Bacterial Infections in Patients with Cirrhosis

Yang, Ying-Ying; H, Lin

doi:10.1016/s1726-4901(09)70072-3

Cited by 25 publications

(30 citation statements)

References 37 publications

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“…The onset of bacterial infection in patients hospitalized with liver cirrhosis is reported to be 30% to 60% [6, 9], and bacteremia has been reported as occurring in 3.5% to 8.8% [2, 3, 10]. …”

Section: Discussionmentioning

confidence: 99%

“…Bacterial infection is involved in a quarter of mortalities among cirrhosis patients [9, 20], and the mortality rate among patients with complications arising from bacterial infection is markedly higher [1, 21, 22]. Previous reports have described short-term mortality rates of 27% to 60% in liver cirrhosis complicated by bacteremia [1, 3, 4, 21], though slightly different definitions of short-term mortality have been employed.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Investigation of Bacteremia due toAeromonasSpecies and Comparison with That due to Enterobacteria in Patients with Liver Cirrhosis

Shizuma

Tanaka

Mori

et al. 2011

Gastroenterology Research and Practice

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Background. The role of Aeromonas species (sp.) in bacteremia in Japanese patients with liver cirrhosis is poorly understood. Aim. To establish the importance of Aeromonas sp. as a cause of bacteremia in patients with liver cirrhosis. Methods. Clinical and serological features and short-term prognosis were retrospectively investigated and compared in Japanese patients with bacteremia due to Aeromonas sp. (n = 11) and due to enterobacteria (E. coli, Klebsiella sp., and Enterobacter sp.) (n = 84). Results. There were no significant differences in patients' clinical background, renal dysfunction, or short-term mortality rate between the two groups. However, in the Aeromonas group, the model for end-stage liver disease (MELD) score and Child-Pugh score were significantly higher than in the enterobacteria group. Conclusion. These results indicate that the severity of liver dysfunction in Aeromonas-induced bacteremia is greater than that in enterobacteria-induced bacteremia in Japanese patients with liver cirrhosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Investigation of Bacteremia due toAeromonasSpecies and Comparison with That due to Enterobacteria in Patients with Liver Cirrhosis

Shizuma

Tanaka

Mori

et al. 2011

Gastroenterology Research and Practice

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“…Urinary tract infections: Urinary tract infections (UTI) in cirrhosis can be asymptomatic or oligosymptomatic, and asymptomatic bacteriuria is frequent [31,32] . The incidence of UTI is higher in cirrhotic patients with indwelling catheters and in women.…”

Section: Other Infections In Patients With Cirrhosismentioning

confidence: 99%

Diagnosis and management of bacterial infections in decompensated cirrhosis

Pleguezuelo

Benítez²,

Jurado³

et al. 2013

WJH

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Bacterial infections are one of the most frequent complications in cirrhosis and result in high mortality rates. Patients with cirrhosis have altered and impaired immunity, which favours bacterial translocation. Episodes of infections are more frequent in patients with decompensated cirrhosis than those with compensated liver disease. The most common and life-threatening infection in cirrhosis is spontaneous bacterial peritonitis followed by urinary tract infections, pneumonia, endocarditis and skin and soft-tissue infections. Patients with decompensated cirrhosis have increased risk of developing sepsis, multiple organ failure and death. Risk factors associated with the development of infections are severe liver failure, variceal bleeding, low ascitic protein level and prior episodes of spontaneous bacterial peritonitis (SBP). The prognosis of these patients is closely related to a prompt and accurate diagnosis. An appropriate treatment decreases the mortality rates. Preventive strategies are the mainstay of the management of these patients. Empirical antibiotics should be started immediately following the diagnosis of SBP and the first-line antibiotic treatment is third-generation cephalosporins. However, the efficacy of currently recommended empirical antibiotic therapy is very low in nosocomial infections including SBP, compared to community-acquired episodes. This may be associated with the emergence of infections caused by Enterococcus faecium and extended-spectrum β-lactamaseproducing Enterobacteriaceae, which are resistant to the first line antimicrobial agents used for treatment. The emergence of resistant bacteria, underlines the need to restrict the use of prophylactic antibiotics to patients with the greatest risk of infections. Nosocomial infections should be treated with wide spectrum antibiotics. Further studies of early diagnosis, prevention and treatment are needed to improve the outcomes in patients with decompensated cirrhosis.

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“…In particular, cases in which renal dysfunction occurs during the course of bacterial infection have a poor prognosis, and renal dysfunction is a key indicator predicting death in patients with bacterial infection 1. Bacterial infections commonly observed in patients with liver cirrhosis are, in descending order of frequency, urinary tract infection, pneumonia, and spontaneous bacterial peritonitis (SBP) 5-8…”

Section: Introductionmentioning

confidence: 99%

Renal Dysfunction Induced by Bacterial Infection other than Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: Incidence and Risk Factor

Kim¹,

Lee²,

Lee³

et al. 2009

Gut Liver

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Background/AimsDeterioration of renal function in cirrhotic patients with spontaneous bacterial peritonitis (SBP) is a predictor for in-hospital mortality; however, the clinical significance of renal dysfunction during bacterial infection other than SBP is unknown. The aim of this study was to investigate the prevalence and clinical significance of renal dysfunction due to bacterial infections other than SBP in patients with liver cirrhosis.MethodsRetrospective data from inpatients with bacterial infections other than SBP were analyzed.ResultsEighty patients were recruited for the analysis. The types of infections included that of urinary tract (37.5%), pneumonia (23.8%), biliary tract (20%), cellulitis (12.5%), and bacteremia of unknown origin (6.3%). Renal dysfunction developed in 29 patients (36.3%), of which 11 patients had irreversible renal dysfunction. The initial MELD score, neutrophil count, albumin, and blood pressure were significant risk factors in the univariate analysis, whereas only the MELD score was an independent risk factor for the development of renal dysfunction (p<0.001) after multivariate analysis.ConclusionsThe prevalence of renal dysfunction during bacterial infection other than SBP in patients with liver cirrhosis was 36.3%, and its development was related to the severity of the liver disease. Occurrence of irreversible renal dysfunction seemed to affect the prognosis of these patients.

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Bacterial Infections in Patients with Cirrhosis

Cited by 25 publications

References 37 publications

Investigation of Bacteremia due toAeromonasSpecies and Comparison with That due to Enterobacteria in Patients with Liver Cirrhosis

Investigation of Bacteremia due toAeromonasSpecies and Comparison with That due to Enterobacteria in Patients with Liver Cirrhosis

Diagnosis and management of bacterial infections in decompensated cirrhosis

Renal Dysfunction Induced by Bacterial Infection other than Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: Incidence and Risk Factor

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