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Our objective was to evaluate the diagnostic yield and accuracy of the BioFire FilmArray Pneumonia Panel (BFPP) for identification of pathogens in lower respiratory tract specimens (n=200) from ED and ICU patients at a tertiary care academic medical center. Specimens were collected between January and November 2018, from patients ≥18 years of age, and had a culture performed as part of standard of care testing. The BFPP identified a viral or bacterial target in 117/200 (58.5%) samples, including Staphylococcus aureus in 22% of samples and Haemophilus influenzae in 14%, and both a viral and bacterial target in 4% of samples. The most common viruses detected by BFPP were rhinovirus/enterovirus (4.5%), influenza A (3%), and RSV (2%). Overall, there was strong correlation between BFPP and standard methods for detection of viruses (99.2%) and bacteria (96.8%). Most bacteria (60/61 [98.4%]) detected by standard methods were also identified by BFPP; and 92 additional bacteria were identified by BFPP alone, including 22/92 (23.9%) additional S. aureus and 25/92 (27.2%) H. influenzae, which were more frequently discordant when detected at low concentrations (S. aureus, p less then 0.001; H. influenzae, p less then 0.0001) and in sputum-type specimens (S. aureus, p less then 0.05). A potential limitation of the BFPP assay is the absence of fungal targets and Stenotrophomonas maltophilia, which were detected in 26 and 4 of 200 specimens, respectively. Real-time specimen analysis with BFPP has the potential to identify bacterial pathogens and resistance markers 44.2 and 56.3 h faster than culture-based methods. The BFPP is a rapid and accurate method for detection of pathogens from lower respiratory tract infections. Copyright © 2020 American Society for Microbiology.Background Compared to the standard two-tier testing algorithm (STTT) for Lyme disease serology using an enzyme immunoassay (EIA) followed by Western blot, data from the United States (US) suggests that a modified two-tiered testing (MTTT) algorithm employing two EIAs has improved sensitivity to detect early localized Borrelia burgdorferi infections, without compromising specificity. From 2011-2014, in the Canadian province of Nova Scotia where Lyme disease is hyperendemic, sera submitted for Lyme disease testing was subjected to a whole cell EIA, followed by C6 EIA and subsequently IgM and/or IgG immunoblots on sera with EIA positive or equivocal results. Here we evaluate the effectiveness of the MTTT algorithm compared to the STTT approach in a Nova Scotian population.Methods Retrospective chart reviews were performed on patients testing positive with the whole cell and C6 EIAs (i.e. MTTT algorithm). [https://www.selleckchem.com/products/NVP-AUY922.html selleck inhibitor] Patients were classified as having Lyme disease if they had a positive STTT result; a negative STTT result, but symptoms consistent with Lyme disease; or evidence of seroconversion on paired specimens.Results Of the 10253 specimens tested for Lyme disease serology, 9806 (95.6%) were negative. Of 447 patients that tested positive, 271 charts were available for review, and 227 were classified as patients with Lyme disease. The MTTT algorithm detected 25% more early infections with a specificity of 99.56% (99.41-99.68%) compared to the STTT.Conclusions This is the first Canadian data to show a MTTT has excellent specificity and improved sensitivity for detecting early B. burgdorferi infection compared to the STTT. Copyright © 2020 American Society for Microbiology.Group A Streptococcus (GAS) causes bacterial pharyngitis in both adults and children. Early and accurate diagnosis of GAS is important for appropriate antibiotic therapy to prevent GAS sequalae. The Revogene® Strep A molecular assay (Meridian Bioscience Canada Inc, Quebec City, QC) is an automated real time PCR assay for GAS detection from throat swab specimens within approximately 70 minutes. This multicenter prospective study evaluated the performance of Revogene Strep A molecular assay compared to that of bacterial culture. Dual throat swab specimens in either liquid Amies or Stuart medium were collected from eligible subjects (pediatric population and adults) enrolled across 7 sites (USA and Canada). Revogene Strep A and reference testing was performed within 7 days and 48 hours of sample collection respectively. Of the 604 evaluable specimens, GAS was detected in 154 (25.5%) samples by reference method and 175 (29%) samples by Revogene Strep A assay. Revogene Strep A assay sensitivity and specificity were reported to be 98.1% (95% confidence interval [lsqb]CI[rsqb], 94.4 - 99.3) and 94.7% (95% CI 92.2 - 96.4) respectively. The positive predictive value was 86.3% (95% CI 80.4 - 90.6), negative predictive value was 99.3% (95% CI 98.0 - 99.8) with 1.0% invalid rate. Discrepant analysis with alternative PCR/bidirectional sequencing was performed for 24 false positive (FP) and 3 false negative (FN) specimens. Concordant results were reported for 17 (FP only) of 27 discordant specimens. Revogene Strep A assay had high sensitivity and specificity for GAS detection and provides a faster alternative for GAS diagnosis. Copyright © 2020 American Society for Microbiology.BACKGROUND Several studies have investigated the association of breastfeeding status with offspring mortality in Africa, but most studies were from one center only or had limited statistical power to draw robust conclusions. METHODS Data came from 75 nationally representative cross-sectional Demographic and Health Surveys in 35 countries in sub-Saharan Africa conducted between 2000 and 2016. Our study relied on 217 112 individuals aged 4 days to 23 months for breastfeeding pattern analysis, 161 322 individuals aged 6 to 23 months for breastfeeding history analysis, and 104 427 individuals aged 12 to 23 months for breastfeeding duration analysis. RESULTS Compared with children aged 4 days to 23 months exclusively breastfed in the first 3 days of life, those not breastfed had a high risk of mortality at less then 2 years of age (odds ratio [OR] = 13.45; 95% confidence interval [CI] = 11.43-15.83). Young children who were predominantly breastfed or partially breastfed had moderately increased risk of mortality at less then 2 years of age (OR = 1.