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Updated: Oct 4, 2025

Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
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Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes

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Management of Multidrug-Resistant Infections in Cirrhosis

Charles E Gallaher1, Debbie L Shawcross1,2

  • 1Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom.

Seminars in Liver Disease
|February 7, 2022
PubMed

Insights

Antimicrobial resistance is a major global threat. Patients with cirrhosis are at high risk for multidrug-resistant organism infections due to frequent antibiotic use and invasive procedures.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Antimicrobial resistance (AMR) is a critical global health concern, driven by widespread antimicrobial use.
  • Patients with cirrhosis face heightened susceptibility to infections, including those caused by multidrug-resistant organisms (MDROs).
  • Factors contributing to this vulnerability include frequent antibiotic prescriptions, invasive procedures like large volume paracentesis, and recurrent hospitalizations.

Purpose of the Study:

  • To review the mechanisms of MDRO infection vulnerability in cirrhosis.
  • To examine the impact of bacterial infections on cirrhosis progression.
  • To explore the prevalence, outcomes, and management strategies for MDRO infections in patients with cirrhosis.

Main Methods:

  • This review synthesizes current literature on MDROs in cirrhosis.
  • It covers mechanisms of infection, disease course impact, prevalence, and outcomes.
  • Management strategies discussed include detection, treatment, prophylaxis, antibiotic stewardship, and technological interventions.

Main Results:

  • MDRO infections pose a significant risk to patients with cirrhosis, impacting disease progression and outcomes.
  • The review highlights the need for effective management strategies tailored to this population.
  • Understanding the gut microbiome and implementing antibiotic stewardship are crucial.

Conclusions:

  • Patients with cirrhosis represent a vulnerable population at increased risk for multidrug-resistant organism infections.
  • Comprehensive management strategies, including early detection, appropriate treatment, and robust antibiotic stewardship, are essential.
  • Further research into novel interventions and microbiome modulation is warranted to improve outcomes.

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