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1. Correlates of Illness Severity in Infectious Mononucleosis

Author

John Odame, Joan Robinson, Nasser Khodai-Booran, Simon Yeung, Tony Mazzulli, Derek Stephens, and Upton D Allen

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV) complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.

Published
2014
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2. Breakthrough Filamentous Fungal Infections in Pediatric Hematopoetic Stem Cell Transplant and Oncology Patients Receiving Caspofungin

Author

Shaun K Morris, Upton D Allen, Sumit Gupta, and Susan E Richardson

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

BACKGROUND: Caspofungin is an echinocandin class antifungal medication that is commonly used empirically in immunocompromised patients at high risk for invasive fungal disease.

Published
2012
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3. The Use of Antiviral Drugs for Influenza: Recommended Guidelines for Practitioners

Author

Upton D Allen, Fred Y Aoki, H Grant Stiver, and for the Canadian Paediatric Society and the Association of Medical Microbiology and Infectious Disease Canada

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

The present document outlines current guidelines and supporting literature relating to the use of antiviral drugs for chemoprophylaxis and influenza illness therapy in paediatric and adult settings. The focus is on the management of influenza in interpandemic periods. Where appropriate, the areas in need of additional research are identified. It will be necessary to update aspects of these guidelines as new information emerges. The recommendations that follow represent the results of a joint effort supported by the Canadian Paediatric Society and the Association of Medical Microbiology and Infectious Disease Canada.

Published
2006
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4. Response to a Protease-Inhibitor (Ritonavir)-Containing Combination Antiretroviral Regimen in HIV-Infected Children

Author

Upton D Allen, Normand Lapointe, Stanley E Read, Jack C Forbes, Susan M King, Samia Wasfy, and the Canadian Pediatric AIDS Research Group

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

INTRODUCTION: The number of antiretroviral agents available for children who are failing existing therapy is limited. Data are lacking on the use of various combination regimens and the resulting viral load dynamics in such children.

Published
2003
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5. Incomplete Kawasaki Disease Associated with Complicated Streptococcus pyogenes Pneumonia: A Case Report

Author

Timothy Ronan Leahy, Eyal Cohen, and Upton D Allen

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

A three-year-old boy presented with community-acquired pneumonia complicated by empyema. Streptococcus pyogenes (group A streptococcus) was identified on culture of the pleural fluid. The patient improved with antibiotic therapy and drainage of the empyema.

Published
2012
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10. The Use of Antiviral Drugs for Influenza: Guidance for Practitioners 2012/2013

Author

Fred Y Aoki, Upton D Allen, H Grant Stiver, and Gerald A Evans

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

The present article addresses the use of antiviral drugs in the management of seasonal influenza illness for the 2012/2013 season. It updates the previous document published in 2011 (1). Noteworthy guidance updates since 2011 include the following: Seasonal influenza in 2012/2013 is predicted to be caused by two human influenza A and one influenza B strain, all of which are anticipated to remain generally susceptible to oseltamivir.The predicted strains are A/California/7/2009 (H1N1) pdm09-like, A/Victoria/361/2011 (H3N2)-like and B/Wisconsin/1/2010-like (Yamagata lineage). All are included in the seasonal influenza vaccine and are susceptible to oseltamivir.Swine-variant H3N2v, which has rarely caused infection in humans exposed to infected swine within the past year in the United States, is susceptible to oseltamivir. It is not included in the current seasonal influenza vaccine.It is still considered that initiation of antiviral therapy more than 36 h to 48 h after onset of symptoms is beneficial in patients hospitalized with complicated influenza and severe illness.Oseltamivir continues to be recommended for the treatment of influenza in pregnant women.The use of antiviral drugs among measures to control outbreaks of influenza in closed facilities such as correctional institutions is now included in the present document.

Published
2012
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11. Pneumocystis Prophylaxis for All, Some, or No HIV-infected Infants Less than One Year of Age: A Decision Analysis Approach

Author

Upton D Allen and Stanley E Read

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Pneumocystis carinii pneumonia (PCP) is associated with significant mortality and morbidity among infants infected with human immunodeficiency virus (HIV). The preferred prophylaxis strategy for such infants is a subject of debate. Medical decision analysis was used to determine the preferred strategy for primary PCP prophylaxis among asymptomatic HIV-infected infants less than one year of age, and to determine the thresholds at which different variables influence decision making. Utility measures (health state preference values) were used to determine whether prophylaxis should be given to all, some or no infants. In this regard, some infants would receive prophylaxis if baseline CD4 counts are fewer than 1500 cells/mm3. The results suggest that the preferred option is to give prophylaxis to all asymptomatic HIV-infected infants despite CD4 counts, if the risk of PCP is equal to or greater than 25%. However, if the risk of PCP is less than 25%, prophylaxis is recommended for those infants with CD4 counts of fewer than 1500 cells/mm3. The results complement current guidelines regarding PCP prophylaxis for HIV-infected infants.

Published
1993
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12. Acute Rheumatic Fever: Findings of a Hospital-Based Study and an Overview of Reported Outbreaks

Author

Upton D Allen, Michael Braudo, and Stanley E Read

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

To review the characteristics of reported outbreaks of acute rheumatic fever in the United States, and to determine if there is an increase in the incidence of acute rheumatic fever in the population served by the Hospital for Sick Children, Toronto, Ontario, the authors conducted a literature search and a retrospective review of inpatients and outpatients, satisfying the revised Jones criteria for the diagnosis of acute rheumatic fever, from 1972 to 1988. Patients satisfying the revised Jones criteria for the time period 1972–88 were included in the study. There have been eight articles reporting an increase in acute rheumatic fever in the United States. In three, the majority of children were white and from middle class suburban/rural communities in different geographic locations. Mucoid strains of group A streptococci were implicated but not confirmed as being associated with the outbreaks in three. The results of the chart review at the Hospital for Sick Children revealed that 83 cases satisfied the revised Jones criteria. The number of cases per 100,000 children (aged 18 years or less) per year, decreased progressively over the study period. Polyarthritis was the most frequently seen major criterion occurring in 73% of patients (61 of 83). The most frequently affected ethnic groups were Italians 23%, Afro-Canadians 19% and Orientals 8%. The reported outbreaks in the United States are multifocal and predominantly confined to white middle class children residing in suburban/rural communities. There was no evidence of an increase in the number of cases of acute rheumatic fever seen in the population served by the Hospital for Sick Children; there was a progressive decline in number of cases over the study period. The results facilitate the characterization of acute rheumatic fever within North America into three different patterns of occurrence.

Published
1990
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13. Safe living strategies for the immunocompromised child

Author

Natalie A Bridger and Upton D Allen

Subjects
medicine.medical_specialty, Infection risk, business.industry, Pediatrics, Perinatology and Child Health, medicine, Practice Points / Points de Pratique, General health, Intensive care medicine, business, Organism
Abstract

This practice point provides guidance for clinicians caring for immunocompromised children, with focus on preventing or managing infection risks associated with a range of activities and exposures. The consequences of these infections depend on numerous factors, including but not limited to the nature of the child's immunocompromised state, general health, and the virulence of the organism involved.

Published
2019

14. HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures

Author

Dorothy L Moore and Upton D Allen

Subjects
Immediate Testing, Pregnancy, medicine.medical_specialty, business.industry, Transmission (medicine), Position Statement and Practice Points / Documents de Principes et Points de Pratique, Human immunodeficiency virus (HIV), Prenatal care, medicine.disease, medicine.disease_cause, Antiretroviral therapy, Perinatal hiv, 03 medical and health sciences, Identification (information), 0302 clinical medicine, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Medicine, 030212 general & internal medicine, business, Intensive care medicine
Abstract

The benefits of human immunodeficiency virus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted.

Published
2019

15. The use of antiviral drugs for influenza: Guidance for practitioners

Author

Upton D Allen

Subjects
medicine.medical_specialty, business.industry, Staphylococcus aureus, Pediatrics, Perinatology and Child Health, Chemoprophylaxis, Streptococcus pneumoniae, Antiviral therapy, Medicine, Practice Points, business, Intensive care medicine, medicine.disease_cause, Severe influenza
Abstract

This practice point summarizes the use of antiviral drugs to manage influenza illness in children and youth. Recommendations are based on previously published Canadian recommendations for clinicians on the use of antiviral drugs to prevent and treat influenza. Detailed information on the selective use of chemoprophylaxis can be found in the original document, which also highlights the importance of secondary bacterial infections (i.e., Streptococcus pneumoniae, methicillin-sensitive Staphylococcus aureus and methicillin-resistant S aureus) in cases of severe influenza illness. This document serves as a reference for all clinicians while providing general principles and a user-friendly flow diagram to assist decision-making.

Published
2018

16. Contributors

Author

Mark J. Abzug, Elisabeth E. Adderson, Allison L. Agwu, Kevin Alby, Grace M. Aldrovandi, Upton D. Allen, Gerardo Alvarez-Hernández, Krow Ampofo, Evan J. Anderson, Margot Anderson, Stella Antonara, Monica I. Ardura, Paul M. Arguin, John C. Arnold, Naomi E. Aronson, Ann M. Arvin, Shai Ashkenazi, Edwin J. Asturias, Vahe Badalyan, Carol J. Baker, Karthik Balakrishnan, Brittany S. Barros, William J. Barson, Daniel G. Bausch, Kirsten Bechtel, Daniel K. Benjamin, David M. Berman, David A. Blanco, Karen C. Bloch, Margaret J. Blythe, Joseph A. Bocchini, Anna Bowen, William R. Bowie, Thomas G. Boyce, John S. Bradley, Michael T. Brady, Denise F. Bratcher, Paula K. Braverman, Joseph Bresee, Itzhak Brook, Kevin E. Brown, Kristina Bryant, E. Stephen Buescher, Jane L. Burns, Carrie L. Byington, Andres F. Camacho-Gonzalez, Paul Cantey, Bryan D. Carter, Mary T. Caserta, Luis A. Castagnini, Chiara Cerini, Ellen Gould Chadwick, Silvia S. Chiang, John C. Christenson, Susan E. Coffin, Melissa G. Collier, Jennifer P. Collins, Laurie S. Conklin, Beverly L. Connelly, Despina Contopoulos-Ioannidis, James H. Conway, Margaret M. Cortese, Elaine G. Cox, C. Buddy Creech, Jonathan D. Crews, Dennis J. Cunningham, Nigel Curtis, Natalie J.M. Dailey, Lara A. Danziger-Isakov, Toni Darville, Gregory A. Dasch, Irini Daskalaki, Robert S. Daum, Michael Davenport, H. Dele Davies, Fatimah S. Dawood, J. Christopher Day, Maite de la Morena, Gail J. Demmler-Harrison, Gregory P. DeMuri, Dickson D. Despommier, Karen A. Diefenbach, Kathryn M. Edwards, Morven S. Edwards, Lawrence F. Eichenfield, Dirk M. Elston, Beth Emerson, Moshe Ephros, Guliz Erdem, Marina E. Eremeeva, Jessica E. Ericson, Douglas H. Esposito, Monica M. Farley, Anat R. Feingold, Kristina N. Feja, Adam Finn, Marc Fischer, Patricia M. Flynn, LeAnne M. Fox, Michael M. Frank, Douglas R. Fredrick, Robert W. Frenck, Sheila Fallon Friedlander, Hayley A. Gans, Gregory M. Gauthier, Jeffrey S. Gerber, Francis Gigliotti, Mark A. Gilger, Carol A. Glaser, Amanda F. Goddard, Benjamin D. Gold, Jane M. Gould, Michael Green, David Greenberg, Tanya Greywal, Daniel Griffin, Patricia M. Griffin, Alexei A. Grom, Kathleen Gutierrez, Julie Gutman, Judith A. Guzman-Cottrill, Aron J. Hall, Jin-Young Han, Marvin B. Harper, Julie R. Harris, Christopher J. Harrison, David B. Haslam, Sarah J. Hawkes, J. Owen Hendley, Marion C.W. Henry, Joseph A. Hilinski, Susan L. Hills, Scott D. Holmberg, Deborah Holtzman, David K. Hong, Peter J. Hotez, Katherine K. Hsu, David A. Hunstad, Loris Y. Hwang, Mary Anne Jackson, Richard F. Jacobs, Ravi Jhaveri, Kateřina Jirků-Pomajbíková, Jeffrey L. Jones, Mahima Karki, M. Gary Karlowicz, Ben Z. Katz, Ishminder Kaur, Gilbert J. Kersh, Jay S. Keystone, Muhammad Ali Khan, David W. Kimberlin, Martin B. Kleiman, Bruce S. Klein, Karl Klontz, Barbara Knust, Andrew Y. Koh, E. Kent Korgenski, Paul Krogstad, Preeta Krishnan Kutty, Christine T. Lauren, Hillary S. Lawrence, Amy Leber, Grace M. Lee, Eugene Leibovitz, Eyal Leshem, Stéphanie Levasseur, David B. Lewis, Robyn A. Livingston, Eloisa Llata, Sarah S. Long, Ben A. Lopman, Yalda C. Lucero, Jorge Luján-Zilbermann, Katherine Luzuriaga, Noni E. MacDonald, Yvonne A. Maldonado, John Manaloor, Chitra S. Mani, Kalpana Manthiram, Gary S. Marshall, Stacey W. Martin, Almea Matanock, Catalina Matiz, Alison C. Mawle, Tony Mazzulli, Kathleen A. McGann, Kenneth McIntosh, Lucy A. McNamara, Michal Meir, Debrah Meislich, H. Cody Meissner, Elissa Meites, Asunción Mejías, Jussi Mertsola, Kevin Messacar, Mohammed Nael Mhaissen, Marian G. Michaels, Melissa B. Miller, Eric D. Mintz, John F. Modlin, Parvathi Mohan, Susan P. Montgomery, José G. Montoya, Pedro L. Moro, Anna-Barbara Moscicki, R. Lawrence Moss, Angela L. Myers, Simon Nadel, Michael N. Neely, Karen P. Neil, Joanna Nelson, Noele P. Nelson, William L. Nicholson, Victor Nizet, Amy Jo Nopper, Theresa J. Ochoa, Walter A. Orenstein, Miguel O'Ryan, Christopher D. Paddock, Harpreet Pall, Suresh Kumar Panuganti, Diane E. Pappas, Robert F. Pass, Thomas F. Patterson, Monica E. Patton, Stephen I. Pelton, Brett W. Petersen, Larry K. Pickering, Swetha Pinninti, Paul J. Planet, Andrew J. Pollard, Klara M. Posfay-Barbe, Casper S. Poulsen, Susan M. Poutanen, Ann M. Powers, Charles G. Prober, Octavio Ramilo, Shawn J. Rangel, Suchitra Rao, Sarah A. Rawstron, Jennifer S. Read, Michael D. Reed, Ryan F. Relich, Megan E. Reller, Neil Rellosa, Katherine A. Rempe, Melissa A. Reyes, Samuel E. Rice-Townsend, Frank O. Richards, José R. Romero, David A. Rosen, Christina A. Rostad, G. Ingrid J.G. Rours, Janell A. Routh, Anne H. Rowley, Lorry G. Rubin, Edward T. Ryan, Lisa Saiman, Julia S. Sammons, Laura Sass, Jason B. Sauberan, Sarah Schillie, Grant S. Schulert, Jennifer E. Schuster, Kevin L. Schwartz, Bethany K. Sederdahl, Jose A. Serpa, Kara N. Shah, Samir S. Shah, Andi L. Shane, Eugene D. Shapiro, Jana Shaw, Avinash K. Shetty, Linda M. Dairiki, George Kelly Siberry, Jane D. Siegel, Robert David Siegel, Kari A. Simonsen, Nalini Singh, Upinder Singh, P. Brian Smith, John D. Snyder, Eunkyung Song, Jennifer L. Sorrell, Emily Souder, Joseph W. St. Geme, Mary Allen Staat, J. Erin Staples, Jeffrey R. Starke, William J. Steinbach, Christen R. Stensvold, Bradley P. Stoner, Raymond A. Strikas, Jonathan B. Strober, Paul K. Sue, Deanna A. Sutton, Douglas Swanson, Jacqueline E. Tate, Marc Tebruegge, Eyasu H. Teshale, Amelia B. Thompson, George R. Thompson, Robert Thompson-Stone, Richard B. Thomson, Emily A. Thorell, Nicole H. Tobin, Philip Toltzis, James Treat, Stephanie B. Troy, Russell B. Van, Louise Elaine Vaz, Jennifer Vodzak, Ellen R. Wald, Rebecca Wallihan, Zoon Wangu, Matthew Washam, Joshua R. Watson, Rachel L. Wattier, Geoffrey A. Weinberg, A. Clinton White, Harold C. Wiesenfeld, John V. Williams, Rodney E. Willoughby, Sarah L. Wingerter, Robert R. Wittler, Karen K. Wong, Kimberly A. Workowski, Terry W. Wright, Pablo Yagupsky, Catherine Yen, Jumi Yi, Jonathan S. Yoder, Edward J. Young, Andrea L. Zaenglein, and Kanecia Zimmerman

Published
2018
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17. Guidance for Practitioners on the Use of Antiviral Drugs to Control Influenza Outbreaks in Long-Term Care Facilities in Canada, 2014-2015 Season

Author

Michel Laverdière, Gerald A Evans, Danuta M. Skowronski, H Grant Stiver, Upton D Allen, Fred Y. Aoki, and University of Manitoba

Subjects
Microbiology (medical), medicine.medical_specialty, business.industry, MEDLINE, Outbreak, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502, AMMI Canada Guidelines, Long-term care, Infectious Diseases, Increased risk, Family medicine, Health care, medicine, Intensive care medicine, business
Abstract

The AMMI Canada Guidelines document ‘The use of antiviral drugs for influenza: A foundation document for practitioners’, published in the Autumn 2013 issue of the Journal, outlines the recommendations for the use of antiviral drugs to treat influenza. This article, which represents the first of two updates to these guidelines published in the current issue of the Journal, aims to inform health care professionals of the increased risk for influenza in long-term care facilities due to a documented mismatch between the components chosen for this season’s vaccine and currently circulating influenza strains. Adjusted recommendations for the use of antiviral drugs for influenza in long-term care facilities for this season are provided.

Published
2015
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18. Invasive group A streptococcal disease: Management and chemoprophylaxis

Author

Timothy Mailman, Upton D Allen, and Dorothy L Moore

Subjects
Penicillin, medicine.medical_specialty, business.industry, Pediatrics, Perinatology and Child Health, Chemoprophylaxis, Practice Points / Points de Pratique, Medicine, Clindamycin, Streptococcal disease, Invasive group, business, Intensive care medicine, medicine.drug
Abstract

Reporting of severe invasive group A streptococcal disease (IGAS) has increased in Canada over the past decade, highlighting the importance of optimal chemoprophylaxis and management strategies. Canadian guidelines have had variable uptake across Canada. This practice point updates relevant aspects of these guidelines, with a focus on chemoprophylaxis of contacts of IGAS cases and clinical management of IGAS. The importance of penicillin in treating group A streptococcal disease is reaffirmed, and the role of clindamycin is discussed. In situations in which chemoprophylaxis may be considered, preferred agents are summarized.

Published
2019
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19. Correlates of Illness Severity in Infectious Mononucleosis

Author

Simon Yeung, Tony Mazzulli, Joan L. Robinson, John Odame, Upton D Allen, Derek Stephens, and Nasser Khodai-Booran

Subjects
Microbiology (medical), Mononucleosis, Infectious and parasitic diseases, RC109-216, medicine.disease_cause, Microbiology, Virus, Hepatitis, hemic and lymphatic diseases, Severity of illness, Epstein-Barr virus, Medicine, Illness severity, Viral load, business.industry, medicine.disease, Epstein–Barr virus, Ebv infection, QR1-502, 3. Good health, Infectious Diseases, Immunology, Original Article, business
Abstract

Infectious mononucleosis is caused by Epstein-Barr virus and can lead to complications, including hepatitis and hematological abnormalities, in a subset of patients. The authors of this article assessed measures of illness severity as well as viral load at presentation and six weeks later among a cohort of individuals, INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV) complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses. OBJECTIVES: To determine the clinical and laboratory correlates of illness severity among infants, children and youth with infectious mononucleosis (IM). METHODS: Study subjects with confirmed IM were prospectively enrolled. Illness severity was assessed at baseline and at six weeks using a scoring tool. Peripheral blood viral loads served as a measure of viral burden. RESULTS: Among 32 children and young adults with IM, the median age was 16 years (range two to 24 years). The predominant clinical findings were lymphadenopathy (23 of 32 [72%]), pharyngitis (16 of 32 [50%]), fever (nine of 32 [28%]) and splenomegaly (six of 32 [19%]). With respect to symptoms or signs that persisted to at least six weeks after illness onset, the predominant complaint was lymphadenopathy in 35% of subjects available for reassessment. Deranged liver function tests were present at presentation in up to 44% of subjects. Patients with the highest viral loads at presentation had significantly higher illness severity scores associated with fatigue (P=0.02). Other than the scores associated with fatigue, viral load values were not significantly correlated with the illness severity scores at baseline and at six weeks. CONCLUSION: In IM, viral loads are not necessarily correlated with illness severity, with the exception of fatigue. EBV-related hepatitis is common in IM, confirming the status of this virus as a relatively common cause of transient hepatitis in children and youth. This entity is not necessarily a marker of disease severity.

Published
2014

21. List of Contributors

Author

Fredrick M. Abrahamian, Michael J. Aldape, Edelweiss Aldasoro, Upton D. Allen, Hythem Al-Sum, Milan J. Anadkat, Katherine Anders, Emmanouil Angelakis, Brian John Angus, Anastasia Antoniadou, Fabio Arena, Joop E. Arends, Jose R. Arribas, Andrew W. Artenstein, John C. Atherton, John N. Aucott, Tar-Ching Aw, Hilary M. Babcock, Robin Bailey, Thomas C. Bailey, Adam Z. Banks, David J. Barillo, Ernie-Paul Barrette, Martijn P. Bauer, Roger Bayston, C. Ben Beard, Justin Beardsley, Nick J. Beeching, Rodolfo E. Bégué, Guido Beldi, Constance A. Benson, Elie F. Berbari, Jean-Michel Berenger, Christoph Berger, Jose I. Bernardino, Jacques Bille, Alexander C. Billioux, Ari Bitnun, Iain Blair, Stéphane Blanche, Thomas P. Bleck, Chantal P. Bleeker-Rovers, Gijs Bleijenberg, Karen C. Bloch, Johannes Blum, Emily A. Blumberg, Robert A. Bonomo, Marc J.M. Bonten, Rafik Bourayou, Emilio Bouza, K. Ashley Brandt, Florence Bretelle, Sylvain Brisse, Warwick J. Britton, Itzhak Brook, Matthijs C. Brouwer, Sarah K. Browne, Amy E. Bryant, Silja Bühler, Eileen M. Bulger, R. Mark L. Buller, Leah A. Burke, Christian Burri, Marcus W. Butler, Thierry Calandra, David P. Calfee, Antonia Calvo-Cano, D. William Cameron, Joseph A. Carcillo, Gail Carson, Stephen T. Chambers, Remi N. Charrel, Vinh Chau Van Nguyen, Stéphane Chevaliez, Tom M. Chiller, Eirini Christaki, Kevin K. Chung, David B. Clifford, Nathan Clumeck, Jonathan Cohen, John Collinge, Christopher P. Conlon, Curdin Conrad, Fiona J. Cooke, Jennifer Rittenhouse Cope, G. Ralph Corey, John H. Cross, Burke A. Cunha, Cheston B. Cunha, Benoit D'Journo, George L. Daikos, Johannes M.A. Daniels, Robert N. Davidson, Nicholas P.J. Day, Kevin M. De Cock, Thushan I. de Silva, Henry J.C. de Vries, Stéphane de Wit, Julie Delaloye, David W. Denning, David T. Dennis, Shireesha Dhanireddy, Elodi J. Dielubanza, David J. Diemert, Mehmet Doganay, Tom Doherty, Christiane Dolecek, Arjen M. Dondorp, Abby Douglas, Michel Drancourt, Grégory Dubourg, Michael N. Dudley, Guillaume Durand, Benjamin J. Eckhardt, Androulla Efstratiou, Miquel B. Ekkelenkamp, Ambika Eranki, Hakan Erdem, Gerome V. Escota, Heather L. Evans, Alice Chijioke Eziefula, Florence Fenollar, Alan Fenwick, Joshua Fierer, Roger G. Finch, James M. Fleckenstein, Christina Forstner, Federico Foschi, Pierre-Edouard Fournier, Martyn A. French, Kenneth L. Gage, Lynne S. Garcia, Joaquim Gascon, Arturo S. Gastañaduy, Philippe Gautret, William M. Geisler, Khalil G. Ghanem, Tommaso Giani, Maddalena Giannella, Bruce L. Gilliam, Michel Gilliet, Carol A. Glaser, Youri Glupczynski, John W. Gnann, Ellie J.C. Goldstein, Bruno Gottstein, Frederique Gouriet, Patti E. Gravitt, Michael D. Green, Stephen T. Green, Andreas H. Groll, Roy M. Gulick, Arjun Gupta, Gilbert Habib, Stephan Harbarth, Marianne Harris, Frederick G. Hayden, David J. Hetem, Philip C. Hill, Bernard Hirschel, Aimee C. Hodowanec, Louis Hoffart, Christian Hoffmann, Steven M. Holland, Peter W. Horby, David J. Horne, Sami Hraiech, Mark W. Hull, Angela Huttner, Richard J.M. Ingram, Jasmin Islam, Michael G. Ison, Scott H. James, Claire Jenkins, Stephen G. Jenkins, Jørgen Skov Jensen, Christine Johnston, Theodore B. Jones, Stephen J. Jordan, Kathleen G. Julian, Yasuyuki Kato, Carol A. Kauffman, Keith S. Kaye, Michael P. Keane, James Keeney, Paul Kelly, Stephen J. Kent, Winfried V. Kern, Yoav Keynan, Andrea A. Kim, Isabelle Koné-Paut, Chris Kosmidis, Aloys C.M. Kroes, Frank P. Kroon, Thomas G. Ksiazek, F. Matthew Kuhlmann, Ed J. Kuijper, Jennie H. Kwon, George B. Kyei, Karine Lacombe, Philippe Lagacé-Wiens, Jean-Christophe Lagier, Theresa Lamagni, Luce Landraud, Fanny Lanternier, Kerry L. LaPlante, Stephen D. Lawn, Steven J. Lawrence, Hakan Leblebicioglu, Nelson Lee, James E. Leggett, Philippe Lehours, Pierre-Yves Levy, Rainer G. Leyh, Rebecca A. Lillis, Direk Limmathurotsakul, Jennifer Lin, H.D. Alan Lindquist, Benjamin A. Lipsky, Christina Liscynesky, David Looney, Olivier Lortholary, Franklin D. Lowy, Benjamin J. Luft, Philip A. Mackowiak, Paul A. MacPherson, Valérie Maghraoui-Slim, Patrick W. Mallon, Julie E. Mangino, Oriol Manuel, Oscar Marchetti, Kristen M. Marks, Kieren A. Marr, Jeanne Marrazzo, Jonas Marschall, David H. Martin, Frédéric Matonti, Richard S. Matulewicz, Kenneth H. Mayer, Russell J. McCulloh, Rose McGready, Rennatus Mdodo, Simon Mead, Francis Mégraud, Graeme Meintjes, Sarah C. Metcalf, Marian G. Michaels, Giovanni Battista Migliori, Michael A. Miles, Alastair Miller, Matthew J. Mimiaga, Marie-Paule Mingeot-Leclercq, Elizabeth Ann Misch, Makedonka Mitreva, Julio S.G. Montaner, Caroline B. Moore, Patricia Muñoz, Jose Muñoz, Clinton K. Murray, Didier Musso, Mable Mutengo, Misha M. Mutizwa, Kurt G. Naber, Pavithra Natarajan, Santiago Neme, Paul N. Newton, Ronald A. Nichols, Lindsay E. Nicolle, François Nosten, Luigi D. Notarangelo, Thomas B. Nutman, Paul Nyirjesy, P. Ronan O'Connell, Steven M. Opal, L. Peter Ormerod, Douglas R. Osmon, Marie Boulze Pankert, Giuseppe Pantaleo, Laurent Papazian, Diane M. Parente, Philippe Parola, Shadi Parsaei, Manuel A. Pascual, Rupa Patel, Eleni Patrozou, Jean-Michel Pawlotsky, Sharon J. Peacock, Jean-Claude Pechère, Ivan Pelegrin, Barry S. Peters, Edgar J.G. Peters, Jeannine M. Petersen, Lyle R. Petersen, Vidmantas Petraitis, Luu-Ly Pham, Albert Picado, Adrian Pilatz, Benoit Pilmis, María-Jesús Pinazo, Mathias W. Pletz, Jason M. Pogue, Evelyn L. Polgreen, Philip M. Polgreen, Klara M. Posfay-Barbe, William G. Powderly, Rachel Presti, Guy Prod'hom, Mirja Puolakkainen, Thomas C. Quinn, Didier Raoult, Raymund R. Razonable, Robert C. Read, Robert R. Redfield, Rob J. Rentenaar, Steven J. Reynolds, Camillo Ribi, Malcolm D. Richardson, Michele L. Ritter, Antoine Roch, Jürgen Kurt Rockstroh, Amanda Rojek, José R. Romero, Suzan H.M. Rooijakkers, Daniel Rosenbluth, Sergio D. Rosenzweig, Gian Maria Rossolini, Ethan Rubinstein, Greg Ryan, Steven A. Safren, Vikrant V. Sahasrabuddhe, Pekka A.I. Saikku, Mohammad M. Sajadi, Michelle R. Salvaggio, Carlos A.Q. Santos, Michael J. Satlin, Anthony J. Schaeffer, Christoph Schimmer, Robert T. Schooley, Richard F. Schumacher, Beverly E. Sha, Daniel S. Shapiro, Gerard Sheehan, David M. Shlaes, Shmuel Shoham, Cameron P. Simmons, Dennis W. Simon, Matthew S. Simon, Kari A. Simonsen, Mary P.E. Slack, Tyrel T. Smith, Jack D. Sobel, Maria Souli, Shruti Sridhar, James M. Steckelberg, Dennis L. Stevens, Heather Strah, A. Willem Sturm, Somnuek Sungkanuparph, Sarah J. Tabrizi, Evelina Tacconelli, Chen Sabrina Tan, Randy A. Taplitz, Guillemette Thomas, Lora D. Thomas, Franck Thuny, Guy Thwaites, Frederic Tissot, Tone Tønjum, Francesca J. Torriani, Christian Toso, Paul M. Tulkens, Allan R. Tunkel, Claire E. Turner, Andrew P. Ustianowski, Françoise van Bambeke, Reinout van Crevel, Diederik van de Beek, Christian van Delden, Menno M. van der Eerden, Jos W.M. van der Meer, Tom van der Poll, Jakko van Ingen, Jos van Putten, Bernard P. Vaudaux, Sten H. Vermund, Raphael P. Viscidi, Kumar Visvanathan, Govinda S. Visvesvara, Lorenz von Seidlein, Florian M.E. Wagenlehner, Anna Wald, Thomas J. Walsh, David C. Warhurst, David W. Warnock, David A. Warrell, Mary J. Warrell, Adilia Warris, Richard R. Watkins, David J. Weatherall, Rainer Weber, Wolfgang Weidner, Jonathan R. White, Peter J. White, James Whitehorn, Richard J. Whitley, Christopher J.M. Whitty, Willem Joost Wiersinga, Mark H. Wilcox, Thomas N. Williams, Cara C. Wilson, Mary Elizabeth Wilson, Hilmar Wisplinghoff, Robin Wood, Richard G. Wunderink, David Wyles, Zhi-Tao Yang, Jonathan S. Yoder, Najam A. Zaidi, Andrea J. Zimmer, Jane N. Zuckerman, and Alimuddin Zumla

Published
2017
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22. Infective Endocarditis: Updated Guidelines

Author

Upton D Allen

Subjects
Microbiology (medical), medicine.medical_specialty, Activities of daily living, business.industry, Adverse outcomes, Dental procedures, Target groups, Infectious and parasitic diseases, RC109-216, medicine.disease, Oral hygiene, Microbiology, QR1-502, Surgery, Infectious Diseases, Infective endocarditis, Bacteremia, Chemoprophylaxis, Pediatrics, Perinatology and Child Health, Paediatric Infectious Disease Notes, medicine, Endocarditis, Intensive care medicine, business
Abstract

The most recent revision of the American Heart Association guidelines on infective endocarditis prophylaxis occurred in 2007. These revisions were based on the fact that current data have brought into question the benefit of previous recommendations for infective endocarditis prophylaxis. It was noted that the bacteremia that occurs following dental procedures represents only a fraction of the episodes of bacteremia that occur with activities of daily living (such as chewing, brushing teeth and other oral hygiene measures). The target groups and the procedures for which prophylaxis is reasonable have been significantly reduced in number. The focus is now on patients who are most likely to have adverse outcomes from infectious endocarditis. The present article is targeted at practicing Canadian physicians and provides the rationale for the current recommendations. In addition to a summary of the indications for prophylaxis, information is provided on the conditions for which prophylaxis is not recommended.

Published
2010

23. Guidance on The Use of Antiviral Drugs for Influenza in Acute Care Facilities in Canada, 2014-2015

Author

Michel Laverdière, H Grant Stiver, Upton D Allen, Gerald A Evans, Fred Y. Aoki, and University of Manitoba

Subjects
Microbiology (medical), medicine.medical_specialty, business.industry, virus diseases, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502, AMMI Canada Guidelines, Infectious Diseases, Increased risk, Acute care, Health care, medicine, Intensive care medicine, business
Abstract

This article represents the second update to the AMMI Canada Guidelines document on the use of antiviral drugs for influenza. The article aims to inform health care professionals of the increased risk for influenza in long-term care facilities due to a documented mismatch between the components chosen for this season's vaccine and currently circulating influenza strains. Adjusted recommendations for the use of antiviral drugs for influenza in the acute care setting for this season are provided.

Published
2015
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24. Sexually transmitted infections in adolescents: Maximizing opportunities for optimal care

Author

Upton D, Allen and Noni E, MacDonald

Subjects
CPS Practice Point, urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Sexually transmitted infections are a growing public health concern in Canada, with rates of Chlamydia trachomatis infection, gonorrhea and syphilis increasing among adolescents and young adults. The present practice point outlines epidemiology, risk factors, laboratory testing and management for C trachomatis, Neisseria gonorrhoeae and Treponema pallidum, with a lesser focus on HIV. The need for test-of-cure and indications for further investigations are also discussed. The importance of maximizing opportunities to screen for and treat sexually transmitted infections in this age group is highlighted.Les infections transmises sexuellement sont une préoccupation croissante en santé publique au Canada. Les taux de l’infection par la

Published
2014

25. Clostridium difficile in paediatric populations

Author

Upton D, Allen

Subjects
CPS Position Statement
Abstract

An increase in Clostridium difficile infection incidence has been observed among hospitalized children in the United States. The present statement, targeted at clinicians caring for infants and children in community and institutional settings, summarizes the relevant information relating to the role of C difficile in childhood diarrhea and provides recommendations for diagnosis, prevention and treatment. Significant differences between adult and paediatric risk factors and disease are discussed, along with emerging therapies. The relationship between age and disease severity in children with a newly emergent and more fluoroqinolone-resistant strain of C difficile (North American Pulse-field type-1 [NAP1]) remains unknown. The importance of antimicrobial stewardship as a preventive strategy is highlighted. This statement replaces a previous Canadian Paediatric Society position statement on C difficile published in 2000.On a observé une augmentation de l’incidence d’infections par le

Published
2014

26. Correlates of Illness Severity in Infectious Mononucleosis

Author

Joan L. Robinson, Upton D Allen, Nasser Khodai-Booran, Tony Mazzulli, and J Odame

Subjects
Pediatrics, medicine.medical_specialty, Mononucleosis, business.industry, Pediatrics, Perinatology and Child Health, medicine, Illness severity, medicine.disease, business
Published
2013
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27. The Use of Antiviral Drugs for Influenza: Guidance for Practitioners 2012/2013

Author

Gerald A Evans, Fred Y. Aoki, H Grant Stiver, Upton D Allen, and University of Manitoba

Subjects
Microbiology (medical), medicine.medical_specialty, Veterinary medicine, Oseltamivir, Human influenza, business.industry, Antiviral therapy, Outbreak, virus diseases, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502, Seasonal influenza, AMMI Canada Guidelines, chemistry.chemical_compound, Infectious Diseases, chemistry, Internal medicine, medicine, Human mortality from H5N1, In patient, business
Abstract

The present article addresses the use of antiviral drugs in the management of seasonal influenza illness for the 2012/2013 season. It updates the previous document published in 2011 (1). Noteworthy guidance updates since 2011 include the following: Seasonal influenza in 2012/2013 is predicted to be caused by two human influenza A and one influenza B strain, all of which are anticipated to remain generally susceptible to oseltamivir.The predicted strains are A/California/7/2009 (H1N1) pdm09-like, A/Victoria/361/2011 (H3N2)-like and B/Wisconsin/1/2010-like (Yamagata lineage). All are included in the seasonal influenza vaccine and are susceptible to oseltamivir.Swine-variant H3N2v, which has rarely caused infection in humans exposed to infected swine within the past year in the United States, is susceptible to oseltamivir. It is not included in the current seasonal influenza vaccine.It is still considered that initiation of antiviral therapy more than 36 h to 48 h after onset of symptoms is beneficial in patients hospitalized with complicated influenza and severe illness.Oseltamivir continues to be recommended for the treatment of influenza in pregnant women.The use of antiviral drugs among measures to control outbreaks of influenza in closed facilities such as correctional institutions is now included in the present document.Le présent article porte sur l’utilisation d’antiviraux pour prendre en charge l’influenza pendant la saison 2012–2013. Il met à jour le document publié en 2011 (1). Les conseils qui méritent d’être soulignés depuis 2011 s’établissent comme suit : On prévoit qu’en 2012–2013, l’influenza saisonnière sera causée par deux souches de l’influenza humaine A et une souche de l’influenza B, qui devraient demeurer généralement susceptibles à l’oseltamivir.Les souches prévues sont le virus analogue à A/California/7/2009 (H1N1)pdm09, le virus analogue à A/Victoria/361/2011 (H3N2) et le virus analogue à B/Wisconsin/1/2010 (lignée Yamagata). Toutes sont incluses dans le vaccin contre l’influenza saisonnière et sont susceptibles à l’oseltamivir.La variante porcine du virus H3N2 (H3N2v), qui a causé peu d’infections chez des humains exposés à des porcs depuis un an aux États-Unis, est susceptible à l’oseltamivir. Elle n’est pas incluse dans le vaccin actuel contre l’influenza saisonnière.On considère encore que l’amorce des antiviraux plus de 36 heures à 48 heures après l’apparition des symptômes est bénéfique aux patients hospitalisés en raison d’une influenza complexe et d’une maladie grave.L’oseltamivir continue d’être recommandé pour le traitement de l’influenza chez les femmes enceintes.Le recours à des antiviraux parmi les mesures de contrôle des éclosions d’influenza dans des établissements fermés, tels que les établissements de détention, fait désormais partie de ce document.

Published
2012

28. Contributors

Author

Elisabeth E. Adderson, Aarti Agarwal, Grace M. Aldrovandi, Upton D. Allen, Manuel R. Amieva, Krow Ampofo, Alicia D. Anderson, Margot Anderson, Paul M. Arguin, John C. Arnold, Ann M. Arvin, Shai Ashkenazi, Carol J. Baker, William J. Barson, Daniel G. Bausch, Kirsten Bechtel, Daniel K. Benjamin, Frank E. Berkowitz, Margaret J. Blythe, Joseph A. Bocchini, Michael Boeckh, Anna Bowen, William R. Bowie, Thomas G. Boyce, John S. Bradley, Michael T. Brady, Denise F. Bratcher, Paula K. Braverman, Caroline Breese Hall, Joseph S. Bresee, Itzhak Brook, Kristina Bryant, E. Stephen Buescher, Jane L. Burns, Gale R. Burstein, Carrie L. Byington, Kathy K. Byrd, Michael Cappello, Bryan D. Carter, Emily J. Cartwright, Mary T. Caserta, Chiara Cerini, Ellen Gould Chadwick, Beth Cheesebrough, P. Joan Chesney, John C. Christenson, Thomas G. Cleary, Susan E. Coffin, Laura M. Conklin, Laurie S. Conklin, Beverly L. Connelly, Despina Contopoulos-Ioannidis, James H. Conway, Margaret M. Cortese, C. Michael Cotten, Elaine Cox, Maryanne E. Crockett, James E. Crowe, Nigel Curtis, Dennis J. Cunningham, Linda Marie Dairiki Shortliffe, Toni Darville, Gregory A. Dasch, Irini Daskalaki, Robert S. Daum, Fatimah S. Dawood, Gail J. Demmler, Dickson D. Despommier, Karen A. Diefenbach, Christopher C. Dvorak, Kathryn M. Edwards, Morven S. Edwards, Lawrence F. Eichenfield, Dirk M. Elston, Janet A. Englund, Veronique Erard, Marina E. Eremeeva, Anat R. Feingold, Adam Finn, Anthony E. Fiore, Marc Fischer, Sarah J. Fitch, Patricia M. Flynn, LeAnne M. Fox, Michael M. Frank, Douglas R. Fredrick, Sheila Fallon Friedlander, Hayley A. Gans, Carla G. Garcia, Maria C. Garzon, Jeffrey S. Gerber, Michael D. Geschwind, Laura B. Gieraltowski, Francis Gigliotti, Peter H. Gilligan, Carol Glaser, Benjamin D. Gold, Brahm Goldstein, Jane M. Gould, Michael Green, David Greenberg, Patricia M. Griffin, Alexei A. Grom, Kathleen Gutierrez, Judith A. Guzman-Cottrill, Aron J. Hall, Marvin B. Harper, Christopher J. Harrison, David B. Haslam, Sarah J. Hawkes, Edward B. Hayes, Rohan Hazra, Sara Jane Heilig, J. Owen Hendley, Marion C.W. Henry, Joseph A. Hilinski, Scott D. Holmberg, Deborah Holtzman, Peter J. Hotez, Katherine K. Hsu, Dale J. Hu, Loris Y. Hwang, David Y. Hyun, Mary Anne Jackson, Richard F. Jacobs, Jeffrey L. Jones, Saleem Kamili, M. Gary Karlowicz, Ben Z. Katz, Gilbert J. Kersh, Laura M. Kester, Jay S. Keystone, David W. Kimberlin, Martin B. Kleiman, Mark W. Kline, Andrew Y. Koh, Andreas Konstantopoulos, Katalin I. Koranyi, E. Kent Korgenski, Andrew T. Kroger, Paul Krogstad, Christine T. Lauren, Hillary S. Lawrence, Eugene Leibovitz, Stéphanie Levasseur, David B. Lewis, Jay M. Lieberman, Jen-Jane Liu, Robyn A. Livingston, Eloisa Llata, Anagha R. Loharikar, Sarah S. Long, Ben A. Lopman, Bennett Lorber, Donald E. Low, Yalda C. Lucero, Jorge Luján-Zilbermann, Katherine Luzuriaga, Noni E. MacDonald, Adam MacNeil, Yvonne A. Maldonado, Chitra S. Mani, Mario J. Marcon, Gary S. Marshall, Stacey W. Martin, Catalina Matiz, Alison C. Mawle, Tony Mazzulli, George H. McCracken, Matthew B. McDonald, Robert S. McGregor, Kenneth McIntosh, Meredith McMorrow, Candice McNeil, Jennifer H. McQuiston, Debrah Meislich, H. Cody Meissner, Asunción Mejías, Manoj P. Menon, Jussi Mertsola, Marian G. Michaels, Melissa B. Miller, Eric D. Mintz, John F. Modlin, Parvathi Mohan, Susan P. Montgomery, Jose G. Montoya, Zack S. Moore, Maite de la Morena, Pedro L. Moro, Anna-Barbara Moscicki, R. Lawrence Moss, Trudy V. Murphy, Dennis L. Murray, Angela L. Myers, Simon Nadel, James P. Nataro, Michael N. Neely, William L. Nicholson, Victor Nizet, Amy Jo Nopper, Anna Norrby-Teglund, Theresa J. Ochoa, Miguel O’Ryan, Walter A. Orenstein, Christopher D. Paddock, Diane E. Pappas, Robert F. Pass, Thomas F. Patterson, Stephen I. Pelton, Larry K. Pickering, Caroline Diane Sarah Piggott, Philip A. Pizzo, Andrew J. Pollard, Klara M. Posfay-Barbe, Susan M. Poutanen, Dwight A. Powell, Alice S. Prince, Charles G. Prober, Octavio Ramilo, Shawn J. Rangel, Sarah A. Rawstron, Jennifer S. Read, Michael D. Reed, Joanna J. Regan, Megan E. Reller, Melissa A. Reyes, Peter A. Rice, Samuel E. Rice-Townsend, Frank O. Richards, Gail L. Rodgers, Pierre E. Rollin, José R. Romero, G. Ingrid J.G. Rours, Anne H. Rowley, Sharon L. Roy, Lorry G. Rubin, Guillermo M. Ruiz-Palacios, Lisa Saiman, Laura Sass, Jason B. Sauberan, Peter M. Schantz, Eileen Schneider, Gordon E. Schutze, Benjamin Schwartz, Heidi Schwarzwald, Kara N. Shah, Samir S. Shah, Andi L. Shane, Craig A. Shapiro, Eugene D. Shapiro, Umid M. Sharapov, Jana Shaw, George Kelly Siberry, Jane D. Siegel, Robert David Siegel, Nalini Singh, Upinder Singh, P. Brian Smith, John D. Snyder, David E. Soper, Mary Allen Staat, J. Erin Staples, Jeffrey R. Starke, William J. Steinbach, Ina Stephens, Joseph W. St. Geme, Bradley P. Stoner, Jonathan B. Strober, Kanta Subbarao, Deanna A. Sutton, Douglas Swanson, Leonel T. Takada, Jacqueline E. Tate, Robert V. Tauxe, Marc Tebruegge, Eyasu H. Teshale, George R. Thompson, Herbert A. Thompson, Richard B. Thomson, Emily A. Thorell, Rania A. Tohme, Robert W. Tolan, Philip Toltzis, James Treat, Stephanie B. Troy, Russell B. Van Dyke, Jorge J. Velarde, Jennifer Vodzak, Ellen R. Wald, Geoffrey A. Weinberg, A. Clinton White, Marc-Alain Widdowson, Harold C. Wiesenfeld, John V. Williams, Roxanne E. Williams, Rodney E. Willoughby, Craig M. Wilson, Sarah L. Wingerter, Jerry A. Winkelstein, Kimberly A. Workowski, Terry W. Wright, Pablo Yagupsky, Nada Yazigi, Catherine Yen, Edward J. Young, Andrea L. Zaenglein, and Theoklis E. Zaoutis

Published
2012
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29. Invasive group A streptococcal disease: Management and chemoprophylaxis

Author

DL Moore and Upton D Allen

Subjects
Microbiology (medical), medicine.medical_specialty, business.industry, Clindamycin, Streptococcal disease, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502, Surgery, Infectious Diseases, Pharmacotherapy, Chemoprophylaxis, Paediatric Infectious Disease Notes, medicine, Invasive group, Intensive care medicine, business, Beta lactam antibiotics, medicine.drug
Abstract

Given the potentially devastating consequences of severe invasive group A streptococcal disease, attention has been directed toward the role of chemoprophylaxis and the optimization of management strategies. In response to this issue, Canadian guidelines were previously developed. However, the uptake of these recommendations is variable across Canada. The present document summarizes key components of the recommendations for use by Canadian physicians. The importance of penicillin in the treatment of group A streptococcal disease is reaffirmed, and the role of clindamycin is discussed. In addition, in situations in which chemoprophylaxis may be considered, the preferred agents are summarized.

Published
2011

30. Contributors

Author

George J. Alangaden, Michael J. Aldape, Jérôme Allardet-Servent, Upton D. Allen, Heidi S.M. Ammerlaan, Emmanouil Angelakis, Andrew Artenstein, David Asboe, Kingsley B. Asiedu, John C. Atherton, Tar-Ching Aw, Seema Baid-Agrawal, Robin Bailey, Christopher Bandel, Philip S. Barie, David J. Barillo, Pierre-Alexandre Bart, Roger Bayston, C. Ben Beard, Nick J. Beeching, Rodolfo E. Bégué, Yves Benhamou, Constance A. Benson, Elie F. Berbari, Anthony R. Berendt, Madhav P. Bhatta, Jacques Bille, Ari Bitnun, Finn T. Black, Iain Blair, Stéphane Blanche, Thomas P. Bleck, Chantal P. Bleeker-Rovers, Gijs Bleijenberg, Karen C. Bloch, Marc J.M. Bonten, Charles A.B. Boucher, Rafik Bourayou, Emilio S. Bouza, William R. Bowie, Barry D. Brause, Sylvain Brisse, Warwick Britton, Itzhak Brook, David W.G. Brown, Christian Brun-Buisson, James C.M. Brust, Amy E. Bryant, André Bryskier, R. Mark L Buller, Karen Bush, Thierry Calandra, D. William Cameron, Michel Caraël, Michael J. Carr, Inmaculada Casas, Stephen T. Chambers, Katarina G. Chiller, Tom M. Chiller, Peter L. Chiodini, Ian Chopra, Anthony C. Chu, Kevin K. Chung, Benjamin M. Clark, Nathan Clumeck, Clay J. Cockerell, Jonathan Cohen, John Collinge, Christopher P. Conlon, G. Ralph Corey, Alan Cross, John H. Cross, Judith Currier, Carmel M. Curtis, Gina Dallabetta, Robert N. Davidson, Jane Davies, Jeremy Day, Nicholas P.J. Day, Cillian F. De Gascun, Stéphane de Wit, Jean Delmont, David T. Dennis, David J. Diemert, Mehmet Doganay, Tom Doherty, Christiane Dolecek, Stéphane Y. Donati, Arjen M. Dondorp, Barbara Doudier, Michel Drancourt, Dimitri M. Drekonja, Richard H. Drew, Jay S. Duker, J. Stephen Dummer, Charles N. Edwards, Miquel B. Ekkelenkamp, Mark C. Enright, Paul R. Epstein, Veronique Erard, Alice Chijioke Eziefula, Mark B. Feinberg, Florence Fenollar, Alan Fenwick, Luis Fernandez, Joshua Fierer, Roger G. Finch, Charles W. Flexner, Ad C. Fluit, Elizabeth Lee Ford-Jones, Pierre-Edouard Fournier, Victoria Fraser, Martyn A. French, Jon S. Friedland, Joseph M. Fritz, E. Yoko Furuya, Kenneth L. Gage, Lynne S. Garcia, Arturo S. Gastañaduy, Khalil G. Ghanem, Maddalena Giannella, Carol A. Glaser, Marshall J. Glesby, Sarah Glover, Youri Glupczynski, John W. Gnann, Andrew F. Goddard, Ellie J.C. Goldstein, Iveth J. González, Sherwood L. Gorbach, Bruno Gottstein, Ravi Gowda, John D. Grabenstein, John M. Grange, Michael D. Green, Stephen T. Green, Danielle T. Greenblatt, Brian Greenwood, Aric L. Gregson, Andreas H. Groll, Aditya K. Gupta, Kok-Ann Gwee, William Hall, Scott M. Hammer, Sajeev Handa, Diane Hanfelt-Goade, Alexandre Harari, Marianne Harris, Barry J. Hartman, Roderick J. Hay, David K. Henderson, Lisa E. Hensley, Luke Herbert, David R. Hill, Timothy J. Hills, John David Hinze, Hans H. Hirsch, Bernard Hirschel, Andy I.M. Hoepelman, Steven M. Holland, Mary M. Horgan, Robin Howe, James M. Hughes, Mark W. Hull, Clark B. Inderlied, Michael G. Ison, Peter J. Jenks, James R. Johnson, Theodore Jones, Mettassebia Kanno, Carol Kauffman, Patrick Kelly, Jason S. Kendler, Yoav Keynan, Ali S. Khan, Grace T. Kho, George R. Kinghorn, Paul E. Klapper, Jan AJW Kluytmans, Menno Kok, Isabelle Koné-Paut, John N. Krieger, Aloys C.M. Kroes, Frank P. Kroon, Christine J. Kubin, Alberto M. La Rosa, Tahaniyat Lalani, David G. Lalloo, Harold Lambert, Luce Landraud, Stephen D. Lawn, Phillipe Lehours Pharm, Marc Leone, Itzchak Levi, Alexandra M. Levitt, H. D. Alan Lindquist, Graham Lloyd, David J. Looney, Franklin D. Lowy, Benjamin J. Luft, William A. Lynn, Mark J. Macielag, Philip A. Mackowiak, Paul A. MacPherson, Valérie Maghraoui-Slim, Janice Main, Vincent Mallet, Julie E. Mangino, Oriol Manuel, Oscar Marchetti, Kristen Marks, Kieren A. Marr, Claude Martin, Pablo Martín-Rabadán, Augusto Julio Martinez, Ellen M. Mascini, Kenneth H. Mayer, Joseph B. McCormick, Rose McGready, Michael W. McKendrick, Simon Mead, Francis Mégraud, André Z. Meheus, Graeme Meintjes, Marian G. Michaels, Michael Miles, Alastair Miller, Matthew J. Mimiaga, Marie-Paule Mingeot-Leclercq, Thomas G. Mitchell, Pamela A. Moise, Julio Montaner, Caroline B. Moore, Philippe Moreillon, Peter Morgan-Capner, Valentina Montessori, Peter Moss, Patricia Muñoz, Kurt G. Naber, Sammy Nakhla, Jai P. Narain, Dilip Nathwani, Paul Newton, Chinh Nguyen, Lindsay E. Nicolle, Michael S. Niederman, Gary J. Noel, S. Ragnar Norrby, François Nosten, Luigi Daniele Notarangelo, Paul Nyirjesy, P. Ronan O'Connell, Jon S. Odorico, Edmund L.C. Ong, Steven M. Opal, L. Peter Ormerod, Douglas R. Osmon, Eric A. Ottesen, Gustavo Palacios, Giuseppe Pantaleo, Laurent Papazian, Philippe Parola, Manuel A. Pascual, Eleni Patrozou, Carlos Paya, Sharon J. Peacock, Jean-Claude Pechère, Mark D. Perkins, Barry Peters, Gaby E. Pfyffer, Paul A. Pham, Peter Piot, Geraldine Placko-Parola, Stainslas Pol, Klara M. Posfay-Barbe, William G. Powderly, Anton Pozniak, Guy Prod'hom, Thomas C. Quinn, Daniel W. Rahn, Aadia I. Rana, Didier Raoult, Raul Raz, Raymund Razonable, Robert C. Read, Stephen J. Reynolds, Malcolm D. Richardson, Christopher C. Robinson, Suzan H.M. Rooijakkers, Daniel Rosenbluth, Sergio D. Rosenzweig, Clarisse Rovery, Robert H. Rubin, Bina Rubinovitch, Kathleen H. Rubins, Ethan Rubinstein, Greg Ryan, Stephen Ryder, Steven Safren, Vikrant V. Sahasrabuddhe, Pekka A.I. Saikku, George Sakoulas, Juan Carlos Salazar, Michelle R. Salvaggio, Kirsten Schaffer, Franz-Josef Schmitz, Robert T. Schooley, Richard-Fabian Schumacher, Euan M. Scrimgeour, James Seddon, Harald Seifert, Graham R. Serjeant, Beverly E. Sha, Keerti V. Shah, Daniel S. Shapiro, Gerard Sheehan, Shmuel Shoham, Cameron P. Simmons, Kari A. Simonsen, Neeraj Singh, Mary P.E. Slack, Jack D. Sobel, Madhuri M. Sopirala, Lisa A. Spacek, Shiranee Sriskandan, Samuel L. Stanley, James M. Steckelberg, Iain Stephenson, Dennis L. Stevens, Walter L. Straus, Willem Sturm, Richard C. Summerbell, Joseph S. Susa, Sarah J. Tabrizi, Marc A. Tack, Randy Taplitz, Pablo Tebas, Marleen Temmerman, Steven F.T. Thijsen, Lora D. Thomas, Gail Thomson, Guy E. Thwaites, Umberto Tirelli, Nina E. Tolkoff-Rubin, Tone Tønjum, Francesca J. Torriani, Gregory C. Townsend, Gloria Trallero Masó, Paul M. Tulkens, Allan R. Tunkel, Emanuela Vaccher, Anaïs Vallet-Pichard, Françoise Van Bambeke, Diederik van de Beek, Jos W.M. van der Meer, Anton M. van Loon, Jos van Putten, Bernard P. Vaudaux, Sten H. Vermund, Hans Verstraelen, Paul Verweij, Raphael P. Viscidi, Kumar Visvanathan, Govinda S. Visvesvara, Lorenz von Seidlein, Florian M.E. Wagenlehner, Victoria Wahl-Jensen, Thomas J. Walsh, David C. Warhurst, David W. Warnock, David A. Warrell, Mary J. Warrell, Adilia Warris, Rainer Weber, Wolfgang Weidner, Vivienne C. Weston, Estella Whimbey, Michael Whitby, Peter J. White, Christopher J.M. Whitty, Rob J.L. Willems, Emrys Williams, Cara Wilson, Mary E. Wilson, Richard E. Winn, Kevin L. Winthrop, Martin J. Wiselka, Hilmar Wisplinghoff, Cameron R. Wolfe, Robin Wood, Natalie Wright, James R. Yankaskas, Najam A. Zaidi, Jonathan M. Zenilman, Yaobi Zhang, Arie J. Zuckerman, Jane Nicola Zuckerman, and Alimuddin Zumla

Published
2010
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31. The battle against influenza: The role of neuraminidase inhibitors in children

Author

Upton D Allen

Subjects
Microbiology (medical), Oseltamivir, biology, Rimantadine, medicine.drug_class, business.industry, Antibiotics, Amantadine, Outbreak, Virology, Virus, lcsh:Infectious and parasitic diseases, Sialic acid, chemistry.chemical_compound, Zanamivir, chemistry, Pediatrics, Perinatology and Child Health, Paediatric Infectious Disease Notes, medicine, biology.protein, lcsh:RC109-216, Viral shedding, business, Neuraminidase, medicine.drug
Abstract

Influenza viruses continue to be a major cause of morbidity and mortality worldwide. During outbreaks of influenza, the highest attack rates are among school-aged children. Secondary spread occurs to adults and other children in the family. The secondary spread is facilitated by viral shedding, which can be quite prolonged in young children (1). In neonates, influenza has been associated with significant morbidity, including a sepsis-like syndrome, apnea and lower respiratory tract disease. Children younger than five years of age have the second highest rates of infection with influenza and hospitalization, which are exceeded only by persons older than 65 years of age (1,2). Increased rates of hospitalization during influenza seasons have been observed among previously healthy infants and young children (3). Besides admissions to hospitals, influenza accounts for a substantial number of outpatient visits and antibiotic prescriptions in children (4,5). Given the burden of influenza infections in children despite the medical community’s best efforts at prevention, treatment strategies are required for certain groups of children, including children at risk of severe complications from influenza. Among the traditional therapeutic agents, only amantadine (Symmetrel, DuPont Pharma, Canada) is approved for treatment in children, and neither amantadine nor rimantadine (Flumadine, Forest Laboratories Inc, USA; not approved for use in Canada) is effective against influenza B. The newly approved neuraminidase inhibitors are active against both influenza A and B (6-8). While the bulk of the evidence for the effectiveness of the neuraminidase inhibitors has been derived from studies in adults and children older than 12 years of age, on-going studies are addressing the role of these agents in the management of influenza infections in young children. INFLUENZA VIRUS NEURAMINIDASE Neuraminidase is a surface glycoprotein that has enzymatic activity essential for the replication of influenza A and B (8). The enzyme catalyses the cleavage of the -ketosidic linkage that exists between a terminal sialic acid, N-acetyl neuraminic acid and an adjacent sugar residue. This action has a number of important effects that enable the spread of the virus within the respiratory tract. These effects include the release of the virus from infected cells, the prevention of viral aggregates after release from host cells, the prevention of viral inactivation and the promotion of viral penetration into respiratory cells.

Published
2000

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