Clinical epidemiology of mono-pyrazinamide-resistant Mycobacterium tuberculosis in Quebec
Bibliographic record
Abstract
Rationale. In Quebec, 6.2% of all Mycobacterium tuberculosis (TB) isolates from Canadian-born patients are resistant to pyrazinamide alone (mono-PZA-R). Over 90% of mono-PZA-R isolates in Quebec have been characterized by a specific and unique mutation in the pncA gene. The unusually high prevalence of mono-PZA-R disease and its associated mutational profile in Quebec provided an exceptional opportunity to study the epidemiologic and clinical significance of mono-PZA-resistance in patients with active TB. Methods. 67 patients with mono-PZA-R TB diagnosed between 1 Jan 1990 and 31 Dec 2000 were compared to 211 randomly selected patients with pan-sensitive (Pan-S) isolates diagnosed within the same time period. Demographic, laboratory, and clinical information pertaining to patients diagnosed with TB from the provincial database of Maladies a declarations obligatoires (MADO) were linked to drug resistance profiles derived from the provincial laboratory. Data from MADO were supplemented by other clinical information abstracted from chart review, the provincial drug insurance database, and the provincial registry for Bacillus Calmette Guerin vaccination. Results. There were no statistically significant differences in demographics or clinical characteristics between patients infected with mono-PZA-R compared to Pan-S strains. Among patients with mono-PZA-R TB, 51 (76%) were cured, 3 (4%) relapsed, and 13 (19%) died within 6 months of diagnosis. In comparison, for subjects with Pan-S TB, 181 (86%) were cured, 2 (1%) relapsed, 2 (1%) failed treatment, and 26 (12%) died within 6 months of diagnosis. In multivariate logistic regression analysis, mono-PZA-R was associated with decreased odds of successful clinical outcomes compared with Pan-S TB (OR=0.38, 95% CI = 0.18-0.81). Conclusion. PZA-resistance had a clinically significant impact on outcome of TB disease.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".