Metronidazole-resistant trichomoniasis: Two Canadian cases
Bibliographic record
Abstract
Metronidazole-resistant trichomoniasis is a health burden for patients, and limited access to susceptibility testing and treatment is a challenge for Canadian clinicians. These cases emphasize the burden of metronidazole resistance in our population. Herein we describe two cases of metronidazole-resistant trichomoniasis. In one case, a patient underwent five courses of therapy to treat a persistent Trichomonas vaginalis infection. International culture and susceptibility testing revealed resistance to metronidazole and susceptibility to tinidazole. The patient was subsequently lost to follow-up. In another case, a patient was treated with six courses of therapy before their infection had cleared. International culture and susceptibility testing indicated resistance to metronidazole and intermediate resistance to tinidazole. In both cases, metronidazole treatment, either alone or in addition to another therapy, was attempted an average of 3.5 times in escalating dose regimens before switching to tinidazole. Tinidazole proved to be an effective second-line therapy when tolerated by the patient. Until susceptibility testing is available in Canada, clinicians should be aware of access to international susceptibility testing of T. vaginalis to appropriately identify metronidazole-resistant cases and make timely and informed decisions regarding treatment.
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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 | 0.009 |
| 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 | 0.001 |
| 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".