Gram-positive pathogens from Canadian hospitals: 17 years of results from the CANWARD study (2007–23)
Bibliographic record
Abstract
OBJECTIVES: CANWARD is a Canadian Antimicrobial Resistance Alliance (CARA)/Health Canada partnered national surveillance study established in 2007 to annually assess antimicrobial susceptibilities for bacterial pathogens isolated from patients receiving care in Canadian hospitals. This paper focuses on Gram-positive pathogens. METHODS: In total, 25 897 Gram-positive pathogens were received and 22 132 underwent CLSI broth microdilution testing providing susceptibility data. RESULTS: 47.9%, 30.2%, 5.7% and 16.2% of isolates tested were from blood, respiratory, urine and wound specimens, respectively; 29.9%, 24.8%, 19.0%, 18.1% and 8.2% of isolates were from patients in medical wards, emergency rooms, intensive care units, hospital clinics and surgical wards. Patient demographics associated with the isolates were: 58.9% male/41.1% female; 13.5% patients aged ≤17 years, 48.5% 18-64 years and 38.0% ≥ 65 years. Of the 25 897 pathogens received, the most common were: Staphylococcus aureus [20.9% (MSSA 16.5%/MRSA 4.4%)], Streptococcus pneumoniae (5.2%) and Enterococcus spp. (Enterococcus faecalis and Enterococcus faecium) (5.0%). MRSA rates (MRSA as a % of all S. aureus tested) decreased significantly during 2007-15 from 26.0% to 19.3% (P < 0.0001); subsequently they increased significantly through study years 2016-23 (16.9%-24.1%; P = 0.002). VRE rates (VRE as a % of all E. faecium tested) ranged from 3.8% to 18.4%, with marked fluctuation year-to-year. Susceptibility rates for MRSA were highest with: 100% ceftobiprole, 99.9% linezolid, vancomycin and daptomycin, 99.8% dalbavancin and 99.4% tedizolid, while susceptibility rates for VRE were 98.4% daptomycin and 86.0% with linezolid. CONCLUSIONS: The CANWARD surveillance study has provided 17 years of reference antimicrobial susceptibility testing data on Gram-positive pathogens.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.008 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".