Research Studies & Projects

Reproductive Infectious Diseases Program research areas of focus include: HIV, human papillomavirus, Hepatitis, perinatal infections, the vaginal microbiome, and antimicrobial stewardship.

Selected current RID Team studies:

Principal Investigator: Dr Chelsea Elwood

Primary Contact: Chelsea Elwood, B.M.ScH, M.Sc, MD,FRCSC, Reproductive Infectious Diseases Specialist, Medical Lead Antimicrobial Stewardship, Department of Obstetrics and Gynecology, University of British Columbia
Chelsea.Elwood@cw.bc.ca
About the Study: The term antimicrobial stewardship was first described as the appropriate use of antibiotics that could help prevent or revert antimicrobial resistance patterns. This includes selecting an appropriate antibiotic, at an optimal dose and duration to eliminate infection while also minimizing toxicity and resistance. Education is a key facet of any antimicrobial stewardship program.
OBGYN residents at BC Women’s Hospital currently engage in a specific curriculum focusing on antimicrobial stewardship (AMS) teaching in the form of academic half days, journal club, lecture, and AMS handshake teaching rounds. The purpose of this study is to assess the effectiveness of this education program on improving residents AMS knowledge by administering a quiz at 3 time points: before, halfway through, and after 8 months of education. These data may be used to inform changes in the curriculum for future improvement.
Study status:  In preparation
Who can participate:  UBC OBGYN Residents at BC Women's Hospital

Principal Investigator: Dr Chelsea Elwood

Primary Contact:
Chelsea Elwood, B.M.ScH, M.Sc, MD,FRCSC, Reproductive Infectious Diseases Specialist, Medical Lead Antimicrobial Stewardship, Department of Obstetrics and Gynecology, University of British Columbia
Chelsea.Elwood@cw.bc.ca

About the Study:

Maternal sepsis is one of the most common contributors to global maternal death and sepsis related maternal morbidity and mortality remains a significant problem even in developed nations.

The objectives of this study are to describe the incidence of bacteremia at our institution, the source of the bacteremia and organisms recovered from the positive blood cultures, and the antibiotics used to treat the identified positive blood cultures. The secondary objectives of this study are to describe maternal, fetal and/or newborn outcome.

A retrospective hospital-based chart review of women who had positive peripartum blood cultures drawn will be undertaken for the years 2015-2018. This data will be linked to two an existing study database containing the same data from 2011-2015, and existing hospital readmission data.

Study Status: Chart review and data analysis

Principal Investigator: Dr Deborah Money
 
Primary Contact: Evelyn Maan, Research Manager, 604-767-5044, emaan@cw.bc.ca
 
About the study: Anti-HIV drugs reduce the chance of HIV transmission from mother to child from 25% to less than 1%. It has been shown that some anti-HIV drugs, as an unwanted side effect, may have a toxic effect on the cells of the body. Some of the medications can have an effect on different body systems that leads to mitochondrial (energy-producing part of body cells) dysfunction. When the mitochondria are not working properly (mitochondrial toxicity) the body can start to build up high levels of lactate (a byproduct of cell function). Some doctors have expressed concerns that mitochondrial toxicity may be even more common in pregnant women than in other adults on these medications.

Preterm delivery is twice as common in women with HIV than women without and the precise cause is unknown.

The purpose of this project is to study the effect of taking anti-HIV drugs during pregnancy using two new laboratory tests. One will test the level of function of the mitochondria and the other test will look at damage drugs may do to the length of DNA at the end of chromosomes. Additionally, we aim to better understand factors that contribute to preterm delivery in HIV+ pregnancies.

Study status: Recruiting at two sites - Vancouver and Montreal

Who can participate: Pregnant women living with HIV who are taking, or are going to be taking, anti-HIV medication during their pregnancy.

Co-Investigators: Dr. Helene Cote, Dr. Julie van Schalkwyk, Dr. Isabelle Boucoiran, Dr. Chelsea Elwood, Dr Ariane Alimenti, Dr Wendy Robinson

Funded by: CIHR

Partners: None

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Primary Investigator: Dr. Julie van Schalkwyk

Primary Contact:   Chelsea Elwood, B.M.ScH, M.Sc, MD,FRCSC, Reproductive Infectious Diseases Specialist, Medical Lead Antimicrobial Stewardship, Department of Obstetrics and Gynecology, University of British Columbia
Chelsea.Elwood@cw.bc.ca

 

About the Study: Sepsis in labour is currently the leading cause of maternal and neonatal morbidity and mortality. Despite significant advances in medical care, sepsis is on the rise. Intra­amniotic infection (IAI) is the most common precursor to sepsis in the setting of labour and delivery. We are reviewing all women with fever in labour in order to identify clinical parameters that can better predict the need for escalation in care. This is in the hopes of proposing a modified scoring system to determine if it is possible to accurately identify patients at risk of IAI, sepsis and adverse fetal and maternal outcomes. If validated, this tool would allow BC Women's Hospital, and other isolated obstetric care facilities in the province, to predict which women will need escalated care, and could significantly impact the health outcomes of mothers and their newborns.

Principal Investigator: Dr. Deborah Money

Primary Contact: Nancy Lipsky, Research Manager, nlipsky@cw.bc.ca, 604-875-2424 Ext. 4877

About the study: This study aims to better understand how the HPV vaccine works in HIV positive girls and women over the long term and to clarify how care can be provided to best protect this population from HPV infection and associated cervical cancer and genital warts. Infection with human papillomavirus (HPV) is the leading cause of cervical cancer and genital warts.  This study extends follow-up of girls and women living with HIV who received a least one dose of quadrivalent human papillomavirus (HPV) vaccine through the first phase of this research.  353 girls and women from across Canada are therefore eligible and are asked to participate in 3 approximately annual study visits.  At each visit, participant health status is reviewed and blood samples and vaginal swabs are taken to assess response to the HPV vaccine and efficacy of the vaccine in preventing HPV infection and associated diseases over time.

Study status: As of June 2019 last visit is complete with 241 women re-engaged to the project and 580 visits complete.

Co-Investigators & Collaborators: Dr. Neora Pick (University of British Columbia), Dr. Mel Krajden (University of British Columbia), Dr. Gina Ogilvie (University of British Columbia), Dr. Simon R.M. Dobson (University of British Columbia), Dr. Marianne Harris (University of British Columbia), Dr. Fiona Smaill (McMaster University), Dr. Lindy Samson (Children’s Hospital of Eastern Ontario), Dr. Sean Ari Bitnun (University of Toronto), Dr. Mona Loutfy (Women’s College Research Institute), Dr. Fatima Kakkar (Universite de Montreal), Dr. Mark Yudin (University of Toronto), Dr. Sharon Walmsley (University of Toronto), Dr. Marina Klein (McGill University), Dr. Francois Coutlee (Universite de Montreal), Dr. Janet Hill (University of Saskatchewan), Dr. Janet Raboud (University of Toronto), Dr. Wendy Wobeser (Queen’s University), Dr. Sylvie Trottier (Universite Laval), Dr. Catherine Hankins (University of Amsterdam), Dr. Normand Lapointe (Hopital Sainte Justine), Dr. Darrell Tan (University of Toronto), Dr. Jason Brophy (University of Ottawa), Dr. Andrew Coldman (BC Cancer Agency), Dr. Angela Kaida (Simon Fraser University), Dr. Arianne Alimenti (University of British Columbia), Dr. Christos Karatzios (University of Montreal), Dr. Dirk van Niekirk (BC Cancer Agency), Dr. Jan Christilaw (BC Women’s Hospital and Health Centre), Dr. Jeff Cohen (HIV Care Program, Ontario), Dr. Joel Singer (Canadian HIV Trials Network), Dr. Julie van Schalkwyk (University of British Columbia), Ms. Laurie Edmiston (CATIE), Ms. Marcie Summers (Positive Women’s Network).

Funded by: Canadian Institutes of Health Research and further supported by the Canadian HIV Trials Network.

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Principal Investigator: Dr. Deborah Money

Primary Contact: Zahra Pakzad, Research Manager, 604-875-2424 ext. 6379, zahra.pakzad@cw.bc.ca

About the study: The role of bacterial communities throughout the body in health and disease is being widely studied. Preliminary research shows a possible link between delivery type (vaginal or caesarean delivery) and the bacterial communities found in the gut in early infancy. In Canada 1 in 4 women have a caesarean delivery and there is some evidence of increased risk of conditions such as asthma, celiac disease, and allergies in caesarean-born infants. To date no cause for this increased risk has been identified. Some researchers have proposed that this potential transfer of maternal vaginal bacteria may be prevented by a caesarean delivery. This may result in altering the establishment of the infant’s own bacterial community. However a clear link between delivery type and the infant’s bacterial community has not been established.

This study will use advanced gene-based methods to profile the bacterial communities present in women who deliver vaginally or via caesarean section and connect these to the infant gut bacterial community in the first 3 months of life. This research will lead to a deeper understanding of the potential role of the maternal bacterial community on the infant gut bacterial community

Interested in ParticipatingFollow the link to the survey, to have us contact you.

Study status: Recruitment and data collection ongoing

Co-Investigators: Dr. Janet Hill (University of Saskatchewan), Dr. K.S. Joseph (University of British Columbia), Dr. Julie van Schalkwyk (University of British Columbia), Dr. Arianne Albert (B.C. Women’s Hospital, Vancouver), Dr. Chelsea Elwood (University of British Columbia), Dr. Soren Grantt (University  of British Columbia), Dr. Kirsten Grabowska (University of British Columbia), Dr. Jennifer Hutcheon (University of British Columbia), Dr. Matthew Links (University of Saskatchewan), Dr. Amee Manges (University of British Columbia), Dr. Sheona Mitchell (University of British Columbia), Dr. Tim Dumonceaux (Agriculture and Agri-Food Canada, Saskatchewan), Dr. Zoe Hodgson (B.C. Women’s Hospital), Dr. Janet Lyons (University of British Columbia).

Funded by: Canadian Institutes of Health Research (CIHR)

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Principal Investigator: Dr Chelsea Elwood

Primary Contact: Chelsea Elwood, B.M.ScH, M.Sc, MD,FRCSC, Reproductive Infectious Diseases Specialist, Medical Lead Antimicrobial Stewardship, Department of Obstetrics and Gynecology, University of British Columbia
Chelsea.Elwood@cw.bc.ca
About the Study:

Penicillin allergy is a common drug allergy diagnosis, yet studies have shown that 90% of those labelled with a Penicillin allergy have negative testing when assessed and/or tested by an Allergist. Almost all of this data comes from adult non­pregnant patients. This study will prospectively enroll women who are undergoing Penicillin allergy de­labelling at the newly created Penicillin Allergy Clinic at BCWH

Study Status: Recruiting

Who can participate: The new penicillin allergy de-labelling clinic will be available for all women registered to deliver at BCWH. Any health care provider with privileges at BC Women’s Hospital can refer their patient to the penicillin de-labelling clinic. The referral form can be located and downloaded from the BCWH website.

Co-Investigators: Elisabeth McClymont, Dr. Julie van Schalkwyk, Dr. Arianne Albert, Dr. Raymond Mak, Dr. Vanessa Paquette, Dr. Ashley Roberts

Principal Investigator: Dr. Chelsea Elwood

Primary Contact: Chelsea Elwood, B.M.ScH, M.Sc, MD,FRCSC, Reproductive Infectious Diseases Specialist, Medical Lead Antimicrobial Stewardship, Department of Obstetrics and Gynecology, University of British Columbia
Chelsea.Elwood@cw.bc.ca
About the Study: Recent evidence has suggested that HPV vaccination may reduce the risk of preterm birth. It is important to determine if this is also the case in British Columbia. This project will determine the feasibility of linking existing provincial databases that contain information on HPV vaccination status and details of pregnancy and delivery to begin to understand if the risk of preterm birth is lower in HPV-vaccinated women. This catalyst project will foster future research utilizing the same linkage and will allow us to continue to assess reproductive outcomes associated with HPV vaccination in the coming years. The pilot data generated will allow us to seek additional funding for a larger Canadian study answering the same question on a national scale. If the risk of preterm birth is reduced by HPV vaccination, this knowledge can directly benefit women and provide public health officials with an additional angle to promote vaccination. In addition, vaccination against HPV could result in improved reproductive outcomes both nationally and globally for women and their infants.

Study Status: Data analysis

Co-Investigators: Elisabeth McClymont, Dr. Gina Ogilvie, Dr. Marette Lee, Dr. Deborah Money

Funded by: BC Women’s Health Foundation

Principal Investigator: Dr. Deborah Money

Primary Contact: Zahra Pakzad, Research Coordinator, 604-875-2424 ext. 6379, zahra.pakzad@cw.bc.ca

About the study: The VOGUE study team is comprised of a diverse group of scientists and clinicians from across Canada who are using genomic methods to study the microbial ecosystem (microbiome) of the vagina in varying states of health and disease. The VOGUE research program comprises 5 sub-studies, each examining the vaginal microbiome of distinct clinical populations: healthy non-pregnant women, women living with HIV, women with recurrent vulvovaginitis, pregnant women at low risk for preterm birth, and pregnant women at high risk for preterm birth. The team is united in their goal of capitalizing on advances in genomic sequencing technology to analyze the composition, distribution, and function of vaginal microbes, and probe the links between these microbes and disease to guide the development of novel diagnostic tools and interventions to improve women’s health in Canada and around the world.

Study status:  Recruitment for all sub-studies is complete. Data analysis, manuscript development, and knowledge translation are ongoing.

Co-Investigators: Dr. Alan Bocking (University of Toronto), Dr. Sean Hemmingsen (National Research Council’s Plant Biotechnology Institute, Saskatchewan), Dr. Janet Hill (University of Saskatchewan), Dr. Gregor Reid (University of Western Ontario), Dr. Tim Dumonceaux (Agriculture and Agri-Food Canada, Saskatoon), Dr. Gregory Gloor (University  of Western Ontario), Dr. Matthew Links (Agriculture and Agri-Food Canada, Saskatoon), Dr. Kieran O’Doherty (University of Guelph), Dr. Patrick Tang (Sidra Medical and Research Center), Dr. Julie van Schalkwyk (University of British Columbia), Dr. Mark Yudin (University of Toronto).

Funded by: Canadian Institutes of Health Research (CIHR) and Genome BC

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