Prediction of vancomycin-resistant phenotype in ICU-onset sterile-site Enterococcus-positive cultures: development and pseudo-temporal validation of a clinical prediction model using MIMIC-IV

Background

Vancomycin-resistant enterococci challenge intensive care. During the interval between organism identification and final phenotypic antimicrobial susceptibility testing, clinicians must balance delayed effective anti-VRE therapy against unnecessary anti-VRE exposure. We aimed to develop and pseudo-temporally validate a model for the vancomycin-resistance phenotype of the index isolate; the model does not determine whether the isolate represents clinically significant infection.