Abstract
ObjectiveThe study aimed at analyzing the epidemiology and outcomes of liver cirrhosis patients undergoing gram-negative bacterial bloodstream infection.ResultsTotally 508 eligible patients were collected, with 25.79% 30-day mortality, and 58.86% patients were confirmed as nosocomial infection. The most common isolates were Escherichia coli (48.29%) and Klebsiella pneumoniae (19.29%), and multidrug-resistant isolates accounted for 36.61%. The bacterial distributions were similar between survivors and non-survivors (P>0.05), but showed close association with acquisition sites of infection (P<0.05). Nosocomial infection (HR=1.589, 95% CI=1.004-2.517), Child-Pugh grade (HR=2.471, 95% CI=1.279-4.772), septic shock (HR=1.966, 95% CI=1.228-3.146), complications (HR=3.529, 95% CI=2.140-5.818), and WBC (HR=1.065, 95% CI=1.018-1.114) were independent indicators for 30-day mortality. β-lactamase inhibitor antibiotics exerted a high antibacterial activity.MethodsThe inpatients with liver cirrhosis developed gram-negative bacterial bloodstream infection were collected. The clinical characteristics, bacterial distribution and drug sensitivity results of patients were compared according to their 30-day survival status and acquisition sites of infections. Cox regression model was applied to evaluate the risk factors for 30-day mortality.ConclusionEscherichia coli and Klebsiella pneumoniae are frequently isolated from gram-negative bacterial bloodstream infection episodes in cirrhosis patients. Acquisition site of infection can influence clinical characteristics and etiological distribution. β-lactamase inhibitor antibiotics may be the first choice for empirical treatments.
Highlights
Liver cirrhosis is a big threat to people’s health in China
Escherichia coli and Klebsiella pneumoniae are frequently isolated from gram-negative bacterial bloodstream infection episodes in cirrhosis patients
Acquisition site of infection can influence clinical characteristics and etiological distribution. β-lactamase inhibitor antibiotics may be the first choice for empirical treatments
Summary
Liver cirrhosis is a big threat to people’s health in China. It is well known that China has a high HBV infection rate [1]. BSI is one of the serious complications of cirrhosis, representing an important reason for liver failure and death. It has been reported that the occurrence of infection in cirrhosis patients is 10 times more than that in noncirrhosis individuals [4]. And appropriate antibiotic treatments are vitally important for prognosis in liver cirrhosis patients developing to BSI [6]. It is necessary to investigate the epidemiology of infection and antibiotics sensitivity, guiding treatments in liver cirrhosis patients
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