Shifting From an Expected to an Opportunistic Pathogen: Characteristics and Trends of Infant Late and Very Late Onset Group B streptococcal (GBS) infection in a Canadian city over a 27-year period
Bibliographic record
Abstract
Abstract Background Despite decades of study, the characteristics of infants with invasive group B streptococcus (GBS) late onset disease (LOD) (onset day 7 to 89 of life) and in particular very late onset disease (VLOD) (after day 89 of life) are not well described. Materials and Methods This was a retrospective cohort study of infants hospitalized in four Edmonton hospitals April 1, 1994 through June 30, 2022 with LOD or VLOD GBS invasive disease. Data were collected on demographics, date of onset of GBS infection, clinical manifestations and outcomes. Results There were 115 episodes of LOD in 111 infants of which 49 (45%) were preterm. Onset was on median day 27 (IQR 19-40.5) of life. All but one infant was bacteremic while 38 (34%) had proven and 17 (15%) had possible GBS meningitis. Five (5%) died before hospital discharge with all deaths presumed to be due to GBS. There were 11 episodes of VLOD in 11 infants (7 [64%] preterm) presenting on median day 116 (IQR 103-138) (range 93-207) of life. Three (27%) had GBS meningitis. All survived to discharge. Infants with VLOD were less likely to be born vaginally and more likely to be mechanically ventilated during their birth hospitalization and have invasive disease with other pathogens than were infants with LOD. Serotype III accounted for 78% of LOD and 64% of VLOD cases. Conclusion GBS remains a significant cause of infant morbidity and mortality. There is increasing evidence that GBS may sometimes be an opportunistic pathogen in infants over 90 days of age.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".