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Outbreaks of Mycoplasma pneumoniae occur every 37 years, with the proportion of respiratory tract infections caused by M. pneumoniae ranging from 0 to 30 depending on the year and region studied. These outbreaks typically occur in late summer and fall and can last for months. School-aged children and adolescents are primarily affected, and transmission rates are low in nonepidemic years. M. pneumoniae infection should be considered in the differential diagnosis of prolonged paroxysmal cough, along with pertussis. The presentation of M. pneumoniae pneumonia is usually subacute with persistent cough and malaise after a few days of influenzalike illness. Rare extrapulmonary manifestations can occur, such as encephalitis, erythema multiforme, myocarditis, arthritis, and hemolytic anemia. Polymerase chain reaction testing should be performed for patients with unexplained protracted cough and bilateral interstitial infiltrates on chest radiograph or those with extrapulmonary manifestations. Treatment is indicated for persistent or severe symptoms, and macrolides, tetracyclines, and fluoroquinolones are effective. It is important to wait for the PCR result before initiating therapy, especially in nonepidemic years. In cases of confirmed M. pneumoniae pneumonia that do not improve on macrolides, treatment should be changed to fluoroquinolones or tetracyclines.

Paquette et al present several facts about parechovirus infections in infants. Severe parechovirus infections are mostly caused by genotype PeV-A3. Outbreaks of PeV-A3 typically follow a biennial pattern. In Jul 2022, the US Centers for Disease Control and Prevention issued a health advisory to alert clinicians of reports of PeV-A3 cases in multiple states. A similar outbreak was observed in parts of Canada, including Montréal. As with enteroviruses, parechoviruses circulate primarily during summer and fall.

Assessment criteria for septic transfusion reactions (STRs) are variable around the world. A scoping review will be carried out to find out, explore and map existing literature on STRs associated criteria. This scoping review will include indexed and grey literatures available in English or French language from January 1, 2000, to December 31, 2021. Literature search will be conducted using four electronic databases (i.e., MEDLINE via PubMed, Web of Science, Science Direct, and Embase via Ovid), and grey literatures accompanying the research questions and objectives. Based on the inclusion criteria, studies will be independently screened by two reviewers for title, abstract, and full text. Extracted data will be presented in tabular form followed by a narrative description of inputs corresponding to research objectives and questions.

Maternal Cytomegalovirus (CMV) infection in the first trimester (T1) of pregnancy is a public health concern, as it increases the risk of severe neurodevelopmental outcomes associated with congenital infection compared to infections occurring later during pregnancy. To determine CMV seroprevalence in T1 of pregnancy, its trend, risk factors and the incidence rate of primary infection during pregnancy. Using the biobank of the prospective cohort \"Grossesse en Santé de Québec\" collected between April 2005 and March 2010 at the Québec-Laval Hospital, Québec, Canada, maternal CMV serology was determined using Abbott Architect Chemiluminescence microparticle immunoassays for immunoglobulin G(IgG), immunoglobulin M(IgM) titration and IgG avidity testing. Changepoint detection analysis was used to assess temporal trends. Risk factors associated with seropositivity were determined by multivariable logistic regression. CMV seroprevalence in T1 of pregnancy was 23.4% (965/4111, 95% CI, 22.1-24.7%). The incidence rate for CMV primary infection during pregnancy was 1.8 (95% CI, 1.2-2.6) per 100 person-years. No changepoint was identified in the maternal CMV-seroprevalence trend. Multivariable analyses showed that T1 maternal CMV seropositivity was associated with having one child OR 1.3 (95% CI, 1.10-1.73) or two or more children OR 1.5 (95%CI, 1.1-2.1), ethnicity other than Caucasian OR 2.1 (95% CI, 1.1-3.8) and country of birth other than Canada and the USA OR 2.8 (95% CI, 1.5-4.9). In this cohort, maternal seroprevalence in T1 of pregnancy and seroconversion rate were low. This information and identified risk factors could help guide the development and implementation of preventive actions and evidence-based health policies to prevent CMV infection during pregnancy.

Background Despite growing interest in universal screening for congenital CMV infection (cCMV), and data to support treatment for cases with central nervous system (CNS) involvement, there is limited regarding the optimal imaging modalities to identify CNS involvement. The objective of this study was to assess the concordance between head ultrasound (US) and magnetic resonance imaging (MRI) or computed tomography (CT), in identifying neurological abnormalities in infants with cCMV infection, and to determine whether the addition of advanced neuroimaging after US had an impact on clinical management. Methods Retrospective review of infants with cCMV infection, referred to the Centre d’Infectiologie Mère-Enfant (CIME) at Sainte-Justine Hospital Center in Montreal, between 2008 and 2016. Only patients who underwent head US followed by and brain MRI or CT scan were included in this analysis. Results Of 46 cases of cCMV identified during the study period, 34 (74%) had a head US followed by MRI ( n  = 28, 61%), or CT scan ( n  = 6, 13%). In the majority of cases ( n  = 24, 71%), both images were concordant (11 both reported abnormal, 13 both reported normal). In 5 cases, US was reported normal and subsequent imaging (MRI = 4, CT = 1); reported abnormal. In all 5 cases patients were clinically symptomatic and met treatment criteria even in the absence of neuroimaging findings. In 5 cases, US was reported abnormal with a subsequent normal MRI (4) or CT (1); in 2 of these cases, patients were clinically symptomatic and met treatment criteria regardless of neuroimaging findings. However, in 3 cases, the patients were clinically asymptomatic, and in 2 of these cases, treated based only on the abnormal US findings. Conclusions In this study, we found that that sequential US and MRI were concordant in the majority (71%) of cases in detecting abnormalities potentially associated with cCMV infection. While the addition of MRI to baseline head ultrasound did not influence the decision to treat in clinically symptomatic infants, the addition of MRI to infants with abnormal HUS imaging who are clinically asymptomatic could help refine treatment decisions in these cases.

Background Cytomegalovirus (CMV) is associated with congenital infections that can lead to severe developmental and neurological complications in affected children. Daycare workers, who frequently interact with infants and young children, may be at higher risk of CMV infection. This study aims to investigate the rates of primary infection and reinfection of CMV among female daycare workers in the province of Québec, Canada to better understand the risk of occupational exposure in this population. Methods This mixed-method observational study protocol uses quantitative (prospective cohort) and qualitative (semi-structured interviews with daycare workers) components. Female daycare workers ( n  = 553) are recruited and enrolled in a prospective cohort study, with a non-daycare workers comparison group comprising hospital employees and plasma donors who do not have direct professional contact with children < 36 months of age (low-risk group, n  = 1659, 1:3 ratio). Participants are followed for 12 months, with blood for CMV serology, strain-specific antibody profiling with CMV-specific ELISA, CMV quantitative polymerase chain reaction (qPCR) and CMV-Scan assay collected from all participants at the first (V0) and last (V12) study visits. Among daycare workers and hospital employees, saliva samples are collected at these visits and monthly throughout the study for testing via CMV qPCR. Testing enables the identification of primary infections, reinfections, and reactivations, and estimates the association between demographic and occupational factors and CMV infection. Additionally, qualitative data is collected through interviews with daycare workers and daycare managers, focusing on their perceptions of CMV risks and current infection control practices. Discussion This study is expected to improve the understanding of CMV epidemiology among a high-risk group (i.e. female daycare workers). By estimating the incidence of CMV infections and patterns of viral shedding, the findings may inform occupational health strategies and public health policies. Based on our findings, guidelines aimed at preventing CMV infections could help protect not only daycare workers but also vulnerable populations, including young children and immunocompromised individuals, with whom they interact.

To perform a post-outbreak prospective study of the Pseudomonas aeruginosa contamination at the faucets (water, aerator and drain) by culture and quantitative polymerase chain reaction (qPCR) and to assess environmental factors influencing occurrence A 450-bed pediatric university hospital in Montreal, Canada Water, aerator swab, and drain swab samples were collected from faucets and analyzed by culture and qPCR for the post-outbreak investigation. Water microbial and physicochemical parameters were measured, and a detailed characterization of the sink environmental and design parameters was performed. The outbreak genotyping investigation identified drains and aerators as the source of infection. The implementation of corrective measures was effective, but post-outbreak sampling using qPCR revealed 50% positivity for P. aeruginosa remaining in the water compared with 7% by culture. P. aeruginosa was recovered in the water, the aerator, and the drain in 21% of sinks. Drain alignment vs the faucet and water microbial quality were significant factors associated with water positivity, whereas P. aeruginosa load in the water was an average of 2 log higher for faucets with a positive aerator. P. aeruginosa contamination in various components of sink environments was still detected several years after the resolution of an outbreak in a pediatric university hospital. Although contamination is often not detectable in water samples by culture, P. aeruginosa is present and can recover its culturability under favorable conditions. The importance of having clear maintenance protocols for water systems, including the drainage components, is highlighted.

While children have experienced less severe coronavirus disease (COVID-19) after SARS-CoV-2 infection than adults, the cause of this remains unclear. The objective of this study was to describe the humoral immune response to COVID-19 in child vs. adult household contacts, and to identify predictors of the response over time. In this prospective cohort study, children with a positive SARS-CoV-2 polymerase chain reaction (PCR) test (index case) were recruited along with their adult household contacts. Serum IgG antibodies against SARS-CoV-2 S1/S2 spike proteins were compared between children and adults at 6 and 12 months after infection. A total of 91 participants (37 adults and 54 children) from 36 families were enrolled. Overall, 78 (85.7%) participants were seropositive for anti-S1/S2 IgG antibody at 6 months following infection; this was higher in children than in adults (92.6% vs. 75.7%) (p = 0.05). Significant predictors of a lack of SARS-CoV-2 seropositivity were age ≥ 25 vs. < 12 years (odds ratio [OR] = 0.23, p = 0.04), presence of comorbidities (vs. none, adjusted OR = 0.23, p = 0.03), and immunosuppression (vs. immunocompetent, adjusted OR = 0.17, p = 0.02).

Leigh Syndrome French Canadian (LSFC) is a rare autosomal recessive metabolic disorder characterized by severe lactic acidosis crises and early mortality. LSFC patients carry mutations in the Leucine Rich Pentatricopeptide Repeat Containing (LRPPRC) gene, which lead to defects in the respiratory chain complexes and mitochondrial dysfunction. Mitochondrial respiration modulates cellular metabolic activity, which impacts many cell types including the differentiation and function of immune cells. Hence, we postulated that, in addition to neurological and metabolic disorders, LSFC patients may show impaired immune activity. To gain insight into the quality of the immune response in LSFC patients, we examined the response to the measles, mumps and rubella (MMR) vaccine by measuring antibody titers to MMR in the plasma. In a cohort of eight LSFC patients, the response to the MMR vaccine was variable, with some individuals showing antibodies to all three viruses, while others had antibodies to two or fewer viruses. These results suggest that the mutations in the LRPPRC gene present in LSFC patients may affect the immune response to vaccines. Monitoring vaccine response in this fragile population should be considered to ensure full protection against pathogens.