Bacterial and fungal infections in acute-on-chronic liver failure: prevalence, characteristics and impact on prognosis

Acute (Not Decompensation)-on-Chronic Liver Failure

“…The prevalence of infection was similar to that described by others (37% of bacterial infections at the time of diagnosis and 46% during the first 4 weeks) [5] . Mortality was independent of the presence or absence of bacterial infection in this sample.…”

“…Bacterial infections were independently associated with mortality in patients with grade 1 or grade 2 ACLF. Fungal infections are uncommon (2% of ACLFs), and the majority occur after the diagnosis of ACLF but have a high mortality rate (71%) at 90 days [5] . However, accurate great differentiation of SIRS from infection is a recognized unmet need.…”

Simvastatin Prevents Progression of Acute on Chronic Liver Failure in Rats With Cirrhosis and Portal Hypertension

“…5,6 ACLF is defined as an acute hepatic insult manifesting as jaundice and coagulopathy, complicated within 4 weeks by ascites and/or encephalopathy with high 28-day mortality, and it is frequently precipitated by bacterial infections and sepsis. 5,7,8 To our knowledge, no experimental model of ACLF has been developed and well characterized, thus limiting the preclinical research in the field.…”

The Importance of Knowing the Local Epidemiology When a Patient With Cirrhosis Acquires a Bacterial Infection

“…3 Adapted to each clinical situation and patient characteristics. 4 According to the clinical situation and the microbiological results. 5 Set up local teams with infectious diseases specialists, clinical microbiologists, hospital pharmacists, infection control practitioners or hospital epidemiologists, and comply with hospital antibiotic policies and guidelines.…”

“…This situation might lead to delayed antibiotic initiation or prescription of ineffective regimens that is associated with poor outcomes. 2,4 In contrast, prescription of broad-spectrum antibiotics to all patients in whom bacterial infections are suspected might favor bacterial resistance development. This is currently a major concern given the alarming proportion of infections being caused by multidrug-resistant microorganisms (MDROs) worldwide.…”