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. 2024 May 14;10(1):FSO945.
doi: 10.2144/fsoa-2023-0160. eCollection 2024.

Clinical impact of multidrug-resistant bacterial infections in patients with cirrhosis

Nouha Trad  1 , Ghanem Mohamed  1 , Sondes Bizid  1 , Hatem Ben Abdallah  1 , Riadh Bouali  1 , Mohamed Nabil Abdelli  1
Affiliations

Clinical impact of multidrug-resistant bacterial infections in patients with cirrhosis

Nouha Trad et al. Future Sci OA. .

Abstract

Aim: Recently, the emergency of multidrug-resistant organisms (MDRO) has complicated the management of bacterial infections (BI) in cirrhosis. We aimed to assess their clinical impact on patients with decompensated cirrhosis. Methods: A retrospective study included consecutive cirrhotic patients hospitalized for acute decompensation (AD) between January 2010 and December 2019. Results: A total of 518 AD admissions in 219 patients were included, with 260 BI episodes (50.2%). MDRO prevalence was 38.2% of the total isolates. Recent antibiotic use (OR = 4.91), nosocomial infection (OR = 2.95), and healthcare-associated infection (OR = 3.45) were their main risk factors. MDROs were associated with empiric treatment failure (OR = 23.42), a higher prevalence of sepsis (OR = 4.93), ACLF (OR = 3.42) and mortality. Conclusion: The clinical impact of MDROs was pejorative, with an increased risk of empiric treatment failure, organ failure and death.

Keywords: bacterial drug resistance; bacterial infection; liver cirrhosis; mortality; prevalence.

Plain language summary

In recent years, an increasing spread of multidrug-resistant bacteria had been observed worldwide. The emergence of these strains could represent a major problem in fragile patients such as cirrhotic patients. Over 10 years, our study analyzed the bacteriological profile of cirrhotic patient infections. The multidrug-resistant bacteria prevalence was 38.2%. Exposure to healthcare facilities and recent antibiotic use, were their main risk factors. These strains had a negative impact with an increased risk of treatment failure and death.

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Conflict of interest statement

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1.
Figure 1.
Flow chart of patients included in the study. MDROs: Multidrug-resistant organisms.
See this image and copyright information in PMC

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