744. Changing Molecular Epidemiology of Staphylococcus aureus Bacteremia in a Metropolitan Area in Canada
Notice bibliographique
Résumé
Abstract Background The incidence of Staphylococcus aureus bacteremia (SAB) has increased in Alberta over the past two decades. It is unclear whether this trend reflects the expansion of a single strain or multiple strains and how much it has been influenced by changes in antibiotic use and resistance. Methods We used data from 5,881 S. aureus isolates representative of all SAB episodes from patients in the greater Calgary region from 2006-2019. Bacteremia episodes were defined as all positive isolates collected from a patient within a 30-day period. Each episode was categorized as community-onset (within 48 hours after admission) or hospital-onset (after 48 hours post admission). Isolates for which sequencing was successful (97.8%) were assigned strain and clonal complex (CC) designations. We computed the incidence of strains and antimicrobial susceptibility to cloxacillin, clindamycin, erythromycin, and ciprofloxacin. Antibiotic prescribing rates for the region were obtained from Alberta Health Services. Results SAB incidence increased from 30 to 40 per 100,000 population. The prevalence of resistance to cloxacillin, clindamycin, erythromycin, and ciprofloxacin fluctuated and decreased from a maximum of 31.8% to 15.6%, 28.2% to 19.2%, 39.1% to 27.5%, and 37.4% to 15%, respectively, by the end of the study period. An overall increase in S. aureus antibiotic susceptibility was driven primarily by an increased incidence of susceptible sub-lineages within several strains (CC30, CC5, CC8, CC45, CC15, CC97) mainly causing community-onset SAB. The incidence of SAB resistant to all four antibiotics decreased over the study period due to a decline in community and hospital-onset infections by one resistant sub-lineage of CC5; from 4.1 to 0.3 per 100,000 population, and was associated with a decline in community antibiotic prescribing for beta-lactamase resistant penicillins, lincosamides, macrolides, and fluoroquinolones (from 6.07 to 3.07, 17.5 to 16, 77 to 73.6, and 55.6 to 40.3 age-standardized number of dispensation per 1,000 population). Incidence rate of Staphylococcus aureus bacteremia per 100,000 Calgary residents stratified by community- and hospital-acquired infections. Bacteremia episodes were defined as all isolates collected from a patient within a 30-day period, and the incident isolate represents the first isolate from each episode. Prevalence of resistance to cloxacillin, clindamycin, erythromycin, and ciprofloxacin between 2006 and 2019. Points represent the proportion of incident isolates resistant to the respective antibiotic. Solid lines are smoothing curves using the loess method. Grey bands represent 95% confidence intervals. Incidence rate of Staphylococcus aureus bacteremia per 100,000 Calgary residents stratified by onset of infection. Points represent the incidence rate, dashed lines are linear interpolations between points, solid lines represent smoothing curves using the loess method. Grey bands represent 95% confidence intervals. Clonal complex designations in brackets represent the clonal complex assigned to the majority of the isolates for the respective strain. Conclusion From 2006-2019, Calgary observed a decline in community antibiotic use, a reduction in the incidence of a resistant strain, and a greater increase in the incidence of community-onset SAB caused by several antibiotic susceptible strains. Disclosures Dan Gregson, MD, BioMerieux Canada: Advisor/Consultant Yonatan H. Grad, MD, PhD, Day Zero Diagnostics: Board Member|GSK: Advisor/Consultant
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,003 | 0,005 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».