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Long Term Intravital Multiphoton Microscopy Imaging of Immune Cells in Healthy and Diseased Liver Using CXCR6.Gfp Reporter Mice
Published on: March 24, 2015
Immune dysfunction and infections in patients with cirrhosis
Alexander R Bonnel1, Chalermrat Bunchorntavakul, K Rajender Reddy
1Division of Gastroenterology/Hepatology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Summary
Patients with cirrhosis face high infection risks, increasing mortality. This review covers infection causes, diagnosis, and management in cirrhosis patients to improve outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Immunology
Background:
- Patients with cirrhosis have weakened immune systems, making them vulnerable to infections.
- Infections significantly increase mortality risk (4-fold) in cirrhosis patients, despite advances in treating spontaneous bacterial peritonitis (SBP).
- Hospitalized cirrhosis patients, particularly those with gastrointestinal hemorrhage, face elevated risks of bacterial infections (32-45%) compared to general hospitalized patients (5-7%).
Purpose of the Study:
- To review the pathogenesis of infections in patients with cirrhosis.
- To discuss diagnostic strategies for infections in this population.
- To outline current management approaches for infections in cirrhosis patients.
Main Methods:
- Review of existing literature on infections in cirrhosis.
- Analysis of common pathogens and their prevalence.
- Examination of the mechanisms leading to infection and sepsis.
Main Results:
- Spontaneous bacterial peritonitis (SBP), urinary tract infections, and pneumonia are the most common infections in cirrhosis patients.
- Bacterial overgrowth and translocation from the GI tract contribute to SBP and bacteremia, triggering inflammatory responses.
- Cirrhosis patients are susceptible to more virulent bacterial and fungal pathogens.
Conclusions:
- Infections remain a major cause of mortality in cirrhosis.
- Understanding pathogenesis is key to developing effective diagnostic and management strategies.
- Improved infection control and treatment are crucial for enhancing survival rates in cirrhosis patients.
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