Comparative analysis of urinary antibiograms in community pediatric and geriatric populations in British Columbia, Canada
Bibliographic record
Abstract
Background: The Clinical and Laboratory Standards Institute (CLSI) recommends the development of enhanced antibiograms specifically for elderly patients (&ge;65 years) to address the needs of long-term care facilities and to account for the anatomical sites from which specimens are collected, thereby facilitating antimicrobial stewardship. Similarly, the Canadian Pediatric Society advocates developing local, age-specific antibiograms to guide antimicrobial selection for targeted infections. Objective: This study aimed to develop antibiograms based on uropathogens identified at LifeLabs in British Columbia (BC), Canada. Methods: Urinary specimens from pediatric (<18 years) and geriatric (&ge;65 years) patients were collected and processed at LifeLabs, a community laboratory network comprising 129 collection centers across BC, between October 1, 2023, and September 30, 2024. Urinary antibiograms for both groups were developed in accordance with CLSI guidelines. Results: Among the 13,870 pediatric specimens, the most common uropathogen was Escherichia coli (13.7%), followed by Enterococcus faecalis (2.0%), Proteus mirabilis (1.1%), Streptococcus agalactiae (0.9%), Staphylococcus saprophyticus (0.9%), and Klebsiella pneumoniae (0.5%). Among the 148,480 geriatric specimens, the most common uropathogen was E. coli (17.1%), followed by E. faecalis (3.6%), K. pneumoniae (3.4%), S. agalactiae (2.0%), P. mirabilis (1.3%), and Pseudomonas aeruginosa (0.8%). Among the routine antimicrobials tested, ciprofloxacin consistently demonstrated significantly different susceptibility rates (p<0.05) between the pediatric and geriatric groups: E. faecalis (96.3% vs. 81.4%), E. coli (73.7% vs. 67.3%), and P. mirabilis (92.6% vs. 84.8%). Conclusion: The distribution of common uropathogens and their susceptibilities differed between pediatric and geriatric groups, supporting the need for age-specific antibiograms in community settings. Ciprofloxacin demonstrated lower susceptibility to the predominant uropathogens in elderly patients. Community antimicrobial stewardship teams should acknowledge these differences to better prioritize interventions tailored to each age group.
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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 | 0.001 | 0.004 |
| 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) | 0.000 | 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".