P3.221 High levels of susceptibility in<i>neisseria gonorrhoeae</i>isolates from saskatchewan canada (2003–2015) to new and older antibiotics used for treatment
Bibliographic record
Abstract
Introduction Antibiotics should have an efficacy of at least 95% for treating infections caused by Neisseria gonorrhoeae (Ng). When more than 5% of Ng isolates are resistant to an antibiotic, treatment guidelines must be changed to a more effective antibiotic. Trends in the antimicrobial susceptibility (AMS) of Ng isolates from Saskatchewan, Canada were ascertained (2003 – 2015) to ascertain whether older antimicrobials might be effective. Methods The susceptibility of 685 Ng isolates to 7 antibiotics was determined by the agar dilution method. β-lactamase production was determined using nitrocefin. Results From 2006–2012, penicillin resistance was below 5% (0%–4.0%) of Ng isolates tested. Penicillin resistance above 5% occurred in 2003 (6.7%), 2004 (6.8%), 2005 (11.5%), 2013 (27.5%) and 2014 (13.5%). Tetracycline resistance remained above 5% (11.8% to 89.1%) of Ng tested throughout the study. Ciprofloxacin resistance ranged between 0% and 1.9% of isolates tested up to 2009 but was over 5% thereafter. All isolates were susceptible to spectinomycin. Over 95% of Ng isolates tested were susceptible to azithromycin except in 2010 (27.6% resistant; 8/29) and 2013 (7.2% resistant; 5/69). Twelve (1.8%) isolates over the period showed reduced susceptibility to cefixime (2006 - 1/55; 2012 - 2/50; 2013 - 4/69; 2014 - 2/89; 2015 - 1/63) and/or ceftriaxone (2012 - 2/50). One isolate was resistant to both azithromycin and cefixime. Conclusions Cases of gonorrhoea in Saskatchewan (>95%) are diagnosed by nucleic acid testing with no AMS testing. Our research showed that many no-longer recommended antibiotics (penicillin, ciprofloxacin) were still effective over many years. Even with the recent higher percentages of Ng isolates resistant to penicillin and ciprofloxacin, ~87% of Ng in the province remains susceptible to these antibiotics. The development of NAATs to test for AMS would enhance knowledge of true levels of resistance and allow discretion as to whether older but still effective antibiotics could be used in individual patient care.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".