Colonization of Returning Travelers With CTX‐M‐Producing<i>Escherichia coli</i>
Bibliographic record
Abstract
BACKGROUND: We previously identified foreign travel as a risk factor for acquiring infections due to CTX-M (active on cefotaxime first isolated in Munich) producing Escherichia coli. The objective of this study was to assess the prevalence of extended-spectrum β-lactamase (ESBL)-producing E coli among stool samples submitted from travelers as compared to non-travelers (a non-traveler had not been outside of Canada for at least 6 months before submitting a stool specimen). METHODS: Once a travel case was identified, the next stool from a non-traveler (not been outside of Canada for at least 6 months) was included and cultured on the chromID-ESBL selection media. Molecular characterization was done using polymerase chain reaction and sequencing for bla(CTX-Ms), bla(TEMs), bla(SHVs), plasmid-mediated quinolone-resistant determinants, O25-ST131, phylogenetic groups, pulsed-field gel electrophoresis (PFGE), and multilocus sequencing typing. RESULTS: A total of 226 individuals were included; 195 (86%) were negative, and 31 (14%) were positive for ESBL-producing E coli. Notably, travelers were 5.2 (95% CI 2.1-31.1) times more likely than non-travelers to have an ESBL-producing E coli cultured from their stool. The highest rates of ESBL positivity were associated with travel to Africa or the Indian subcontinent. Among the 31 ESBL-producing E coli isolated, 22 produced CTX-M-15, 8 produced CTX-M-14, 1 produced CTX-M-8, 12 were positive for aac(6')-Ib-cr, and 8 belonged to clone ST131. CONCLUSIONS: Our study confirms that foreign travel, especially to the Indian subcontinent and Africa, represents a major risk for rectal colonization with CTX-M-producing E coli and contributed to the Worldwide spread of these bacteria.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".