This week in research.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent bacterium in medical settings. It can result in bloodstream infections and other severe illnesses, and patients may have a high risk of dying from these conditions. This study aimed to examine MRSA transmission in hospitals across Alberta and how undetected colonized patients on admission affect MRSA spread. METHODS: We used a Bayesian compartmental model to simulate MRSA spread across 106 acute care hospitals in Alberta. The model assumes that MRSA spreads through interactions between susceptible individuals and MRSA patients, including both hospital-acquired (HA) and community-acquired (CA) MRSA cases. Data from Edmonton, Calgary, rural Alberta and all regions in Alberta were used to fit the model. We also assumed that a small percentage of patients were colonized upon admission but were not promptly identified in hospitals, and we tested the model assumptions. Transmission rates were estimated using a Bayesian framework with Markov chain Monte Carlo (MCMC) algorithms. We compared transmission rates across several regions in Alberta and assessed the effect of MRSA prevalence at hospital admission on MRSA transmission. RESULTS: When the model fit the data in hospitals in all areas of Alberta, the average number of susceptible people colonized due to patients with HA-MRSA colonization, patients with HA-MRSA infections, patients with CA-MRSA colonization, and patients with CA-MRSA infections per contact per month are around 0.03 (95% CI: (0.001, 0.101)), 0.08 (95% CI: (0.002, 0.278)), 0.01 (95% CI: (0.000, 0.033)) and 0.05 (95% CI: (0.001, 0.182)), respectively. Assuming 0.8 colonized cases per 1000 admissions, the average number of susceptible people who become colonized due to patients with HA-MRSA infections per contact per month in Edmonton, Calgary and rural hospitals are 0.05 (95% CI: (0.001, 0.174)), 0.43 (95% CI: (0.018, 1.152)) and 0.22 (95% CI: (0.007, 0.722)), respectively. Assuming more unidentified colonized cases in hospitals, transmission rates between susceptible people and infected patients increase marginally. CONCLUSION: MRSA transmission rates appear to be marginally higher in Calgary hospitals compared to Edmonton, and rural hospitals seem to have lower transmission rates than in Calgary but higher than in Edmonton, with 95% credible intervals (CIs) overlapping. Our model also suggests that infected patients have a higher probability of transmitting MRSA to susceptible people in most Alberta hospitals.

Background Antimicrobial resistance (AMR) in Candida species is an emerging global health threat. This study aims to document the implementation of standardized surveillance tools from the Global Antimicrobial Resistance and Use Surveillance System (GLASS) and to describe the distribution and antifungal resistance profiles of Candida species in bloodstream infections generated through the study outputs. Methods The GLASS-Fungi pilot was a multicentre observational demonstration study where twenty-four laboratories were invited to collect and share Candida bloodstream infections (BSIs) data with the World Health Organization (WHO) using a standardized surveillance protocol and WHONET software. Data were collected for patients with laboratory-confirmed Candida bloodstream infections between January 2017 and July 2021. Participating sites were trained to collect, deduplicate, and report clinical and microbiological data. Patient demographic and microbiological data were summarized using descriptive statistics. The percent distribution of Candida species and resistance profiles were analysed with a 95% confidence interval (CI) calculated using robust standard errors clustered at the site level. Participating sites shared experiences with using the standardised GLASS surveillance tools and procedures through structured feedback forms and consultative meetings. This study was not designed to support causal inference or population-level generalization; analyses are descriptive and intended to illustrate outputs generated through pilot surveillance implementation. Findings Fourteen laboratories from 13 countries contributed data from 3447 patients with candidemia. Overall, Candida albicans was the predominant species (37.6%; 95% CI: 33.8–41.5). C. albicans was most common in the Americas, Europe, and Africa, whereas Candida tropicalis was more prevalent in Southeast Asia. Candida auris was detected by two laboratories in Southeast Asia and Africa. Among isolates with interpretable antifungal susceptibility testing (AFST) results and corresponding established breakpoints, 13.6% (95% CI: 10.1–17.2%) were resistant to at least one antifungal, with fluconazole resistance highest among C. parapsilosis isolates (29.7%; 95% CI: 18.2–41.2). Challenges to scaling up fungal AMR surveillance globally included limited fungal laboratory testing capacity, restricted access to antifungal susceptibility testing, and lack of sustained funding, particularly in low and middle-income countries. Interpretation The study was a global, multi-centre initiative to systematically collect and report surveillance data on Candida BSIs using standardised data collection tools and reporting procedures. The study identified major training capacity and infrastructure gaps. Addressing those is an essential step for anticipating and responding to emerging invasive fungal infections. Funding This work was supported by the United States Centers for Disease Control and Prevention.

This is supplementary data for a paper to be submitted titled, "Marketing Routes, Health Management Practices, and Challenges in Dairy-Beef Production: Producer Perspectives from Atlantic Canada". The purpose of the project is to identify how dairy beef animals are raised in Atlantic Canada and how the different stakeholders are connected through the production chain. Project objectives are as follows: 1) To identify the stakeholders and the dairy-beef production chain in Atlantic Canada. 2) To characterize the dairy-beef production systems in Atlantic Canada in terms of demographics and general management practices. 3) To describe dairy producers’ motivations and challenges toward the dairy-beef production. 4) To describe the commercial routes of dairy beef animals in Atlantic Canada. 5) To describe the antibiotic use practices throughout the dairy-beef production chain in Atlantic Canada.

Introduction: Echinococcus multilocularis is a small but deadly tapeworm species found worldwide that can cause a disease called Alveolar Echinococcosis (AE) in humans and animals (Gottstein et al., 2015; Kolapo et al., 2023; Meyer et al., 2020). AE is a rare zoonotic disease that typically affects the liver of a susceptible host and can be fatal if left untreated (Meyer et al., 2020; WOAH, 2022). E. multilocularis normally occurs in predator-prey cycles of wild definitive hosts (e.g. foxes and coyotes) and intermediate hosts (e.g. rodents; WOAH, 2022). AE occurs in intermediate hosts when eggs are ingested from the environment and are transported to the liver where the metacestode (larval) stage of the parasite proliferates (Lundström-Stadelmann et al., 2025). However, AE has been found in aberrant intermediate hosts (e.g. humans, dogs) increasingly in recent years in both North America and Europe (Jenkins et al., 2025). Currently, most human cases of AE (greater than 90%) are reported in Asia (Torgerson et al., 2010), with most others reported in Europe, where there has been an increase in the parasite’s prevalence and endemic range expansion since 2001 (Jenkins et al., 2025). Prior to 2009, there were only two North American cases of AE in humans (Manitoba 1928, Minnesota 1977; Gamble et al., 1979; James & Boyd, 1937), and none reported in dogs (Jenkins et al., 2025; Kolapo et al., 2023). Similar to trends observed in Europe, animal AE cases (since 2009) and human AE cases (since 2013) have been increasing at a concerning rate, whilst expanding the range of historically endemic areas (Deplazes et al., 2017; Jenkins et al., 2012; Massolo et al., 2014). This increase in prevalence of AE cases could be attributed to the introduction and virulence of the European strain of E. multilocularis (Jenkins et al., 2025; Luong et al., 2020). The global rise of AE cases poses a threat to human and animal health and requires a One Health approach to appropriately coordinate research efforts to respond to this emerging disease. Identification of risk factors of AE could aid in reducing exposure to and transmission of the parasite, as well as early detection of infection. Given the sudden emergence of AE affecting humans and other atypical animal hosts in North America, there is an urgent need to understand the epidemiology of AE. In other endemic parts of the world, such as Asia and Europe, the epidemiology of AE is better understood and could help inform the unprecedented situation in North America. Therefore, to address the knowledge gap in exposure and host risk factors associated with AE in humans and animals, we will identify and synthesize current knowledge from peer-reviewed scientific publications and grey literature globally. Objective: The objective of this review is to identify, assess, and synthesize current knowledge on host and exposure risk factors associated with AE in humans and animals in the peer-reviewed scientific literature, theses and dissertations, and grey literature globally using a One Health framework. Methods: Relevant article databases will be searched for literature on either E. multilocularis or AE in human or animal species. ProQuest Dissertations & Theses global will also be searched to identify relevant dissertations. Additional grey literature sources will be identified through expert consultation to identify data collection tools currently in use for human AE cases. There will be 2 stages that comprise the article screening process. The first stage of screening will be title and abstract, while the second stage is full text. The initial search will include concepts of E. multilocularis and AE in both humans and animals. Inclusion of articles in this review will be peer-reviewed scientific literature (case studies/reports, review articles, and journal articles) and grey literature (data collection tools identified through consultation with experts, conference proceedings, and theses/dissertations) discussing AE caused by infection of E. multilocularis in humans and animals. Any source that clearly is unrelated to risk factors for AE or E. multilocularis will be excluded at the title/abstract stage of screening. Literature that focuses solely on the intestinal form of E. multilocularis and does not discuss the liver form of the disease (AE) will be excluded in this review. Sources will be excluded if they are not written in English. Since 2001, there has been a slow, but steady increase in AE human cases in Europe (Jenkins et al., 2025). In Canada, the index case of confirmed AE in dogs occurred in 2009, and the first confirmed human case (since 1928) was identified in 2013 (James & Boyd, 1937; Massolo et al., 2014; Peregrine et al., 2012). Due to the upward trend of AE prevalence since the early 2000s (in Europe and North America), resources prior to 2000 will be excluded. At the stage of the full-text screening, literature will be included only if exposures, risk factors, predictors, and determinants are discussed and relevant to AE. Exposure risk factors will be defined as external factors that increase the likelihood of a human or animal being exposed to E. multilocularis which could lead to AE. Host risk factors will be defined as internal factors that affect an organism’s predisposition to AE. Data from sources that meet these criteria will be extracted into an Excel spreadsheet for analysis and synthesis. The results will highlight risk factors of consensus across research and grey literature worldwide to address the gaps in knowledge of AE transmission in North America and Europe.