Original Research
Multidrug-resistant bacterial infections in cirrhotic patients: an epidemiological study
Ruihong Zhao, Jianke Ma, Pengcheng Li, Hong Fang, Shanshan Sun, Wei Wu, show all
Received 13 Jun 2018, Accepted 21 Aug 2018, Accepted author version posted online: 28 Aug 2018
Background: The purpose of this study is to describe the epidemiological features of bacterial infections caused by MDR bacteria in cirrhotic patients and their impact on mortality.
Methods: A retrospective study of cirrhotic patients with culture-confirmed bacterial infections was performed between 2011 and 2017.
Results: A total of 635 episodes in 563 patients with cirrhosis were included. Bacterial infections caused by MDR isolates accounted for 44.1% (280/635) of the episodes, nearly half of which were hospital acquired (48.4%). The most common MDR isolation site was the respiratory tract (36.4%, 102 episodes), followed by the abdominal cavity (35.4%, 99 episodes). Of the MDR isolates, carbapenem-resistant Enterobacteriaceae (CRE) (91 episodes) were the most common. Patients infected with MDR bacteria had significantly higher mortality than those not infected (25.1% vs 17.4%, p=0.025). However, this increased mortality could be largely attributed to MRSA. After adjustment for age, sex and the MELD score, only MRSA infection was an independent risk factor for 28-day mortality in the multivariable Cox proportional hazard regression model analysis (HR, 2.964, 95% CI (1.175-7.478), p=0.021).
Conclusions: MDR bacterial infections, especially CRE, have become frequent in patients with cirrhosis in recent years, with MRSA infections significantly increasing short-term mortality.
Keywords: Bacterial infections, liver cirrhosis, multidrug-resistant bacteria, mortality, prognosis作者: StephenW 时间: 2018-8-29 08:28