Clinical impact of multidrug-resistant bacterial infections in patients with cirrhosis.
Nouha TradGhanem MohamedSondes BizidHatem Ben AbdallahRiadh BoualiMohamed Nabil AbdelliPublished in: Future science OA (2024)
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.
Keyphrases
- risk factors
- multidrug resistant
- end stage renal disease
- healthcare
- ejection fraction
- newly diagnosed
- chronic kidney disease
- heart failure
- gram negative
- emergency department
- prognostic factors
- liver failure
- peritoneal dialysis
- acinetobacter baumannii
- public health
- type diabetes
- coronary artery disease
- patient reported outcomes
- klebsiella pneumoniae
- respiratory failure
- cystic fibrosis
- acute respiratory distress syndrome
- hepatitis b virus
- urinary tract infection
- cardiovascular events
- extracorporeal membrane oxygenation
- septic shock