Bibliographic record
Abstract
Background The rapidly changing antimicrobial susceptibility of N. gonorrhoeae since the introduction of antibiotics has created challenges in gonorrhoea control. Antimicrobial resistance has regularly appeared and expanded with every release of new classes of antibiotics for gonorrhoea. Methods The Gonococcal Antimicrobial Surveillance Programme (GASP) has been documenting the emergence and spread of antimicrobial resistance in gonorrhoea since 1992 and has informed treatment guidelines. Results Sixty two countries participated in GASP in varying degrees including the extend of specific antimicrobials tested for resistance in 2010. There are high rates of resistance in N. gonorrhoeae to penicillin and quinolones. There are 36 countries reporting increasing minimum inhibitory concentration (MIC) to Cefixime (≥ 0.25 μg/mL) or Ceftriaxone (≥ 0.125 μg/mL). Treatment failures to Ceftriaxone were reported in Japan, Austria, Australia, Canada, France, Norway, Slovenia, Sweden, UK and South Africa. Majority of reports is from developed countries. This is only the tip of the global health burden as surveillance data from resource-constrained settings are scarce. Spectinomycin and azithromycin resistance are monitored in limited countries. Brunei, China, Mongolia and Russia reported decreased susceptibility to spectinomycin. Resistance to azithromycin has been identified in some European countries, US and Chile. Azithromycin resistance remains well below the 5% threshold in most countries. Conclusions Treatment options for gonorrhoeae is dwindling. In the short term, options for treatment will include increasing dosage, using intramuscular or intravenous route and multiple doses of Ceftriaxone; use of alternative medication (e.g. gentamycin), and combination therapies. In the long term there is a need to develop newer classes of antibiotic. There is a need to ensure rational drug use and strengthen antimicrobial resistance monitoring in gonorrhoea including detection and management of treatment failure.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".