Inter-country transfer of Gram-negative organisms carrying the VIM-4 and OXA-58 carbapenem-hydrolysing enzymes
Bibliographic record
Abstract
1Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia; 2Microbiology and Infectious Diseases Department, Women's and Children's Hospital, Adelaide, Australia; 3Microbiology Department, Royal Melbourne Hospital, Melbourne, Australia Sir, The widespread dissemination of acquired carbapenem-hydrolysing enzymes, particularly Ambler classes B [metallo-β-lactamases (MBLs)] and D (oxacillinases), is of great clinical concern. Of the MBLs, the IMP and VIM types are the most frequent, with more than 20 countries reporting their presence.1 The VIM-4 enzyme was first described from a Pseudomonas aeruginosa isolate from Larissa, Greece,2 and, soon after, an outbreak occurred at that institution. The blaVIM-4 gene has also been reported from Italy and Poland, but thus far there have been no reports from Australia.1 The class D carbapenemases are now divided into four distinct phylogenetic clusters: OXA-23 (OXA-23 and OXA-27), OXA-24 (OXA-24, OXA-25, OXA-26 and OXA-40), OXA-58 and OXA-51. OXA-58 has recently been shown to contribute significantly to carbapenem resistance in Acinetobacter baumannii, especially when additional efflux mechanisms are expressed.3 This enzyme has now been reported from France, Spain, Turkey and Romania, and, more recently, from Australia4 and Greece.5 The role of international travel in the global dissemination of carbapenemase genes is often reported, but rarely has this been well illustrated.6
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 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".