Highlights We evaluated the impact of extended use and H 2 O 2 decontamination on N95 respirators. Extended N95 use and decontamination was associated with a rapid loss of fit test. User seal check overestimated user fit test. Single-use N95 respirator longevity may be shorter than previously reported.

Gabapentinoid prescriptions are increasing in North America, with frequent off-label use despite limited proven efficacy. This retrospective cohort study describes prescribing trends among hospitalized patients with a focus on dosing and deprescribing. We examined consecutive inpatients between December 2013 and July 2017 on a 52-bed medical unit in Montréal, Canada. Prevalence of off-label use, median doses prescribed, and deprescribing trends were analyzed over time. Of 4,103 hospitalized patients, 550 (13.4%) were prescribed gabapentinoids preadmission, with two patients being coprescribed gabapentin and pregabalin (total 552 prescriptions). A minority (94/552, or 17%) were for approved indications. Although it was uncommon for gabapentinoids to be newly prescribed in hospital, preadmission gabapentinoids were also seldom deprescribed (65/495 patients discharged alive, or 13%). Given a high prevalence of use, limited efficacy, and potential harms, gabapentinoids may represent an ideal target for re-evaluation of indication and effectiveness in hospitalized adults, with consideration given to deprescribing.

Multisystem Inflammatory Syndrome in Adults is a rare and life-threatening complication that follows natural COVID-19 infection, primarily affecting young unvaccinated adults. This complication is seldomly described following vaccination, which would have important implications for this population's vaccination timing and platform. COVID-19 vaccines are extremely effective; however, the risk of rare adverse events needs to be balanced with the vaccination benefits.

Aims: We characterize the epidemiology of Actinotignum schaalii within a large Canadian region after implementation of improved identification methods. Patients & methods: Positive cultures for A. schaalii from a centralized microbiology laboratory in Canada were analyzed. Clinical data were retrieved through administrative databases and chart reviews. Primary outcome was incidence of A. schaalii infections; secondary outcomes included mortality, hospital admission and length of stay. Results & conclusions: 86 unique isolates were studied, 37 bloodstream infections (BSI) and 49 non-BSIs. Patients with BSIs were older with more comorbidities, with urinary tract infections implicated as the most frequent source; skin abscesses caused the most non-BSIs. Hospitalization and 90-day mortality was higher in the BSI group. A. schaalii is an important community-acquired pathogen with the potential to cause invasive infections.

Q uebec was the epicentre of the COVID-19 health crisis in Canada between March and August 2020, accounting for more than half of Canada's cases and deaths. 1 As of Feb. 9, 2021, over 271 700 cases and 10 000 deaths attributed to COVID-19 occurred in Quebec, of which more than 50% of cases and 60% of deaths occurred in Montréal. 1 The first case of COVID-19 in Quebec was diagnosed on Feb. 27, 2020, in an international traveller. 2 Early transmission dynamics were driven by returning international travellers, many of whom were returning from school spring break. 2,3 By mid-April, however, numerous outbreaks occurred in public and private residential care facilities (RCFs). The residents of these institutions bore the greatest burden of the first wave of the pandemic, accounting for 70% of the deaths in Canada and Quebec, with a case fatality rate estimated to be 36% (range 20% to 42%). 2,4,5 Of the 59 845 patients with SARS-CoV-2 infection reported in Quebec between Mar. 1 and July 27, 2020, people living in RCFs represented a disproportionate burden of COVID-19, accounting for 23.4% of all patients, 43% of hospitalizations and 84.3% of deaths attributed to During the first wave of the pandemic, the incidence and mortality rates of COVID-19 peaked in Quebec in mid-May