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Infections in Cirrhosis.
Sirina Ekpanyapong1, K Rajender Reddy2
1Division of Gastroenterology and Hepatology, University of Pennsylvania, 2 Dulles, 3400 Spruce Street, HUP, Philadelphia, PA, 19104, USA.
Current Treatment Options in Gastroenterology
|April 14, 2019
Summary
Patients with cirrhosis face high risks of bacterial infections, including multidrug-resistant (MDR) strains. Early diagnosis and treatment are crucial for preventing severe outcomes like acute-on-chronic liver failure (ACLF).
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Cirrhosis patients have a high susceptibility to bacterial infections, a leading cause of mortality.
- Infections significantly contribute to morbidity and mortality in individuals with liver cirrhosis.
Purpose of the Study:
- To review the prevalence of infections in cirrhosis patients, focusing on multidrug-resistant (MDR) pathogens.
- To discuss the pathogenesis of infection-related acute-on-chronic liver failure (ACLF).
- To outline current treatment and prophylactic strategies for infections in cirrhosis.
Main Methods:
- Literature review of recent epidemiological studies on infections in cirrhosis.
- Analysis of data on prevalence, risk factors, and outcomes of bacterial infections.
- Synthesis of current treatment guidelines and preventive measures.
Main Results:
- Emerging prevalence of MDR bacterial infections in cirrhosis patients, linked to poor prognosis.
- Spontaneous bacterial peritonitis (SBP) and urinary tract infections (UTI) are most common; pneumonia has the highest mortality risk.
- Increasing incidence of MDR infections in healthcare settings; factors like hospitalization, organ failure, and high MELD scores correlate with poor survival.
Conclusions:
- Prompt diagnosis and effective treatment of infections are vital for reducing mortality in cirrhosis.
- Updated empirical antibiotic strategies based on local epidemiology are recommended.
- Preventive measures are essential to mitigate the impact of infections in this vulnerable population.
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