bla VIM-Producing Enterobactercloacae in Ontario, Canada: Links Between Sewage, Surface Water, and Human Isolates
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background. In Canada, carbapenemase-producing Enterobacteriaceae (CPE) are rare and usually imported from CPE-endemic countries. We report 2 patient clusters—none with hospitalizations abroad—of Verona integron-encoded metallo-β-lactamase-producing Enterobacter cloacae (VIM-EC) linked to isolates from water in Ontario, Canada. Methods. We analyzed population-based data from Toronto Invasive Bacterial Diseases Network (TIBDN) surveillance from first identified CPE in 2007 until March 2016 to identify VIM-EC colonized/infected patients. Sewage treatment plants (STP) and 1 watershed (WS) in the population area were sampled in 2015. Pulsed-field gel electrophoresis (PFGE) and plasmid sequencing (PS) was performed. Results. We identified 10 patients with VIM-EC; median age 76.5 years; median Charlson score 2 (table). Five developed a urinary tract infection; 1 a blood stream infection. Eight patients comprised 2 PFGE clusters: cluster I linked 4 patients from 3 hospitals to a WS sample and cluster II 4 patients from 2 hospitals to an STP sample (Figures 1 and 2). PS showed high similarity between plasmids from cluster II and the WS sample from cluster I, suggesting horizontal gene transfer. None of the 8 patients linked to a cluster had been hospitalized abroad, whereas the patient with a unique PFGE isolate had been hospitalized in Croatia. Description of Patient and Water Samples With VIM-EC 1within 1 year before detection; += died; PD, peritoneal dialysis fluid; U, urine; R, rectal; UTI, urinary tract infection; BSI, blood stream infection. Conclusion. Most VIM-EC in Ontario is autochthonous, and water may be an important reservoir. More work is urgently needed to identify environmental reservoirs for CPE. Disclosures. J. Powis, GSK: Investigator, Research support; S. Poutanen, Merck: Board Member, Honoraria and Speaker honorarium. Paladin Labs: Board Member, Honoraria. Accelerate Diagnostics: Board Member, Honoraria
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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 it