Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 05 / 13 / 2021

Articles

ORIGINAL ARTICLE

Bacterial Infections in Cirrhotic Patients in a Tertiary Care Hospital

Vivek A. Lingiah* and Nikolaos T. Pyrsopoulos*

Department of Medicine, Division of Gastroenterology and Hepatology, Rutgers University, New Jersey Medical School, Newark, NJ, USA
*Correspondence to: Nikolaos T. Pyrsopoulos and Vivek A. Lingiah, Division of Gastroenterology and Hepatology, Rutgers University, New Jersey Medical School, MSB H-355, 185 S Orange Ave, Newark, NJ 07103, USA. Tel: +1-973-972-5252, Fax: +1-973-972-3144, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. (NTP) or This email address is being protected from spambots. You need JavaScript enabled to view it. (VAL)

Journal of Clinical and Translational Hepatology 2021;9(1):32-39 DOI: 10.14218/JCTH.2020.00076
Received: August 16, 2020 AcceptedDecember 5, 2020 Published online: December 22, 2020

Abstract

Background and Aims: Patients with cirrhosis are immunocompromised and at higher risk of developing infections compared to the general population. The aim of this study was to assess the incidence of infections in cirrhotic patients in a large academic liver center and investigate potential associations between infections, bacteria isolated, therapeutic regimens used, and mortality.

Methods: This was a retrospective chart review study, including 192 patients. All patients had a diagnosis of cirrhosis and were admitted to University Hospital. Information collected included demographics, etiology of cirrhosis, identification of bacteria from cultures, multidrug-resistant (MDR) status, antibiotics administered, intensive care unit (ICU) admission, and patient mortality.

Results: Infections were present in 105 (54.6%) patients, and 60 (31.2%) patients had multiple infections during a hospitalization(s) for infections. A total of 201 infections were identified. Urinary tract infections (UTIs) were the most common infection (37.8%), followed by bacteremia (20.4%), pneumonia (12.9%), spontaneous bacterial peritonitis (SBP) (11.9%), abscess/cellulitis (6.0%), infectious diarrhea (6.0%), and other (5.0%). Escherichia coli was the most common bacteria isolated (13.4%), both among sensitive and MDR infections. MDR bacteria were the cause for 41.3% of all infections isolated. Fungi accounted for 9.5% of infections. 21.9% of patients had decompensation from their infection(s) that required ICU care, and 14.6% of patients died during hospitalization or soon after discharge.

Conclusions: The incidence of infections in cirrhotic patients is much higher than in their non-cirrhotic counterparts (54.6%), even higher than prior studies suggest. As many of these infections are caused by MDR bacteria and fungal organisms, stronger empiric antibiotics and antifungals should be considered when initially treating this immunocompromised population. However, once organism sensitivities are discovered, narrowing of antibiotic regimens must occur to maintain good antibiotic stewardship.

Keywords

Cirrhosis, Bacterial infections, Multidrug resistance, Fungal infections

Journal of Clinical and Translational Hepatology 2021 vol. 9, 32-39  [ Html  ] [ PDF Full-text ]

© The Author(s) 2021. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 logo

You are here: Home