Utilization of target enriched multiplex PCR for detection of panton-valentine leukocidin in necrotizing pneumonia complicating influenza A
Bibliographic record
Abstract
Necrotizing pneumonia caused by Staphylococcus aureus (SA) is a complication of Influenza A (INFA) related to the SA virulence factor, Panton-Valentine leukocidin (PVL). Patients presenting with Influenza-like illness and respiratory failure underwent bronchoscopy and testing for viral respiratory pathogens and SA using Diatherix target enriched multiplex PCR (Tem-PCR) proprietary assay. The assay is nested PCR, with tagged, target specific primers providing initial target gene identification, and common flanking Super Primers providing bulk amplification. Two patients with SA PVL necrotizing pneumonia complicating INFA are described. 22 yo female presented with respiratory failure, SA-PVL bacteremia and septic shock. Bronchoscopy revealed necrotizing, hemorrhagic pneumonia with specimens positive by Tem-PCR for INFA H3N2 and PVL positive SA. Patient eventually died. 64 yo male presented with progressive shortness of breath after viral illness, rapidly developed septic shock and multiorgan failure. Bronchoscopy showed severe necrotizing hemorrhagic tracheobronchitis. Tem-PCR revealed INFA H1N109 and methicillin resistant PVL positive SA. Patient was successfully treated with linezolid and clindamycin with complete recovery. PVL is a cytotoxin causing leukocyte destruction, tissue necrosis precipitating shock, respiratory failure and leukopenia. Bronchoscopy reveals airway bleeding and acute inflammatory exudate. PVL-producing strains of SA have affinity for exposed basement membrane in the ciliary epithelium of the lung present after viral illness. Tem-PCR is unique technology detecting PVL-positive SA and INFA resulting in targeted therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".