59. Trend of bacterial infections in cirrhosis in a tertiary care centre

Abstract

Background and Aims: Patients with liver cirrhosis have a high susceptibility for bacterial infections and multidrug resistant infections can result in a rapidly downhill course. Identifying the organism early in the course might be essential to salvage these patients. We aim to study the clinical profile of most common infections in patients with liver cirrhosis in our tertiary care referral center and set up an antibiotic profile Methods: This is a single centre retrospective analysis of prospectively collected data at a tertiary referral centre. The study was conducted in the Institute of Hepatobiliary Sciences, Madras Medical College, Chennai. The study includes 107 patients evaluated for a period of eight months- June 2017 to January 2018. Results: The study included 107 patients with cirrhosis. The most common site of infection was urinary tract followed by blood stream infections and spontaneous bacterial peritonitis. The most common organisms found were Escherichia coli in blood stream infections. Klebsiella followed by enterococcus were prevalent in UTIs. Candiduria was found in one subset of patients with prolonged intensive care unit stay. The most common culturable organism in the urine was Klebsiella of which 40% proved to be multi-drug resistant. Apart from those attributed to nosocomial acquisition, MDR Klebsiella was found in patients with remote hospital admissions, which led to the suspicion of a possible colonic carrier state. Conclusions: This subset of patients may need a more extensive initial empiric antibiotic regimen. To define this subset of patients we plan to advocate rectal swab cultures in those with recurrent in-hospital admissions The authors have none to declare.