Increased risk of vancomycin-resistant enterococcus (VRE) infection among patients hospitalized for inflammatory bowel disease in the United States
Bibliographic record
Abstract
BACKGROUND: Vancomycin-resistant Enterococcus (VRE) infection has become an increasingly common hospital-acquired infection in U.S. hospitals. Patients with inflammatory bowel disease (IBD) frequently require hospitalization and therefore may be at increased risk of nosocomial infections. METHODS: We used the Nationwide Inpatient Sample (NIS) to identify admissions for IBD (n = 116,842) between 1998 and 2004. We compared the prevalence of VRE in this group to that of non-IBD gastrointestinal (GI) inpatients and general inpatients and assessed for associations between VRE and hospital mortality, length of stay, and total charges. RESULTS: The crude VRE prevalence was 2.1/10,000 in hospitalized IBD patients, 1.3/10,000 in non-IBD GI patients, and 0.9/10,000 in general inpatients. After adjustment for confounders, IBD inpatients were at increased risk of VRE compared to the non-IBD GI (adjusted odds ratio [aOR] 1.65; 95% confidence interval [CI]: 1.03-2.64) and general inpatient (aOR 2.37; 95% CI: 1.31-4.27) groups. Among IBD patients, there was a higher prevalence of VRE infection in those who had surgery (4.4/10,000 versus 1.7/10,000; P < 0.04) and total parenteral nutrition (6.9/10,000 versus 1.8/10,000; P < 0.003). VRE infection was not associated with an increase in mortality (0% versus 0.7%, P = 0.8); however, it was associated with 3-fold higher total hospital charges ($63,517 versus $21,918 USD; P < 0.0001) and increased average length of stay in hospital (16.1 versus 6.1 days; P < 0.0001). CONCLUSIONS: Hospitalized IBD patients have increased susceptibility to VRE that is associated with increased economic burden. This study reinforces the importance of measures to prevent nosocomial infection, particularly in the vulnerable IBD population.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".