Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May-Jun;14(3):101346.
doi: 10.1016/j.jceh.2024.101346. Epub 2024 Jan 17.

High Mortality With Non-O1/Non-O139 Vibrio cholera Bacteraemia in Patients With Cirrhosis

Kunwar A Singh  1 , Shalini Anandan  2 , Anand Sharma  1 , Santhosh E Kumar  1 , Dhanalakshmi Solaimalai  2 , Balaji Veeraraghavan  2 , Ashish Goel  1 , Chundamannil E Eapen  1 , Uday G Zachariah  1
Affiliations

High Mortality With Non-O1/Non-O139 Vibrio cholera Bacteraemia in Patients With Cirrhosis

Kunwar A Singh et al. J Clin Exp Hepatol. 2024 May-Jun.

Abstract

Background: Data on non-O1/non-O139 Vibrio cholera (NOVC) infection in liver disease is limited. We studied the clinical features and outcome of patients with cirrhosis with non-NOVC bacteraemia and/or spontaneous bacterial peritonitis (SBP) when compared to non-extended spectrum beta lactamase (non-ESBL) Escherichia coli (E. coli).

Methods: Hospital information system of patients with cirrhosis admitted with bacteraemia and/or SBP from 2010 to 2020 was searched to include patients with NOVC infection. Non-ESBL E. coli bacteraemia/bacterascites were chosen as a comparator group, matched for the date of admission within 5 days of index case. Propensity score matching (PSM) was done for patient's age and Child score to compare outcome at discharge between NOVC-infected and E. coli-infected cirrhotic patients.

Results: There were 2545 patients admitted with bacteraemia and/or SBP during the study period; 29 had NOVC isolated (M:F = 23:6; age: 39, 18-54 years; median, range; model for end-stage liver disease [MELD] score: 25, 12-38; Child score: 11, 10-12.5) from either blood (26), ascites (3), or both (8). Of these, 26 isolates were pan-sensitive to antibiotic sensitivity tests. Fifty-three patients with non-ESBL E. coli were isolated (M: F = 43:10; age: 48; 18-69 years; MELD score: 25, 20-32; Child score:12,11-13) from blood (31), ascites (17), or both (5) within the selected time frame. Of these, 48 isolates were sensitive to the empirical antibiotics initiated.After PSM, in comparison with 29 non-ESBL E. coli patients (age: 41, 18-55 years; MELD score: 24, 19-31; Child score: 12, 11-13), NOVC patients had higher incidence of circulatory failure at admission (14 [49 %] vs 4 [13 %]; P: 0.01) and significantly higher in-hospital mortality (15 [52 %] vs 6 [20 %];P: 0.028].

Conclusions: Bacteraemia due to non-O1/non-O139 strains of V. cholera, is an uncommon cause of bacteraemia or bacterascites in patients with cirrhosis and is associated with high incidence of circulatory failure and significant mortality.

Keywords: Escherichia Coli; bacterial infection; cirrhosis; non-O1/non-139 Vibrio cholera; non-extended spectrum beta lactamase (ESBL); spontaneous bacterial peritonitis.

PubMed Disclaimer

Figures

Image 1
Graphical abstract
Figure 1
Figure 1
Flow chart of patient selection process and subsequent matching and outcome of the study.
See this image and copyright information in PMC

References

    1. Deshayes S., Daurel C., Cattoir V., Parienti J.J., Quilici M.L., de La Blanchardière A. Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review. SpringerPlus. 2015;4:575. - PMC - PubMed
    1. El-Hiday A.H., Khan F.Y., Al Maslamani M., El Shafie S. Bacteremia and spontaneous bacterial peritonitis due to Vibrio cholerae (non-O1 non-O139) in liver cirrhosis. Indian J Gastroenterol. 2006;25:107. - PubMed
    1. George N., Fredrick F., Mohapatra A., et al. Non-O1, non-O139 Vibrio cholerae sepsis in a patient with nephrotic syndrome. Indian J Nephrol. 2013;23:378–380. - PMC - PubMed
    1. Jesudason M.V., Lalitha M.K., Koshi G. Non 01 Vibrio cholerae in intestinal and extra intestinal infections in Vellore, S. India. Indian J Pathol Microbiol. 1991;34:26–29. - PubMed
    1. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies.

LinkOut - more resources