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[Retrospective study of liver failure complicated with bacterium and fungous infection]
Hai-Bin Su1, Hui-Fen Wang, Fang Lin
1The Department of severe liver diseases, The 302 Hospital of the PLA, Beijing, China.
Objective:
To study clinic character of liver failure complicated with bacterium and fungous infection.
Methods:
The patients with liver failure complicated with bacterial and fungous infection who were treated in our hospital from January 1986 to June 2006 were studied. All patients had clinical manifestation and positive of bacterium. The data were statistical analysis.
Results:
507 patients diagnosed with fungous infection were found from January 1986 to June 2006 in which 132 patients were diagnosed with bacterial and fungous infection. There were 85 patients (64.39%) with chronic severe hepatitis and 40 patients (30.3%) with decompensation cirrhosis. Bacterial infection happened in 153 cases in which the rate of nosocomial infections was 54.90%. 204 bacterial strains were separated in which 143 strains (70.10%) were gram-negative bacterium and 61 (29.90%) strains were gram-positive bacterium. The main sites of bacterial infection were abdominal cavity (122 cases) and lung (30 cases). Fungous infection happened in 143 cases in which the rate of nosocomial infections was 86.71%. 155 fungous strains were separated in which 90 strains (58.06%) were Candida albicans, 17 strains (10.97%) were Aspergillus fumigatus and 25 (16.13%) strains were non-Candida albicans. The main sites of fouguns infection were lung (94 cases) and mouth (53 cases). 84 patients (63.64%) were ineffective and died after treatment.
Conclusion:
The patients with decompensation cirrhosis and chronic severe liver hepatitis were easy to be infected by bacterial and fungous. the rate of fungous nosocomial infections is higher than that of bacterium. The prognosis is bad in patients who had secondary fungous infection.
Insights
Patients with liver failure, particularly chronic severe hepatitis and decompensated cirrhosis, face high risks of bacterial and fungal infections. Fungous infections, often hospital-acquired, are more prevalent and linked to poor outcomes.
Area of Science:
- Infectious Diseases
- Hepatology
- Critical Care Medicine
Context:
- Liver failure patients are susceptible to secondary infections.
- Bacterial and fungal co-infections pose significant challenges in managing liver failure.
- Understanding infection patterns is crucial for improving patient outcomes.
Purpose:
- To investigate the clinical characteristics of bacterial and fungal infections in patients with liver failure.
- To identify common pathogens, infection sites, and predisposing conditions.
- To analyze the impact of these infections on patient prognosis.
Summary:
- A study of 507 patients with liver failure complicated by fungal infections and 132 with co-infections revealed chronic severe hepatitis and decompensated cirrhosis as primary conditions.
- Bacterial infections occurred in 153 cases (54.90% nosocomial), predominantly gram-negative bacteria in abdominal cavity and lung.
- Fungal infections occurred in 143 cases (86.71% nosocomial), mainly Candida albicans and Aspergillus species, frequently in the lungs and mouth. Poor treatment outcomes were observed in 63.64% of patients.
Impact:
- Highlights the high incidence and mortality associated with bacterial and fungal infections in liver failure.
- Emphasizes the greater prevalence of nosocomial fungal infections compared to bacterial infections.
- Underscores the poor prognosis for patients with secondary fungal infections, informing clinical management strategies.
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