Epidemiology of borderline oxacillin‐resistant <i>Staphylococcus aureus</i> in Pediatric cystic fibrosis
Bibliographic record
Abstract
A single-center retrospective study was undertaken in children with cystic fibrosis (CF) to evaluate (1) risk factors for acquisition; (2) molecular epidemiology; and (3) impact on disease progression of borderline oxacillin-resistant Staphylococcus aureus (BORSA) versus mecA-positive methicillin-resistant Staphylococcus aureus (MRSA). The study comprised of (1) identification of all children with at least one respiratory specimen positive for either BORSA or MRSA during the study period; (2) compilation of relevant clinical and epidemiological data from 12-month period leading up to first positive (index) culture; (3) microbiological and molecular characterization of index isolates and (4) measurement of subsequent clinical outcome. Thirty-eight children were identified with at least one positive isolate; 4 were excluded due to insufficient clinical or laboratory data. Eighteen children (53%) grew BORSA in their index culture. Children who acquired BORSA only (n = 16) were more likely to have had prior MSSA colonization (P < 0.0001). Usage of oral cephalexin (P < 0.01) and inhaled tobramycin (P < 0.03) prior to index culture was significantly and independently associated with acquisition of BORSA. The majority of BORSA isolates were hyper β-lactamase producers and susceptible to a greater range of antibiotics. Strain relatedness was not evident within the BORSA group. There was no difference in disease progression between the two groups. This is the first study to demonstrate that a significant proportion of S. aureus isolates with methicillin resistance in the CF population are BORSAs that lack mecA. Antibiotic pressure may lead to the development of BORSA in CF patients. Prospective studies are needed to assess its clinical impact.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".