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Published on: December 8, 2014
Bowel Colonization With Carbapenem-Resistant Bacteria Is Associated With Short-Term Outcomes in Patients With
Satender Pal Singh1, Vikram Bhatia1, Pratibha Kale2
1Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India.
Fecal carbapenem-resistant gram-negative bacteria (CR-GNB) colonization in acute-on-chronic liver failure (ACLF) patients is common and linked to increased infection and mortality risks. Early identification of CR-GNB in ACLF patients is crucial for better outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Bowel colonization by antimicrobial-resistant bacteria is linked to poor outcomes in cirrhosis patients.
- This association has not been previously studied in patients with acute-on-chronic liver failure (ACLF).
Purpose of the Study:
- To investigate the prevalence of fecal carbapenem-resistant gram-negative bacteria (CR-GNB) in hospitalized ACLF patients.
- To determine the impact of CR-GNB fecal carriage on short-term clinical outcomes, including infections and mortality.
Main Methods:
- 150 ACLF patients were enrolled (June 2020 - Dec 2021).
- Stool cultures were performed at baseline and every 5 days.
- Patients were followed for 60 days post-discharge.
Main Results:
- CR-GNB were isolated from 42% of ACLF patients, with E. coli and K. pneumoniae being most common.
- CR-GNB fecal carriage was associated with higher CTP, MELD, and DF scores.
- Patients with CR-GNB had a significantly higher incidence of infectious complications (57.3% vs 19.7%) and mortality (in-hospital and 60-day).
Conclusions:
- Hospitalized ACLF patients with CR-GNB in stool face a substantially elevated risk of extraintestinal infections.
- CR-GNB fecal carriage is an independent predictor of both in-hospital and 60-day mortality in ACLF patients.
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