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Risk factors for the emergence of multidrug-resistant organisms in liver cirrhosis

Luísa Martins Figueiredo1, Maria Ana Rafael1, Gonçalo Alexandrino1

  • 1Gastroenterology Department, Hospital Professor Doutor Fernando Fonseca, Portugal.

Gastroenterologia Y Hepatologia
|May 30, 2021
PubMed
Abstract

Insights

Multidrug-resistant organism (MDRO) infections are common in liver cirrhosis (LC) patients and linked to higher mortality. Proton pump inhibitor (PPI) use and prior antibiotics increase MDRO risk.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Multidrug-resistant organisms (MDROs) pose a significant challenge in managing infections among liver cirrhosis (LC) patients.
  • Understanding risk factors for MDROs is crucial for effective treatment and prevention strategies in this vulnerable population.

Purpose of the Study:

  • To identify specific risk factors associated with the development of multidrug-resistant organism infections in hospitalized patients with decompensated liver cirrhosis.

Main Methods:

  • A prospective study was conducted from October 2017 to March 2018.
  • Infected, consecutively hospitalized patients with decompensated liver cirrhosis were enrolled.
  • Blood, urine, and ascitic fluid cultures were analyzed to identify pathogens and their resistance profiles.

Main Results:

  • Multidrug-resistant organisms (MDROs) were identified in 18 out of 52 infection episodes.
  • Significant risk factors included proton pump inhibitor (PPI) use (p=0.0312), recent antibiotic therapy (p=0.0033), and prolonged hospitalization (p=0.0082).
  • MDRO infections were associated with a higher 90-day mortality rate (71.4% vs. 35.7%, p=0.0316).

Conclusions:

  • MDRO infections are prevalent in liver cirrhosis patients and significantly increase 90-day mortality.
  • Restricting the use of proton pump inhibitors (PPIs) and antibiotics to essential indications may reduce MDRO risk.
  • Minimizing hospitalization duration for liver cirrhosis patients is recommended to prevent MDRO acquisition.
Keywords:
90-day mortalityCirrosis hepáticaInfecciónInfectionInhibidores de la bomba de protonesLiver cirrhosisMortalidad a 90 díasMultidrug-resistant organismsOrganismos multirresistentesProton pump inhibitors

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