Sensitivity of Different Anatomic Sites for Detection and Duration of Colonization with Carbapenemase-Producing Enterobacteriaceae (CPE)
Bibliographic record
Abstract
CPE are a growing threat worldwide. Screening to identify colonization is critical to control transmission in hospitals, but the sensitivity of screening of different anatomic sites to detect colonization remains uncertain. We describe the results of CPE screening by anatomic site in a study of duration of colonization in Toronto, Canada. The Toronto Invasive Bacterial Diseases Network conducts population-based surveillance of CPE in Toronto/Peel Region. Consenting participants enrolled in the duration of colonization study are screened at enrolment, then q3mo until four consecutive negative swabs are obtained. At each visit, a questionnaire is completed and swabs of groin, rectum and previously positive sites are obtained. Swabs are incubated in BHI broth then planted to MacConkey agar with cefpodoxime. CPE are detected by standard methodology with PCR confirmation. Of 147 eligible patients colonized/infected with CPE, 119 are enrolled, and 465 swab sets have been collected from 99. Overall, 16% (69/434) groin, 21% (92/431) rectal, 27% (22/81) urine, and 17% (9/47) wound cultures yielded CPE. Positive CPE results were obtained in 126 swab sets; in 35 (25%) both rectal and groin yielded CPE, in 57 (45%) only rectal yielded CPE, in 34 (27%) only groin yielded CPE. In 8/22 (36%) culture sets with positive urine specimens CPE was identified only in the urine. Species yield differed by anatomic site, with Klebsiella pneumoniae being detected in 25 (42%) rectal and 34 (58%) groin swabs, and Escherichia coli being detected in 58 (67%) rectal and 29 (33%) groin swabs (P < 0.05). Using rectal swabs only in follow-up would have detected 17/21 (81%) patients followed with both groin/rectal swabs; among 35 urine/groin/rectal specimen sets with at least one swab yielding CPE, 20 (57%) yielded CPE from the rectal swab. Differences in pathogen detection, prevalence, and species suggest multi-site swabbing may be important in identifying CPE colonization. Consistency in the site of detection suggests testing of previously positive sites should not be ignored when assessing duration of colonization. All authors: No reported disclosures.
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.
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 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 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".