019  Volume 4, Issue 3, Page(s) 125–130

    Language English
    Publishing date 2019-10-11
    Publishing country Canada
    Document type Editorial
    ISSN 2371-0888
    ISSN (online) 2371-0888
    DOI 10.3138/jammi.2019-0012
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  4. Article ; Online: [No title information]

    Afra, Kevin / Chen, Luke Y C / Sweet, David

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2021  Volume 193, Issue 26, Page(s) E1027–E1028

    Title translation Le tocilizumab pour les patients hospitalisés atteints de la COVID-19.
    MeSH term(s) Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/drug therapy ; COVID-19/epidemiology ; Hospitalization/statistics & numerical data ; Humans ; Pandemics ; SARS-CoV-2 ; Treatment Outcome
    Chemical Substances Antibodies, Monoclonal, Humanized ; tocilizumab (I031V2H011)
    Language French
    Publishing date 2021-07-05
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.210066-f
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  5. Article ; Online: Tocilizumab for hospitalized patients with COVID-19.

    Afra, Kevin / Chen, Luke Y C / Sweet, David

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2021  Volume 193, Issue 15, Page(s) E521

    MeSH term(s) Antibodies, Monoclonal, Humanized/adverse effects ; Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/drug therapy ; Critical Care ; Hospital Mortality ; Humans ; Immunologic Factors/adverse effects ; Immunologic Factors/therapeutic use ; Interleukin-6/antagonists & inhibitors ; SARS-CoV-2 ; Time-to-Treatment
    Chemical Substances Antibodies, Monoclonal, Humanized ; IL6 protein, human ; Immunologic Factors ; Interleukin-6 ; tocilizumab (I031V2H011)
    Language English
    Publishing date 2021-03-09
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.210066
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  6. Article ; Online: Oral beta-lactam step down in bacteremic E. coli urinary tract infections.

    Saad, Stephan / Mina, Neil / Lee, Colin / Afra, Kevin

    BMC infectious diseases

    2020  Volume 20, Issue 1, Page(s) 785

    Abstract: Background: Literature is scarce regarding oral step down to beta-lactams in bacteremic urinary tract infections. Oral fluoroquinolones are an accepted and common step down for bacteremic urinary tract infections; however, their use is associated with ... ...

    Abstract Background: Literature is scarce regarding oral step down to beta-lactams in bacteremic urinary tract infections. Oral fluoroquinolones are an accepted and common step down for bacteremic urinary tract infections; however, their use is associated with mounting safety concerns. We compared clinical cure in patients with E. coli bacteremic urinary tract infections who were stepped down to oral beta-lactams compared to oral fluoroquinolones.
    Methods: This multicentre retrospective cohort study included patients with first positive concurrent urine and blood cultures from January 2016 to December 2016. Patients were included if they received empiric intravenous beta-lactam therapy with step down to either oral beta-lactam or fluoroquinolone for treatment completion. The primary outcome was clinical cure. Secondary outcomes were length of hospitalization, all-cause mortality and C. difficile infection. Multivariate analysis and propensity score were used to control for confounding.
    Results: A total of 207 patients were identified with bacteremic E.coli urinary tract infections. Clinical cure was achieved in 72/77 (94%) in the oral beta-lactam group versus 127/130 (98%) in the oral fluoroquinolone group (absolute difference - 4.2, 95% confidence interval [CI] -10.3 to 1.9%, p = 0.13). The adjusted odds ratio (OR) for clinical cure with oral beta-lactams was 0.31 (95% CI 0.05-1.90, p = 0.21); propensity score adjusted analysis showed a similar result. There was no statistically significant difference in secondary outcomes.
    Conclusions: Oral beta-lactams appear to be a safe and effective step down option in bacteremic E. coli urinary tract infections compared to oral fluoroquinolones.
    MeSH term(s) Administration, Oral ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy ; Bacteremia/microbiology ; Blood Culture ; Clostridium Infections/diagnosis ; Clostridium Infections/microbiology ; Clostridium difficile/isolation & purification ; Escherichia coli/isolation & purification ; Escherichia coli Infections/drug therapy ; Escherichia coli Infections/microbiology ; Female ; Fluoroquinolones/administration & dosage ; Fluoroquinolones/adverse effects ; Fluoroquinolones/therapeutic use ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/microbiology ; beta-Lactams/administration & dosage ; beta-Lactams/adverse effects ; beta-Lactams/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Fluoroquinolones ; beta-Lactams
    Language English
    Publishing date 2020-10-21
    Publishing country England
    Document type Comparative Study ; Journal Article ; Multicenter Study
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-020-05498-2
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  7. Article: Developing a Tool for Prospective Assessment of Treatment Appropriateness in Urinary Tract Infections.

    Bredenkamp, Nina / Afra, Kevin / Chow, Ivy / Lee, Colin / Leung, Vivian W Y

    Hospital pharmacy

    2020  Volume 56, Issue 6, Page(s) 664–667

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2020-07-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1468893-1
    ISSN 0018-5787
    ISSN 0018-5787
    DOI 10.1177/0018578720936585
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  8. Article ; Online: Hyponatremia and polyuria in an older woman.

    Afra, Kevin / James, Matthew T

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2013  Volume 185, Issue 12, Page(s) 1055–1058

    MeSH term(s) Aged ; Diagnosis, Differential ; Female ; Humans ; Hyponatremia/etiology ; Hyponatremia/physiopathology ; Polyuria/etiology ; Polyuria/physiopathology ; Renal Artery Obstruction/complications ; Renal Artery Obstruction/etiology ; Renal Artery Obstruction/physiopathology ; Renal Artery Obstruction/therapy
    Language English
    Publishing date 2013-05-27
    Publishing country Canada
    Document type Case Reports ; Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.121757
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  9. Article ; Online: Incidence, risk factors, and outcomes of Fusobacterium species bacteremia.

    Afra, Kevin / Laupland, Kevin / Leal, Jenine / Lloyd, Tracie / Gregson, Daniel

    BMC infectious diseases

    2013  Volume 13, Page(s) 264

    Abstract: Background: Fusobacterium species (spp.) bacteremia is uncommon and has been associated with a variety of clinical presentations. We conducted a retrospective, population based study to determine the relative proportion of species in this genus causing ... ...

    Abstract Background: Fusobacterium species (spp.) bacteremia is uncommon and has been associated with a variety of clinical presentations. We conducted a retrospective, population based study to determine the relative proportion of species in this genus causing bacteremia and the risk factors for infection and adverse clinical outcomes.
    Methods: All cases of Fusobacterium spp. bacteremia detected at a regional microbiology laboratory serving outpatient and acute care for a population of approximately 1.3 million people over 11 years were identified from a computerized database. Clinical data on these cases was extracted from an administrative database and analyzed to determine underlying risk factors for and outcomes of infection.
    Results: There were 72 incident cases of Fusobacterium spp. bacteremia over the study period (0.55 cases/100,000 population per annum). F. nucleatum was the most frequent species (61%), followed by F. necrophorum (25%). F. necrophorum bacteremia occurred in a younger population without underlying comorbidities and was not associated with mortality. F. nucleatum bacteremia was found in an older population and was associated with underlying malignancy or receiving dialysis. Death occurred in approximately 10% of F. nucleatum cases but causality was not established in this study.
    Conclusions: Fusobacterium spp. bacteremia in our community is uncommon and occurs in approximately 5.5 cases per million population per annum. F. necrophorum occurred in an otherwise young healthy population and was not associated with any mortality. F. nucleatum was found primarily in older patients with chronic medical conditions and was associated with a mortality of approximately 10%. Bacteremias from other Fusobacterium spp. were rare.
    MeSH term(s) Adolescent ; Adult ; Aged ; Alberta/epidemiology ; Bacteremia/epidemiology ; Bacteremia/microbiology ; Cohort Studies ; Female ; Fusobacterium/isolation & purification ; Fusobacterium Infections/epidemiology ; Fusobacterium Infections/microbiology ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Young Adult
    Language English
    Publishing date 2013-06-05
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/1471-2334-13-264
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  10. Article ; Online: Polyether ether ketone surface modification with plasma and gelatin for enhancing cell attachment.

    Mehdizadeh Omrani, Maryam / Kumar, Hitendra / Mohamed, Mohamed G A / Golovin, Kevin / S Milani, Abbas / Hadjizadeh, Afra / Kim, Keekyoung

    Journal of biomedical materials research. Part B, Applied biomaterials

    2020  Volume 109, Issue 5, Page(s) 622–629

    Abstract: Polyether ether ketone (PEEK) has shown great promise for implant and biomedical applications because of its excellent chemical, mechanical, and biocompatible properties. However, PEEK is bioinert, which causes weak cell adhesion and limits its use for ... ...

    Abstract Polyether ether ketone (PEEK) has shown great promise for implant and biomedical applications because of its excellent chemical, mechanical, and biocompatible properties. However, PEEK is bioinert, which causes weak cell adhesion and limits its use for biomedical applications such as bone implants. Therefore, the activation of the PEEK's surface for cell attachment is desirable. In this study, oxygen plasma and gelatin were used to modify PEEK's surface and the effects of surface roughness, wettability, and cell adhesion to the surface were studied. Surface roughness was measured using a laser scanning confocal microscope, and wettability was measured using the sessile drop method. There was no significant difference in the roughness of the three samples. The gelatin-coated surface showed higher wettability than the plasma-modified or control samples. The cell attachment and proliferation rate were assessed by scanning electron microscopy and the XTT assay, respectively. The XTT assay results indicated that a greater number of cells grew on the gelatin-coated PEEK surface than on the control or plasma-treated surfaces. These results confirmed that the plasma and gelatin treatments enhanced the biocompatibility of the PEEK samples. The increase in biocompatibility could make PEEK a better material candidate for treating bone related injuries and defects.
    MeSH term(s) Animals ; Benzophenones/chemistry ; Biocompatible Materials/chemistry ; Cell Adhesion/drug effects ; Cell Proliferation ; Gelatin/pharmacology ; Ketones/chemistry ; Mice ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; NIH 3T3 Cells ; Osteoblasts/cytology ; Osteogenesis/drug effects ; Oxygen/chemistry ; Polyethylene Glycols/chemistry ; Polymers/chemistry ; Prostheses and Implants ; Surface Properties ; Titanium/chemistry ; Wettability
    Chemical Substances Benzophenones ; Biocompatible Materials ; Ketones ; Polymers ; polyetheretherketone (31694-16-3) ; Polyethylene Glycols (3WJQ0SDW1A) ; Gelatin (9000-70-8) ; Titanium (D1JT611TNE) ; Oxygen (S88TT14065)
    Language English
    Publishing date 2020-09-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2099992-6
    ISSN 1552-4981 ; 1552-4973 ; 0021-9304
    ISSN (online) 1552-4981
    ISSN 1552-4973 ; 0021-9304
    DOI 10.1002/jbm.b.34726
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