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Adult cystic fibrosis exacerbations and new strains of Pseudomonas aeruginosa.

https://arctichealth.org/en/permalink/ahliterature182440
Source
Am J Respir Crit Care Med. 2004 Apr 1;169(7):811-5
Publication Type
Article
Date
Apr-1-2004
Author
Shawn D Aaron
Karam Ramotar
Wendy Ferris
Katherine Vandemheen
Raphael Saginur
Elizabeth Tullis
David Haase
Dan Kottachchi
Melissa St Denis
Francis Chan
Author Affiliation
Department of Medicine and Peditrics Univeristy of Ottawa; Otawa, Ontario, Canada. saaron@ottawahospital.on.ca
Source
Am J Respir Crit Care Med. 2004 Apr 1;169(7):811-5
Date
Apr-1-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anti-Bacterial Agents - pharmacology - therapeutic use
Canada - epidemiology
Chronic Disease
Cystic Fibrosis - drug therapy - epidemiology - microbiology
Female
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Molecular Epidemiology
Polymorphism, Restriction Fragment Length
Prospective Studies
Pseudomonas Infections - microbiology
Pseudomonas aeruginosa - drug effects - genetics
Abstract
We hypothesized that in adults with cystic fibrosis, the acquisition of a new strain of Pseudomonas aeruginosa may be associated with a pulmonary exacerbation. Eighty-four patients who were chronically infected with P. aeruginosa were prospectively followed from eight centers over a 26-month period. Patients had sputum cultures performed every 3 months while clinically stable and at the time of an exacerbation. Forty patients (48%) had an exacerbation requiring intravenous antibiotics during the study period, and in 36 of these patients, their P. aeruginosa isolates were genetically typeable by pulsed-field gel electrophoresis. In 34 of the 36 patients (94%), P. aeruginosa recovered during clinical stability and at exacerbation were of the same genotype. In only two patients (6%; 95% confidence interval, 0-18%) was a new P. aeruginosa clone cultured during an exacerbation that had not been cultured during clinical stability. There were no significant differences in antibiotic susceptibilities, measured as mean minimal inhibitory concentrations, for isolates retrieved during clinically stable periods compared with isolates retrieved during exacerbations. We conclude that for the majority of adult patients with cystic fibrosis a new pulmonary exacerbation is not caused by the acquisition of a new strain of P. aeruginosa.
Notes
Comment In: Am J Respir Crit Care Med. 2004 Apr 1;169(7):781-215044219
PubMed ID
14670805 View in PubMed
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Catching the right wave: evaluating wave energy resources and potential compatibility with existing marine and coastal uses.

https://arctichealth.org/en/permalink/ahliterature119059
Source
PLoS One. 2012;7(11):e47598
Publication Type
Article
Date
2012
Author
Choong-Ki Kim
Jodie E Toft
Michael Papenfus
Gregory Verutes
Anne D Guerry
Marry H Ruckelshaus
Katie K Arkema
Gregory Guannel
Spencer A Wood
Joanna R Bernhardt
Heather Tallis
Mark L Plummer
Benjamin S Halpern
Malin L Pinsky
Michael W Beck
Francis Chan
Kai M A Chan
Phil S Levin
Stephen Polasky
Author Affiliation
The Natural Capital Project, Stanford University, Stanford, California, United States of America. ckim3@stanford.edu
Source
PLoS One. 2012;7(11):e47598
Date
2012
Language
English
Publication Type
Article
Keywords
Algorithms
British Columbia
Conservation of Natural Resources
Decision Support Techniques
Electricity
Environment
Fisheries - statistics & numerical data
Humans
Oceans and Seas
Renewable Energy - economics
Software
Water Movements
Abstract
Many hope that ocean waves will be a source for clean, safe, reliable and affordable energy, yet wave energy conversion facilities may affect marine ecosystems through a variety of mechanisms, including competition with other human uses. We developed a decision-support tool to assist siting wave energy facilities, which allows the user to balance the need for profitability of the facilities with the need to minimize conflicts with other ocean uses. Our wave energy model quantifies harvestable wave energy and evaluates the net present value (NPV) of a wave energy facility based on a capital investment analysis. The model has a flexible framework and can be easily applied to wave energy projects at local, regional, and global scales. We applied the model and compatibility analysis on the west coast of Vancouver Island, British Columbia, Canada to provide information for ongoing marine spatial planning, including potential wave energy projects. In particular, we conducted a spatial overlap analysis with a variety of existing uses and ecological characteristics, and a quantitative compatibility analysis with commercial fisheries data. We found that wave power and harvestable wave energy gradually increase offshore as wave conditions intensify. However, areas with high economic potential for wave energy facilities were closer to cable landing points because of the cost of bringing energy ashore and thus in nearshore areas that support a number of different human uses. We show that the maximum combined economic benefit from wave energy and other uses is likely to be realized if wave energy facilities are sited in areas that maximize wave energy NPV and minimize conflict with existing ocean uses. Our tools will help decision-makers explore alternative locations for wave energy facilities by mapping expected wave energy NPV and helping to identify sites that provide maximal returns yet avoid spatial competition with existing ocean uses.
Notes
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Cites: Proc Natl Acad Sci U S A. 2012 Mar 20;109(12):4696-70122392996
Cites: PLoS One. 2012;7(1):e3003122253865
PubMed ID
23144824 View in PubMed
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Infection with transmissible strains of Pseudomonas aeruginosa and clinical outcomes in adults with cystic fibrosis.

https://arctichealth.org/en/permalink/ahliterature139266
Source
JAMA. 2010 Nov 17;304(19):2145-53
Publication Type
Article
Date
Nov-17-2010
Author
Shawn D Aaron
Katherine L Vandemheen
Karam Ramotar
Tracy Giesbrecht-Lewis
Elizabeth Tullis
Andreas Freitag
Nigel Paterson
Mary Jackson
M Diane Lougheed
Christopher Dowson
Vijay Kumar
Wendy Ferris
Francis Chan
Steve Doucette
Dean Fergusson
Author Affiliation
Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada, K1H 8L6. saaron@ohri.ca
Source
JAMA. 2010 Nov 17;304(19):2145-53
Date
Nov-17-2010
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Cystic Fibrosis - complications - microbiology
Female
Great Britain - epidemiology
Humans
Incidence
Lung Transplantation
Male
Ontario - epidemiology
Prevalence
Pseudomonas Infections - epidemiology - transmission
Pseudomonas aeruginosa - classification - genetics - isolation & purification
Risk factors
Survival Analysis
Treatment Outcome
Young Adult
Abstract
Studies from Australia and the United Kingdom have shown that some patients with cystic fibrosis are infected with common transmissible strains of Pseudomonas aeruginosa.
To determine the prevalence and incidence of infection with transmissible strains of P. aeruginosa and whether presence of the organism was associated with adverse clinical outcomes in Canada.
Prospective observational cohort study of adult patients cared for at cystic fibrosis clinics in Ontario, Canada, with enrollment from September 2005 to September 2008. Sputum was collected at baseline, 3 months, and yearly thereafter for 3 years; and retrieved P. aeruginosa isolates were genotyped. Vital status (death or lung transplant) was assessed for all enrolled patients until December 31, 2009.
Incidence and prevalence of P. aeruginosa isolation, rates of decline in lung function, and time to death or lung transplantation.
Of the 446 patients with cystic fibrosis studied, 102 were discovered to be infected with 1 of 2 common transmissible strains of P. aeruginosa at study entry. Sixty-seven patients were infected with strain A (15%), 32 were infected with strain B (7%), and 3 were simultaneously infected with both strains (0.6%). Strain A was found to be genetically identical to the Liverpool epidemic strain but strain B has not been previously described as an epidemic strain. The incidence rate of new infections with these 2 transmissible strains was relatively low (7.0 per 1000 person-years; 95% confidence interval [CI], 1.8-12.2 per 1000 person-years). Compared with patients infected with unique strains of P. aeruginosa, patients infected with the Liverpool epidemic strain (strain A) and strain B had similar declines in lung function (difference in decline in percent predicted forced expiratory volume in the first second of expiration of 0.64% per year [95% CI, -1.52% to 2.80% per year] and 1.66% per year [95% CI, -1.00% to 4.30%], respectively). However, the 3-year rate of death or lung transplantation was greater in those infected with the Liverpool epidemic strain (18.6%) compared with those infected with unique strains (8.7%) (adjusted hazard ratio, 3.26 [95% CI, 1.41 to 7.54]; P = .01).
A common strain of P. aeruginosa (Liverpool epidemic strain/strain A) infects patients with cystic fibrosis in Canada and the United Kingdom. Infection with this strain in adult Canadian patients with cystic fibrosis was associated with a greater risk of death or lung transplantation.
PubMed ID
21081727 View in PubMed
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Nanolitre real-time PCR detection of bacterial, parasitic, and viral agents from patients with diarrhoea in Nunavut, Canada.

https://arctichealth.org/en/permalink/ahliterature114881
Source
Int J Circumpolar Health. 2013;72:19903
Publication Type
Article
Date
2013
Author
David M Goldfarb
Brent Dixon
Ioana Moldovan
Nicholas Barrowman
Kirsten Mattison
Chad Zentner
Maureen Baikie
Sabah Bidawid
Francis Chan
Robert Slinger
Author Affiliation
Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Source
Int J Circumpolar Health. 2013;72:19903
Date
2013
Language
English
Publication Type
Article
Keywords
Arctic Regions
Diarrhea - diagnosis - microbiology
Feces - microbiology
Humans
Nunavut
Real-Time Polymerase Chain Reaction - methods
Time Factors
Abstract
Little is known about the microbiology of diarrhoeal disease in Canada's Arctic regions. There are a number of limitations of conventional microbiology testing techniques for diarrhoeal pathogens, and these may be further compromised in the Arctic, given the often long distances for specimen transport.
To develop a novel multiple-target nanolitre real-time reverse transcriptase (RT)-PCR platform to simultaneously test diarrhoeal specimens collected from residents of the Qikiqtani (Baffin Island) Region of Nunavut, Canada, for a wide range of bacterial, parasitic and viral agents.
Diarrhoeal stool samples submitted for bacterial culture to Qikiqtani General Hospital in Nunavut over an 18-month period were tested with a multiple-target nanolitre real-time PCR panel for major diarrhoeal pathogens including 8 bacterial, 6 viral and 2 parasitic targets.
Among 86 stool specimens tested by PCR, a total of 50 pathogens were detected with 1 or more pathogens found in 40 (46.5%) stool specimens. The organisms detected comprised 17 Cryptosporidium spp., 5 Clostridium difficile with toxin B, 6 Campylobacter spp., 6 Salmonella spp., 4 astroviruses, 3 noroviruses, 1 rotavirus, 1 Shigella spp. and 1 Giardia spp. The frequency of detection by PCR and bacterial culture was similar for Salmonella spp., but discrepant for Campylobacter spp., as Campylobacter was detected by culture from only 1/86 specimens. Similarly, Cryptosporidium spp. was detected in multiple samples by PCR but was not detected by microscopy or enzyme immunoassay.
Cryptosporidium spp., Campylobacter spp. and Clostridium difficile may be relatively common but possibly under-recognised pathogens in this region. Further study is needed to determine the regional epidemiology and clinical significance of these organisms. This method appears to be a useful tool for gastrointestinal pathogen research and may also be helpful for clinical diagnostics and outbreak investigation in remote regions where the yield of routine testing may be compromised.
Notes
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PubMed ID
23570023 View in PubMed
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Staphylococcus lugdunensis: low prevalence and clinical significance in a pediatric microbiology laboratory.

https://arctichealth.org/en/permalink/ahliterature118094
Source
Pediatr Infect Dis J. 2013 Jan;32(1):87-9
Publication Type
Article
Date
Jan-2013
Author
Gregory J German
Bing Wang
Kathryn Bernard
Nancy Stewart
Francis Chan
Ana Luisa Pacheco
Deborah Wiebe
Tamara Burdz
Robert Slinger
Author Affiliation
Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Source
Pediatr Infect Dis J. 2013 Jan;32(1):87-9
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Child
Coagulase - metabolism
Female
Hospitals, Pediatric
Humans
Infant
Infant, Newborn
Laboratories, Hospital
Male
Ontario - epidemiology
Prevalence
Prospective Studies
Retrospective Studies
Skin - microbiology
Staphylococcal Infections - epidemiology - microbiology
Staphylococcus lugdunensis - enzymology - isolation & purification
Urinary Catheters - microbiology
Abstract
Staphylococcus lugdunensis is reported to be a highly virulent coagulase-negative Staphylococcus species, but whether it is an important pediatric pathogen is uncertain. At our pediatric center, only 2.1% (7/347) of coagulase-negative Staphylococcus isolates were found to be S. lugdunensis, and only 1 isolate was considered possibly clinically significant.S. lugdunensis does not appear to be a common pathogen in children.
PubMed ID
23241991 View in PubMed
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