<i>Editorial Commentary:</i>Decreased Effectiveness of Metronidazole for the Treatment of<i>Clostridium difficile</i>Infection?
Bibliographic record
Abstract
Since the emergence of a new virulent strain of Clostridium difficile—characterized as toxinotype III, North American PFGE type 1 (NAP1), restriction endonuclease analysis group type BI, and PCR ribotype 027 (type 027)—multiple outbreaks have been reported in North America and Europe [1, 2]. The first reports were from Canada, where the province of Quebec was the earliest and most severely affected [3]. In the United States, at least 38 states have been affected by the new emerging strain [4]. Outbreaks in the United Kingdom and The Netherlands have been followed by a rapid spread of the strain throughout Europe, now including 18 countries [5]. A worrisome new development is outbreaks in Europe attributable to clindamycin-resistant NAP1/027 strains (MIC, >256 mg/L) that harbor the ermB gene [6]. Clindamycin has been considered to be a “protective” antibiotic for the development of C. difficile–associated disease (CDAD) attributable to NAP1/027, but resistance to this agent increases the risk of C. difficile infection in patients, and the use of this agent may be an important factor contributing to the persistence and spread of this strain [7].
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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 | 0.005 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.005 | 0.001 |
| Research integrity | 0.027 | 0.022 |
| Insufficient payload (model declined to judge) | 0.012 | 0.009 |
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".