Fatal<i>Balamuthia mandrillaris</i>Meningoencephalitis in the Netherlands after Travel to The Gambia
Bibliographic record
Abstract
International concern is growing regarding antimicrobial drug resistance in Shigella infections associated with India.Fluoroquinolone resistance emerged in S. dysenteriae in 2002, in S. flexneri in 2004, and in S. sonnei in 2007 (5).Studies from Japan have also reported an association between travel to India and infection with an S. sonnei clonal group that was multidrug resistant, including resistance to nalidixic acid (6).Furthermore, ciprofloxacin-resistant S. sonnei isolates from foodborne outbreaks in India in 2009 and 2010 (7) had XbaI-PFGE types and resistance profiles visually indistinguishable from those reported in our study.A study of S. sonnei isolates in Bhutan showed that this clonal group was also common there (8).Furthermore, a 2010 outbreak of ciprofloxacin-resistant S. sonnei in Canada associated with men who have sex with men showed XbaI-and BlnI-PFGE patterns that appear similar to the patterns for isolates in this study (9).Antimicrobial drug resistance is a major global problem that is likely to be exacerbated in places with poor sanitation and intensive use of antimicrobial drugs in humans and animals.These factors have contributed to increased ciprofloxacin resistance in Salmonella enterica serovars Typhi and Paratyphi A (10).A review of published literature and informal communication indicates that our observation of ciprofloxacin resistance in S. sonnei infections associated with travel to India is part of a general global trend.This increasing resistance suggests that ciprofloxacin may no longer be suitable for empiric therapy for S. sonnei infection, particularly for patients with a history of travel to the subcontinent of India.
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.009 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".