Prevalence of Infections in Acute Decompensation of Cirrhosis: A Tertiary Care Centre

Abstract

Background and Aim: Infections are the most common cause of acute decompensation of cirrhosis. The present study was conducted to evaluate incidence of bacterial infections in acute decompensation of cirrhosis, pathogens involved and their impact on prognosis. Methods: It was a prospective study, which enrolled 179 inpatients of acute decompensation of cirrhosis admitted between July 2013 and October 2015. Clinical and microbiological data were recorded. Results: Out of 179 patients, 102 (56.9%) patients were found to have bacterial infections. Out of these, SBP was most common infection in 65 (36%) followed by pneumonia, UTI, SBE and cellulitis in 9 (5%), 8 (4.5%), 4 (2.2%) and 2 (1.1%) respectively. Community acquired infections and nosocomial infections were present in 85 (83.3%) and 17 (16.6%) patients at admission respectively. Low serum albumin (mean 2.7 g/dLvs 2.9 g/dL; P = 0.015) and low serum sodium (129.8 mEq/L vs 132.4 mEq/L; P = 0.015) were present in patients with infection than without infection indicating more advanced liver disease. Escherichia coli was the most common causative organism for SBP (14; 21.5%), UTI (5; 45.5%) and bacteremia (3; 20%) followed by Acinetobacter in blood and sputum and Enterococcus in blood and urine. Other causative organisms were Streptococcucs pneumonia, Klebsiella pneumonia, Aeromonas hydrophila Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia and Crysobacterium. There was no difference in 28- and 90-day mortality due to presence or absence of infection at admission. Multivariate analysis demonstrated that the severity of liver disease was independent factor of mortality. Conclusion: Infections are most common cause of acute decompensation. SBP is most common infection and E coli is most common causative agent at admission. The authors have none to declare.