Analysis of <i>Neisseria gonorrhoeae</i> and <i>Mycoplasma genitalium</i> from nucleic acid amplification test specimens, Nunavut region of Inuit Nunangat, Canada, 2020–2023
Bibliographic record
Abstract
ABSTRACT This study analyzed Neisseria gonorrhoeae (GC) and Mycoplasma genitalium (Mgen) from remnant nucleic acid amplification test (NAAT) specimens in Nunavut, Canada (2020–2023) to assess strain distribution, antimicrobial resistance (AMR), and co-infection rates. Among 2,221 GC-positive specimens, no cephalosporin resistance was detected, but intermediate-to-decreased susceptibility increased in 2023. Predicted ciprofloxacin resistance was 45%, and azithromycin resistance remained stable at 9.6%. Of 778 tested specimens, 31.4% were co-infected with Mgen, with 49.2% associated with azithromycin resistance, but none with moxifloxacin resistance. These findings highlight emerging AMR trends and support reassessment of current treatment guidelines. Remnant urine specimens submitted for nucleic acid amplification testing identified differences in the prevalence and AMR patterns in GC and Mgen in a large Canadian Arctic territory. IMPORTANCE Nunavut has the highest gonorrhea rates in Canada, yet antimicrobial resistance (AMR) surveillance is limited to culture-based testing. This study bridges that gap by using molecular assays to predict AMR directly from remnant nucleic acid amplification test specimens, providing data for remote regions that lack the resources to culture and transport Neisseria gonorrhoeae cultures. Findings highlight relevant AMR trends for gonorrhea treatment. Mgen, despite increasing clinical prevalence and high co-infection rates with other sexually transmitted infections, is not included in national surveillance programs, furthering the need for extended monitoring.
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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) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| 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".