Infectious Complications of Acute and Chronic Liver Disease

Leber, Bettina; Spindelboeck, Walter; Stadlbauer, Vanessa

doi:10.1055/s-0032-1301737

Cited by 91 publications

(78 citation statements)

References 208 publications

(218 reference statements)

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“…For this reason, infection is considered an important prognostic marker in patients with ESLD. 7 Bloodstream infections (BSIs) are a common complication in patients with ESLD, affecting 4-21% of patients, 8 making them 10 times more common in cirrhotic than in non-cirrhotic patients. 9 The increased gut permeability and the cirrhosis associated immune dysfunction (CAID) make this population prone to develop BSI by endogenous route, particularly during acute-on-chronic liver failure (ACLF).…”

Section: Introductionmentioning

confidence: 99%

Bloodstream infections in patients with liver cirrhosis

et al. 2016

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Bloodstream infections are a serious complication in patients with liver cirrhosis. Dysregulated intestinal bacterial translocation is the predominant pathophysiological mechanism of infections in this setting. For this reason enteric Gram-negative bacteria are commonly encountered as the first etiological cause of infection. However, through the years, the improvement in the management of cirrhosis, the recourse to invasive procedures and the global spread of multidrug resistant pathogens have importantly changed the current epidemiology. Bloodstream infections in cirrhotic patients are characterized by high mortality rate and complications including metastatic infections, infective endocarditis, and endotipsitis (or transjugular intrahepatic portosystemic shunt-related infection). For this reason early identification of patients at risk for mortality and appropriated therapeutic management is mandatory. Liver cirrhosis can significantly change the pharmacokinetic behavior of antimicrobials. In fact hypoproteinaemia, ascitis and third space expansion and impairment of renal function can be translated in an unpredictable drug exposure.

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Section: Introductionmentioning

confidence: 99%

Bloodstream infections in patients with liver cirrhosis

et al. 2016

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“…The reasons for the susceptibility to infections associated with bacteremia are different and include impaired immunity, bacterial translocation, and clinical factors (i.e., variceal bleeding, spontaneous bacteria peritonitis, skin lesions) [12]. Healthcare-associated infections are reported with increasing frequency in this setting; about 15-35 % of patients with liver disease develop nosocomial infections during their hospital stay as compared with 5-7 % in the general hospital population [13]. Cirrhosis has been associated with an increased risk of developing an episode of IE in a cohort of patients followed for three years [2].…”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis in patients with hepatic diseases

Seminari

Silvestri

Ravasio

et al. 2015

Eur J Clin Microbiol Infect Dis

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Few data have been published regarding the epidemiology and outcome of infective endocarditis (IE) in patients with chronic hepatic disease (CHD). A retrospective analysis of the Studio Endocarditi Italiano (SEI) database was performed to evaluate the epidemiology and outcome of CHD+ patients compared with CHD− patients. The diagnosis of IE was defined in accordance with the modified Duke criteria. Echocardiography, diagnosis, and treatment procedures were in accordance with current clinical practice. Among the 1722 observed episodes of IE, 300 (17.4 %) occurred in CHD+ patients. The cause of CHD mainly consisted of chronic viral infection. Staphylococcus aureus was the most common bacterial species in CHD+ patients; the frequency of other bacterial species (S. epidermidis, streptococci, and enterococci) were comparable among the two groups. The percentage of patients undergoing surgery for IE was 38.9 in CHD+ patients versus 43.7 in CHD− patients (p = 0.06). Complications were more common among CHD+ patients (77 % versus 65.3 %, p < 0.001); embolization (43.3 % versus 26.1 %, p < 0.001) and congestive heart failure (42 % versus 34.1 %, p = 0.01) were more frequent among CHD+ patients. Mortality was comparable (12.5 % in CHD− and 15 % in CHD+ patients). At multivariable analysis, factors associated with hospitalassociated mortality were having an infection sustained by S. aureus, a prosthetic valve, diabetes and a neoplasia, and CHD. Being an intravenous drug user (IVDU) was a protective factor and was associated with a reduced death risk. CHD is a factor worsening the prognosis in patients with IE, in particular in patients for whom cardiac surgery was required.

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“…While hepatotrpic viruses are the most common causes of acute hepatitis, bacterial hepatitis are relatively very rare [4] . …”

Section: Bacterial Hepatitismentioning

confidence: 99%

“…implicated in cases of acute hepatitis [4] . Most bacterial infections of liver are however, secondary hepatitis with only discrete clinical and laboratory findings.…”

Section: Gastroenterology and Hepatology Researchmentioning

confidence: 99%

“…The gastrointestinal tract harbors the most complex human microbial ecosystem, estimated to be colonized by more than a trillion bacteria of different species [2] . Injury of the gut barrier causes intestinal translocation and accumulation of bacteria and their components (DNA and endotoxin) towards hepatopathogenesis [3][4][5][6] , directly or indirectly.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bacterial Infection of Liver: A Bird’s Eye View

Parvez

Niyazi

2016

Journal of Gastroenterology and Hepatology Research

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The gastrointestinal tract is colonized by trillions of bacteria and, any injury of the gut barrier causes their translocation to liver and pathogenesis, directly or indirectly. The bacterial infections manifest as liver abscess, acute hepatitis, granulomatous hepatitis, hepatic tuberculosis, spontaneous peritonitis, spontaneous empyema, syphilitic hepatitis, and hepatic brucellosis. The diagnosis includes standard assays for stool and blood culture, biochemistry of liver function and radiology. Chemotherapy with antibiotics as per international guidelines is the treatment option.

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Infectious Complications of Acute and Chronic Liver Disease

Cited by 91 publications

References 208 publications

Bloodstream infections in patients with liver cirrhosis

Bloodstream infections in patients with liver cirrhosis

Infective endocarditis in patients with hepatic diseases

Bacterial Infection of Liver: A Bird’s Eye View

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