The ability of prior urinary cultures results to predict future culture results in neurogenic bladder patients
Bibliographic record
Abstract
AIMS: To determine if previous urinary cultures can predict the organism and susceptibility of subsequent urinary cultures in patients with neurogenic bladder dysfunction. METHODS: We retrospectively identified a sample of neurogenic bladder patients from a tertiary care urology clinic (July 2015-July 2016). We reviewed the patient chart, and then used the electronic laboratory record to identify all urine cultures done in the 2 years prior. We identified sequential culture pairs and determined the concordance of the initial culture organism to the subsequent one and similarly the concordance of the initial culture's antibiotic resistance status to the subsequent culture's one. RESULTS: We identified 146 people with neurogenic bladder (mostly due to spinal cord injury [n = 61], multiple sclerosis [n = 26], or spina bifida [n = 25]). These individuals used primarily intermittent catheterization (n = 69, 47%) spontaneous voiding (n = 59, 40%), or indwelling foley catheter (n = 31, 21%). During the previous 2-years, 81 participants had at least two positive urine cultures and a total of 479 cultures could be examined for organism/susceptibility concordance. There was 56% concordance of bacterial species between subsequent urine cultures, and this decreased significantly with increasing time between cultures (P = 0.02). Antibiotic susceptibility concordance was high for ciprofloxacin (77%), nitrofurantoin (79%), and trimethoprim-sulfamethoxazole (75%), with no significant change with increasing time between cultures (P > 0.90). CONCLUSIONS: Previous positive urine cultures can provide valuable information regarding future organism and antibiotic susceptibility in individuals with neurogenic bladder. The practise of reviewing the previous urine culture when selecting empiric therapy is likely an effective practise in this population.
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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 | 0.001 |
| 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".