O-15 INFECTIONS BY MULTI-DRUG RESISTANT BACTERIA WERE INDEPENDENTLY ASSOCIATED WITH HOSPITAL MORTALITY IN CIRRHOTICS WITH ACUTE DECOMPENSATION: A PROSPECTIVE STUDY ON 433 ADMISSIONS

It has been described as bacterial infections (BIs) due to multidrug-resistant bacteria (MRB) in cirrhosis with acute decompensation (AD), with a potentially poor prognosis. This study aimed to determine the frequency of BIs due to MRB in a tertiary centre and its association with mortality. This is...

Full description

Saved in:

Bibliographic Details
Published in:	Annals of hepatology Vol. 28; p. 101025
Main Authors:	Ruffillo, Gabriela, Codd, Juan Cruz, Martínez, Limbert Jesús Padilla, Tejada, Miguel Angel Puga, Lausi, Adriana Fernández, Landeira, Graciela, Priore, Graciela, Longo, Cristina, Gualano, Gisela, Domínguez, Nora, Socas, Maximiliano, Bartolomeo, Susana di, Fassio, Eduardo
Format:	Journal Article
Language:	English
Published:	Elsevier España, S.L.U 01-03-2023 Elsevier
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	It has been described as bacterial infections (BIs) due to multidrug-resistant bacteria (MRB) in cirrhosis with acute decompensation (AD), with a potentially poor prognosis. This study aimed to determine the frequency of BIs due to MRB in a tertiary centre and its association with mortality. This is a prospective cohort study. Cirrhotics with AD were enrolled. At admission, polymorphonuclear leukocytes (PMN) count was performed in ascites patients. Blood, urine and fluids cultures were collected in patients with encephalopathy, ascites, digestive bleeding or because of IBs suspicion. Sample cultures were repeated during hospitalization when necessary. BIs diagnosis was established based on international consensus. Association among data versus BIs diagnosis was assessed through respective hypothesis testing. Data association with mortality was verified through univariate/multivariate logistic regression: Odds Ratio (OR), 95% confidence interval (CI). 327 males, median age of 56. Child-Pugh A, B and C were estimated in 22, 197, and 214 cases, respectively, median MELD of 16. BIs were diagnosed in 212/433 (49%) inpatients: 128/212 community-acquired (CA) infections, 22/212 healthcare-associated (HCA) infections and 62 nosocomial infections. The most frequent BIs were spontaneous bacterial peritonitis in 69/212 cases, followed by 59/212 respiratory tract infections and 29/212 urinary tract infections. Bacterial isolation was obtained in 108/212 BIs: 35/108 (32.4%) were MRB. MRB was more frequent in cases with HCA (53%) and nosocomial (41%) infections compared with CA (22%) infections; (P=.0279). Mortality was 17.6% in patients without BIs, 28.8% in non-isolation BIs, 24.7% in non-MRB BIs and 51.4% in BIs due to MRB (P<.001). Multivariate analysis showed that mortality was significantly associated with Child-Pugh C, acute kidney injury, but mainly with MRB BIs (OR 4.41; 95% CI 1.94-10.2; P<.001). MRB frequency was 32.4% among BIs with bacterial isolation. It represents an independent predictor for inpatient mortality.
ISSN:	1665-2681 2659-5982
DOI:	10.1016/j.aohep.2023.101025