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. 2011 Jul;6(3):185-92.

A retrospective study of bacterial infections in cirrhosis

Carmen Monica Preda  1 , Ruxandra Ghita, Camelia Ghita, Cezarina Mindru, Livia Vlaicu, Adriana Andrei, Sorin Andrei, Mircea Diculescu
Affiliations

A retrospective study of bacterial infections in cirrhosis

Carmen Monica Preda et al. Maedica (Bucur). 2011 Jul.

Abstract

Aim: To evaluate the incidence of bacterial infections (BI) in hepatic cirrhosis (HC), the pathogen agents involved, to define the risk factors and impact on prognosis.

Methods: There was a retrospective study that enrolled a total of 1046 patients with HC admitted in our clinic between 1.10.2008-31.03.2009 (6 months). Clinical, biological and bacteriological data were monitored.

Results: 51 patients (4.9%) were found with BI. In one patient BI was located in three sites: peritoneal, blood and urine, and in 7 patients BI was located in 2 sites. BI location was: peritoneal-26 cases, urinary-20 cases, pneumonia - 8 cases, skin - 4 cases and bacteremia -1 case. 43 episodes were community acquired, while 17 episodes were - nosocomial (peritoneal - 3 cases, lung - 6 cases, skin - 2 cases, urinary - 5 cases). Of the 26 cases with bacterial peritonitis, the etiologic agent was identified in three: E. coli, Klebsiella, Alcaligenes. 18% of patients with HC and BI presented upper GI bleeding. 12 cases required admission to the Intensive Care Unit, where the death rate reached 83%. The risk factors for BI in HC were: decompensated HC OR=58,23 (95% CI 8.63÷1141.31), p-value 10-12, Child Pugh score C: OR =1.99 (95% CI 1.04÷3.8), p-value= 0.02.

Conclusions: In this study the rate of bacterial infections in HC is low compared with the literature (4.9% vs. 15-30%), because the study was retrospective, hence recorded only severe infections. We must actively seek infections in all hospitalized patients with HC, especially in the ones with decompensated cirrhosis and with upper GI bleeding.

Keywords: bacterial infection; liver cirrhosis; spontaneous bacterial peritonitis; upper gastrointestinal bleeding.

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Figures

Figure 1
Figure 1. Frequency of infection types
Figure 2
Figure 2. Distribution of cases with infection according to admission moment
Figure 3
Figure 3. Distribution of the cases with nosocomial and community acquired infections
Figure 4
Figure 4. Distribution of patients with bacterial infection by associated pathology
Figure 5
Figure 5. Distribution of cases with spontaneous infection of ascites
Figure 6
Figure 6. Etiologic agents of urinary tract infection
Figure 7
Figure 7. Distribution of patients by status at discharge from hospital
See this image and copyright information in PMC

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