P648 Factors associated with<i>neisseria gonorrhoeae</i>azithromycin resistance in the quebec sentinel network, 2015–2017
Bibliographic record
Abstract
<h3>Background</h3> <i>N. gonorrhoeae</i> azithromycin resistance (MIC ≥ 2 mg/L) increased from 1.7% to 30.9% between 2013 and 2017 in Quebec, Canada. The Quebec sentinel network aims to 1) maintain a sufficient number of cultures for antimicrobial resistance surveillance; 2) link antimicrobial susceptibility surveillance to epidemiological and clinical information; and 3) monitor treatment failures. We herein examine the associations between <i>N. gonorrhoeae</i> azithromycin resistance and epidemiological/clinical characteristics. <h3>Methods</h3> Three regions participated: Montréal (two clinics recruiting mostly men having sex with men (MSM)), Montérégie (22 clinics recruiting mostly heterosexuals) and Nunavik (participated only in 2016, recruited mainly heterosexual Inuit people). One strain per year, per individual was selected. When data was presented for 2015–2017 (2015 was incomplete), the most recent strain per individual was considered. Proportions were compared using chi-square tests. <h3>Results</h3> Between September 2015 and December 2017, 68% of episodes (840/1240) had a culture performed and 571 strains were obtained, including all duplicates. This analysis includes 190 strains in 2016, 270 strains in 2017 and 469 strains for 2015–2017. Most isolates were collected in MSM (349/469; 76%). Sampling sites were urethra (329/469; 70.2%), rectum (90/469; 19.2%) and pharynx (50/469; 10.7%). Azithromycin resistance was significantly higher in MSM (25.5% vs 9.2% in heterosexuals, p<0.001), in cases who reported previous gonorrhea (27.3% vs 15.3%, p=0.004), syphilis (29.5% vs 19.8%, p=0.045), HIV (31.8% vs 20.1%, p=0.035) and who reported a sex partner outside Quebec in 2016 (36.7% vs 16.8%, p=0.021), but this difference was not maintained in 2017 (21.2% vs 21.7%, p=0.951). No significant difference was observed with regard to age, number of sex partners, anatomical site and presence of symptoms. <h3>Conclusion</h3> Recommendations to perform cultures appear to be well implemented (70% of episodes). Azithromycin resistance seems to be well established in Quebec with a possible declining contribution of travel-acquired resistant infection. <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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".