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Your search keyword '"Lam, John C."' showing total 4 results
Start Over Author "Lam, John C." Journal bmc infectious diseases
4 results on '"Lam, John C."'

1. Incidence, susceptibility and outcomes of candidemia in adults living in Calgary, Alberta, Canada (2010–2018)

Author

Bourassa-Blanchette, Samuel, Biesheuvel, Marit M, Lam, John C, Kipp, Alexander, Church, Deirdre, Carson, Julie, Dalton, Bruce, Parkins, Michael D, Barkema, Herman W, and Gregson, Daniel B

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Hematology, Infectious Diseases, Clinical Research, Sepsis, Infection, Good Health and Well Being, Humans, Adult, Female, Middle Aged, Male, Candidemia, Antifungal Agents, Incidence, Alberta, Candida, Fluconazole, Candida albicans, Candida glabrata, Microbial Sensitivity Tests, Mortality, Antifungal susceptibility, Fungemia, Microbiology, Medical Microbiology, Clinical sciences, Medical microbiology, Public health
Abstract

BackgroundCandidemia is increasing in frequency and is associated with high mortality. We sought to determine the burden of illness, the population it affects and its resistance profile in our region.MethodsThe Calgary Zone (CZ) provides all care for residents of Calgary and surrounding communities (~ 1.69 million) via five tertiary hospitals each served by a common single laboratory for acute care microbiology. All adult patients in the CZ with at least one Candida spp.-positive blood culture between January 1, 2010, and December 31, 2018, were identified using microbiological data from Calgary Lab Services, the laboratory that processes > 95% of all blood culture samples in the CZ, were reviewed for the study.ResultsThe overall annual incidence of candidemia among individuals living in the CZ was 3.8 per 100,000 persons (Median age 61 years (IQR 48-72) and 221/455 (47.4%) were female). C. albicans was the most common species (50.6%), followed by C. glabrata, (24.0%). No other species accounted for more than 7% of cases. Overall mortality at 30, 90, and 365 days was 32.2, 40.1, and 48.1% respectively. Mortality rate did not differ by Candida species. Of individuals who developed candidemia, more than 50% died within the next year. No new resistance pattern has emerged in the most common Candida species in Calgary, Alberta.ConclusionsIn Calgary, Alberta, the incidence of candidemia has not increased in the last decade. C. albicans was the most common species and it remains susceptible to fluconazole.

Published
2023

4. Reduction in Pseudomonas aeruginosa sputum density during a cystic fibrosis pulmonary exacerbation does not predict clinical response

Author

Lam, John C, Somayaji, Ranjani, Surette, Michael G, Rabin, Harvey R, and Parkins, Michael D

Subjects
Adult, Male, Cystic Fibrosis, Failure, Sputum, Biomarker, Bacterial Load, Bronchiectasis, Anti-Bacterial Agents, Treatment, Infectious Diseases, Treatment Outcome, Pseudomonas aeruginosa, Disease Progression, Humans, Female, Pseudomonas Infections, Heterogeneity, Cefepime, Research Article, Outcome, Retrospective Studies
Abstract

Background Pulmonary exacerbations (PEx) are critical events in cystic fibrosis (CF), responsible for reduced quality of life and permanent loss of lung function. Approximately 1/4 of PEx are associated with failure to recover lung function and/or resolve symptoms. Developing tools to optimize PEx treatment is of paramount importance. Methods We retrospectively audited all adults infected with Pseudomonas aeruginosa, experiencing PEx necessitating parenteral antibiotic therapy from 2006–2012 from our center. Quantitative analysis of sputum at admission, twice-weekly during hospitalization, and end of therapy were compared to baseline (most recent healthy) and follow-up (after PEx) samples. Change in P. aeruginosa burden from baseline was assessed for any and all morphotypes (ALL), as well as mucoid (MUC) and non-mucoid (NON) isolates specifically. PEx were identified as failures if >90% of baseline pulmonary function was not recovered. Results Forty-six patients meeting the above inclusion and exclusion criteria experienced 144 PEx during this time (median 3, IQR 2–6). Patients were treated for a median 14 days (IQR 13–16). No increase in ALL, MUC or NON were detected at PEx, nor was there an association between change in sputum density and magnitude of lung function decline. PEx failures were observed in 30% of events. Reductions of at least 1-log and 2 log P. aeruginosa sputum density was observed in 57% and 46% (ALL), 73% and 55% (MUC) and 58% and 46% (NON) of PEx, respectively. Factors associated with greater reduction of P. aeruginosa sputum density included choice of β-lactam antibiotic, antibiotics with in vitro predicted activity and treatment duration. PEx associated with reductions in P. aeruginosa sputum density were not associated with a reduced risk of PEx failure. Conclusions Enhanced killing of P. aeruginosa during PEx does not predict improved clinical outcomes. Studies accounting for the polymicrobial nature of CF respiratory disease and the heterogeneity of P. aeruginosa causing chronic infection may enable the identification of a more appropriate pathogen(s) based biomarker of PEx outcomes.

Published
2015

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