A120 CLOSTRIDIUM DIFFICILE SCREENING IN HOSPITALIZED PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Bibliographic record
Abstract
The Clostridium difficile (C.diff) incidence in the inflammatory bowel disease (IBD) population is approximately 7%, which is three times more than the general population. According to the Canadian gastroenterology guidelines, all patients who have symptoms suggesting a flare up of their disease should be tested for C.diff. The goal of this study was to determine if a systematic screening is required for all patients considering the potential delays in treating the IBD flare. The primary outcome was to determine the incidence of C.diff infection in these patients. The secondary outcomes were to determine the rate of screening for C.diff during the first days of hospitalisation, the delay in treatment of the IBD caused by the C.diff investigation and to determine if an early IBD flare treatment worsened the C.diff infection. This is a descriptive and retrospective study with a source population including all IBD patients that were hospitalised in the gastroenterology service of the CHUM Hospital between 2014 and 2017. These patients were initially hospitalised for clinical symptoms suggesting an IBD flare. 429 patients constituted our source population. 216 patients were included in our study according to the inclusion and exclusion criteria (total of 269 hospitalisations). The mean age was 49 years old and 39,4% (n=106) were men. 55,7% (n=150) had Crohn’s disease, 39,8% (n=107) had ulcerative colitis (UC) and 4,5% (n=12) an indeterminate colitis. The screening test for C.diff was prescribed in 67,3% of cases (n=181). 14 of these tests were positive, corresponding to an incidence of 7,73% (UC: 8 cases out of 86 tested (9,30%); CD: 3 cases out of 87 tested (3,45%); indeterminate colitis: 3 cases out of 9 tested (33,30%). The location of the 3 positives C.diff cases in patients with Crohn was pancolic (n=2) and ileocolic (n=1). 8 of these 14 patients who tested positive for C.diff already had started a treatment for the IBD flare when the screening result was obtained. These patients had a mean duration of hospitalisation of 5,4 days (σ=2,77) vs 14,5 days (σ=10,97) for those who had not started any IBD treatment. The treatment of the IBD was delayed by a mean of 0,5 days in the patients with a negative screening test. The incidence of C.difficile in this study population was 7,73%, which is similar to what is reported in the literature for other IBD populations. This high incidence reinforces the need to screen all IBD patients that consult for symptoms suggestive of an IBD flare, particularly those with ulcerative colitis and indeterminate colitis. None
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".