Multidrug-resistant bacterial infections in patients with liver cirrhosis in a tertiary referral hospital

Béjar-Serrano, Sergio; Pozo, Pablo del; Varga, Molly; Benlloch, S.

doi:10.1016/j.gastre.2019.03.010

Cited by 6 publications

(3 citation statements)

References 32 publications

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“…The most frequent bacterial isolate turned out to be gram-negative enteric bacteria, which is similar with other studies [ 31 ]. The common bacterial isolate was E. coli (36.3%, n = 4), which agrees with other reports [ 7 , 32 – 34 ]. Of the gram-positive bacterial isolates, coagulase-negative staphylococcus species were common, accounting for 18.18% and aligning with other studies [ 9 ].…”

Section: Discussionsupporting

confidence: 92%

Bacterial profile, drug resistance pattern, clinical and laboratory predictors of ascites infection in cirrhosis patients

Helil,

Haile,

Birhanu

et al. 2024

BMC Infect Dis

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Ascites is a pathological collection of free fluid in the peritoneal cavity, which is a common complication in patients with cirrhosis, an advanced liver disease. Bacterial infection increases the mortality rate of hospitalized patients with cirrhosis, irrespective of the severity of the liver disease. Around 60% of patients with compensated cirrhosis developed ascites within 10 years during the course of their disease. The in-hospital mortality rate due to spontaneous bacterial peritonitis (SBP) could exceed 90%, but with early diagnosis and prompt antibiotic therapy, this rate has been shown to decrease to 20%. Here, we enrolled adult (age ≥ 18) patients with liver disease with evidence of cirrhosis who developed ascites and assessed the presence of spontaneous ascites fluid infection (SAFI) in these patients. Of the total 218 patients, 22.9% (50/218) develop ascites infection. The liver organ function tests like alanine aminotransferase, aspartate aminotransferase, total bilirubin, and direct bilirubin were found to be significantly (P < 0.05) higher in patients with ascites fluid infection compared to patients with non-ascites fluid infection. Of the gram-negative bacteria, K. pneumonia and E. coli were isolated and found to be 100% resistant to amoxicillin and clavulanate. From the gram-positive bacterial isolates, S. aureus was only resistant to penicillin, whereas Str. viridans was resistant to ceftriaxone, cefotaxime, cefepime, and penicillin. On the other hand, clinical features such as a history of jaundice, low arterial blood pressure, and ultrasound results such as a shrunken liver and enlarged spleen were also independent predictors of spontaneous bacterial peritonitis. In conclusion, given the high probability of death following SAFI, early detection, and treatment, as well as knowledge of the microbial agent, resistance profile, and predictive markers in various contexts, are essential for the timely diagnosis and management of SAFI in these patients.

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Section: Discussionsupporting

confidence: 92%

Bacterial profile, drug resistance pattern, clinical and laboratory predictors of ascites infection in cirrhosis patients

Helil,

Haile,

Birhanu

et al. 2024

BMC Infect Dis

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“…When the analysis was stratified according to the type of MTT, probiotics did not reduce HVPG in cirrhosis more efficiently than antibiotic therapy, because the differences were not statistically significant. Considering the advanced effects and resistance to the long-term antibiotic therapy [ 28 ], probiotics in cirrhosis may show more potential for clinical application with more needed validation.…”

Section: Discussionmentioning

confidence: 99%

“…antibiotic therapy [28], probiotics in cirrhosis may show more potential for clinical application with more needed validation.…”

Section: Plos Onementioning

confidence: 99%

Antibiotics and probiotics on hepatic venous pressure gradient in cirrhosis: A systematic review and a meta-analysis

Zhang

Gao²

2022

PLoS ONE

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Background Modulation of the gut microbiome could favorably alter the hepatic venous pressure gradient (HVPG) in cirrhosis and portal hypertension (PH). Aim This meta-analysis was to evaluate the effects of microbiome-targeted therapies (MTTs) on HVPG in persons with cirrhosis and PH. Methods PubMed, The Cochrane Library, Embase, Web of Science and Scopus were searched for randomized clinical trials (RCTs) analyzing the effects on HVPG in people with cirrhosis who received MTTs. Clinical outcomes were pooled using RevMan5.3 software. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta-analysis results. Results A total of six studies were included. MTTs were associated with a reduction of 1.22 mm Hg in HVPG (95% CI: -2.31, -0.14 mmHg, P = 0.03). Subgroup analysis showed a greater reduction with longer duration (-1.88 mmHg;95% CI: -3.23, -0.53; P = 0.006). In the trial sequential analysis of HVPG reduction, the cumulative Z curve crossed the traditional significance boundary without the achievement of required information size (330). Conclusions MTTs may be associated with a reduction in HVPG in patients with cirrhosis and PH. Microbiome-targeted therapies merit additional large-sample studies to define the efficacy of HVPG. Systematic review registration PROSPERO 2020: CRD4202021609.

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Antimicrobial Resistance in Cirrhosis

Jahagirdar,

Habeeb,

Kulkarni

2024

Curr Hepatology Rep

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Multidrug-resistant bacterial infections in patients with liver cirrhosis in a tertiary referral hospital

Cited by 6 publications

References 32 publications

Bacterial profile, drug resistance pattern, clinical and laboratory predictors of ascites infection in cirrhosis patients

Bacterial profile, drug resistance pattern, clinical and laboratory predictors of ascites infection in cirrhosis patients

Antibiotics and probiotics on hepatic venous pressure gradient in cirrhosis: A systematic review and a meta-analysis

Antimicrobial Resistance in Cirrhosis

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