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. 2024;36(1):90-96.
doi: 10.5455/msm.2024.36.90-96.

Characteristics and Related Factors of Bacterial Infection Among Patients With Cirrhosis

Nguyen-Thi Ngoc Lan  1 , Dau Quang Lieu  2 , Tran Ngoc Anh  2   3 , Le Hoai Thuong  3 , Tran-Thi Khanh Tuong  4 , Mai Hong Bang  5
Affiliations

Characteristics and Related Factors of Bacterial Infection Among Patients With Cirrhosis

Nguyen-Thi Ngoc Lan et al. Mater Sociomed. 2024.

Abstract

Background: Infection causes cirrhosis to decompensate, affecting liver function and resulting in several complications, including esophageal variceal hemorrhage, hepatic encephalopathy, and hepatorenal syndrome. Objective: This study aimed to identify the prevalence, essential features, and related factors of bacterial infection among patients with cirrhosis in Vietnam.

Methods: This retrospective study included 317 patients diagnosed with cirrhosis, who were divided into two groups: group 1 including 125 patients with bacterial infection and group 2 including 192 patients without bacterial infection. Infection was diagnosed on the basis of its localization.

Results: Spontaneous bacterial peritonitis (SBP; 31.2%) and pneumonia (28.8%) were the most common infections identified. The procalcitonin (PCT) level had a strong diagnostic value with an area under the curve value of 0.868. The most common type of gram-negative bacteria was Escherichia coli, while the gram-positive bacteria seen were Staphylococcus, Enterococcus, and Streptococcus among the patients with infection. In the logistic regression analysis, Child-Pugh class B and C (p<0.001, OR=4.14, CI=1.90-9.03; OR=4.76, CI=2.03-11.16, respectively) and the presence of acute kidney injury (p=0.009, OR=2.57, CI=1.27-5.22) and gastrointestinal hemorrhage (p=0.035, OR=0.39, CI=0.16-0.94) significantly differed between the groups.

Conclusion: The most prevalent type of bacterial infection in patients with cirrhosis is SBP, with gram-negative bacteria being the most common cause. The PCT level is useful in identifying infection in patients with cirrhosis. Decompensated cirrhosis is linked to a higher risk of infection.

Keywords: Bacterial infection; Cirrhosis; Procalcitonin.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 2.
Figure 2.. Top five most common infections noted in the patients with cirrhosis
Figure 3.
Figure 3.. Performance of the WBC count, CRP level, PCT level, NLR, and presence of SIRS in the diagnosis of bacterial infection among the patients with cirrhosis
Figure 4.
Figure 4.. Prevalence of gram-negative bacteria in the patients with infection (n=20)
Figure 5.
Figure 5.. Prevalence of gram-positive bacteria in the patients with infection (n=6)
See this image and copyright information in PMC

References

    1. GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020 Mar;5(3):245–266. doi: 10.1016/S2468-1253(19)30349-8. - DOI - PMC - PubMed
    1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1204–1222. doi: 10.1016/S0140-6736(20)30925-9. Erratum in: Lancet. 2020 Nov 14; 396(10262): 1562. - DOI - PMC - PubMed
    1. Fernández J, Acevedo J, Castro M, Garcia O, de Lope CR, Roca D, Pavesi M, Sola E, Moreira L, Silva A, Seva-Pereira T, Corradi F, Mensa J, Ginès P, Arroyo V. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: a prospective study. Hepatology. 2012 May;55(5):1551–1561. doi: 10.1002/hep.25532. - DOI - PubMed
    1. Preda CM, Ghita R, Ghita C, Mindru C, Vlaicu L, Andrei A, Andrei S, Diculescu M. A retrospective study of bacterial infections in cirrhosis. Maedica (Bucur) 2011 Jul;6(3):185–192. - PMC - PubMed
    1. Lingiah VA, Pyrsopoulos NT. Bacterial Infections in Cirrhotic Patients in a Tertiary Care Hospital. J Clin Transl Hepatol. 2021 Feb 28;9(1):32–39. doi: 10.14218/JCTH.2020.00076. - DOI - PMC - PubMed

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