P686 The enhanced surveillance of antimicrobial-resistant gonorrhea (ESAG) in canada
Bibliographic record
Abstract
<h3>Background</h3> Gonorrhea (GC) is the most commonly reported drug resistant sexually transmitted infection (STI) in Canada with 23,708 cases reported in 2016, double the 11,874 cases reported in 2007, corresponding to an 81% increase in rates. Only about 19% of these were cultured, meaning that direct AMR data was only available for one-fifth of GC cases. The Public Health Agency of Canada (PHAC) launched the Enhanced Surveillance of Antimicrobial-Resistance Gonorrhea (ESAG) program in 2013 in three jurisdictions (Alberta, Manitoba, and Nova Scotia) in order to improve the understanding of current trends of AMR-GC. This enhanced laboratory-epidemiological linked surveillance program collects data not available via its existing routine and laboratory surveillance. <h3>Methods</h3> All cultures and data from participating jurisdictions are included in the surveillance program. The National Microbiology Laboratory performs antimicrobial susceptibility testing for a panel of antimicrobials and sequence typing. Enhanced epidemiological data collected includes treatment information and risk factors. <h3>Results</h3> From 2014–2017, ESAG captured 2767 cultures from 2566 cases. The majority of the cases were male (81%) and less than 40 years old (83%). There was a 25% decrease from 2014 to 2017 in the number of cases from men who have sex with men. The proportion of isolates demonstrating resistance to at least one antibiotic agent steadily increased from 2014 (54%) to 2016 (66%), dropping to 58% in 2017. Large declines in decreased susceptibility to both cefixime (91%) and ceftriaxone (88%) and increasing rates of resistance to azithromycin were observed. <h3>Conclusion</h3> ESAG data for 2014–2017 demonstrated decreased susceptibility to the preferred therapy antimicrobials, suggesting that resistance to these key antimicrobials could complicate GC treatment considerably in the future. The expansion of ESAG remains a priority with negotiations currently underway with the remaining jurisdictions with the goal national representation. <h3>Disclosure</h3> No significant relationships.
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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 | 0.000 |
| 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) | 0.001 | 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".