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Infection in cirrhosis: A prospective study.
Chandramouli Bhattacharya1, Manisha Das-Mondal2, Debkishore Gupta3
1Department of General Medicine, Peerless Hospitex Hospital and Research Center, Kolkata, West Bengal, India.
Multidrug-resistant infections are frequent in cirrhosis patients, leading to worse outcomes. This study highlights the critical impact of bacterial resistance and appropriate antibiotic selection on patient survival.
Area of Science:
- Hepatology
- Infectious Diseases
- Clinical Microbiology
Background:
- Multidrug-resistant (MDR) infections pose significant challenges in patients with cirrhosis.
- These infections are associated with considerably poorer clinical outcomes.
Purpose of the Study:
- To prospectively evaluate the microbiology of infections in cirrhosis patients.
- To assess the impact of bacterial resistance, antibiotic choice, and liver disease severity on patient outcomes.
Main Methods:
- A prospective study of 159 cirrhosis patients over 24 months.
- Infection data, microbiology, demographics, and clinical outcomes were collected.
- Comparison between infected and non-infected patient groups.
Main Results:
- Gram-negative bacilli, including Escherichia coli and Klebsiella pneumoniae, were common pathogens.
- A high prevalence (84.9%) of extended-spectrum beta-lactamase (ESBL), AmpC, or carbapenemase production was observed in Enterobacteriaceae.
- Spontaneous bacterial peritonitis and urinary tract infections were the most frequent infection sites, with a 21.9% in-hospital mortality rate.
Conclusions:
- MDR infections are prevalent in cirrhosis patients.
- These infections significantly impact treatment strategies and patient prognosis.
- Higher MELD and CTP scores were associated with increased mortality in infected patients.
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