TITLE

Risk Factors for the Development of Bacterial Infections in Hospitalized Patients With Cirrhosis

AUTHOR(S)
Deschênes, Marc; Villeneuve, Jean-Pierre
PUB. DATE
August 1999
SOURCE
American Journal of Gastroenterology;Aug1999, Vol. 94 Issue 8, p2193
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: Bacterial infection is a frequent and severe complication of cirrhosis. Cirrhotic patients admitted for gastrointestinal bleeding are at high risk of such a complication and have been targeted in trials of antibiotic prophylaxis. However, it has not been shown that these patients are at a higher risk than cirrhotic patients hospitalized for other reasons. This prospective study was performed to assess the risk of bacterial infection in unselected hospitalized cirrhotic patients and to evaluate possible risk factors for this complication. METHODS: One hundred-forty hospitalized cirrhotic patients without clinical evidence of infection at the time of initial presentation were followed-up prospectively for manifestations of infection. RESULTS: Twenty-eight (20%) patients developed an infection during their hospitalization. Infections without a specific site (39%) and spontaneous bacterial peritonitis (32%) were the most common diagnoses. Univariate analysis showed that patients who developed an infection were more likely to have a low serum albumin level, to be admitted for gastrointestinal bleeding, to stay in the intensive care unit, and to undergo therapeutic endoscopy. Logistic regression identified admission for gastrointestinal bleeding (odds ratio (OR) = 4.3, 95% confidence interval (CI) = 1.7-10.9) and a low serum albumin (OR = 1.3, 95% CI = 1.03-1.22) as the only two variables independently associated with the development of an infection. CONCLUSION: The present study indicates that patients with severe cirrhosis who are admitted for gastrointestinal bleeding have a higher risk of developing a bacterial infection during their hospitalization than other cirrhotic patients.
ACCESSION #
17830829

 

Related Articles

  • Prevention and Management of Bacterial Infections in Cirrhosis. Taneja, Sunil K.; Dhiman, Radha K. // International Journal of Hepatology;2011, p1 

    Patients with cirrhosis of liver are at risk of developing serious bacterial infections due to altered immune defenses. Despite the widespread use of broad spectrum antibiotics, bacterial infection is responsible for up to a quarter of the deaths of patients with liver disease. Cirrhotic...

  • Spontaneous Bacterial Peritonitis. Horinek, Erica; Fish, Doug // AACN Advanced Critical Care;Apr-Jun2009, Vol. 20 Issue 2, p121 

    The article discusses spontaneous bacterial peritonitis (SBP), its pathophysiology, risk factors, and treatment. The author explains that SBP has been acknowledged as the most common infection among patients with cirrhosis. Two variants of SBP, bacterascites and culture-negative SBP, are...

  • Impact of Rifaximin on the Frequency and Characteristics of Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis and Ascites. Lutz, Philipp; Parcina, Marijo; Bekeredjian-Ding, Isabelle; Nischalke, Hans Dieter; Nattermann, Jacob; Sauerbruch, Tilman; Hoerauf, Achim; Strassburg, Christian P.; Spengler, Ulrich // PLoS ONE;Apr2014, Vol. 9 Issue 4, p1 

    Background: Rifaximin is a non-absorbable antibiotic used to prevent relapses of hepatic encephalopathy which may also be a candidate for prophylaxis of spontaneous bacterial peritonitis (SBP). Aim: To detect the impact of rifaximin on the occurrence and characteristics of SBP. Methods: We...

  • Parenteral Antibiotic Prophylaxis of Bacterial Infections Does Not Improve Cost-Efficacy of Oral Norfloxacin in Cirrhotic Patients With Gastrointestinal Bleeding. Sàbat, Míriam; Kolle, Lillian; Soriano, Germán; Ortiz, Jordi; Pamplona, Javier; Novella, Maria Teresa; Villanueva, Càndid; Sainz, Sergio; Torras, Javier; Balanzó, Joaquím; Guarner, Carlos // American Journal of Gastroenterology;Dec1998, Vol. 93 Issue 12, p2457 

    Objective: Selective intestinal decontamination with norfloxacin is useful in the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding. However, bleeding cirrhotic patients with ascites, encephalopathy, or shock are at high risk to develop bacterial infections...

  • NORFLOXACIN PROPHYLAXIS: NEW HOPE FOR BLEEDING CIRRHOTICS. Lawson, J. Mark; Johnson, David A.; Cattau Jr., Edward L. // American Journal of Gastroenterology;Sep1993, Vol. 88 Issue 9, p1455 

    The use of norfloxacin as prophylactic therapy to prevent infection in cirrhotics has been reported in a number of recent studies. The authors of this paper wished to assess the prevention of infectious complications with norfloxacin in cirrhotics admitted to the hospital with gastrointestinal...

  • Review: Antibiotic prophylaxis reduces mortality and bacterial infection in cirrhosis and gastrointestinal bleeding. Ioannou, George N.; Kowdley, Kris V. // ACP Journal Club;Nov/Dec2002, Vol. 137 Issue 3, p94 

    Discusses research being done on the effectiveness of antibiotic prophylaxis in reducing bacterial infection and mortality in patients with cirrhosis and gastrointestinal bleeding. Reference to study by K. Soares-Weiser and colleagues; Sources of data; Results and conclusion.

  • Acute Gastrointestinal Bleeding from Portal Hypertensive Gastropathy: Prevalence and Clinical Features. Gostout, Christopher J.; Viggiano, Thomas R.; Balm, Rita K. // American Journal of Gastroenterology;Dec1993, Vol. 88 Issue 12, p2030 

    The clinical and endoscopic features of patients diagnosed with acute bleeding due to portal hypertensive gastropathy (PHG) were evaluated. Acute bleeding from PHG was diagnosed in 12 patients (0.8%) of 1496 patient admissions prospectively evaluated by our Gastrointestinal Bleeding Team over a...

  • The Effect of Ciprofloxacin in the Prevention of Bacterial Infection in Patients With Cirrhosis After Upper Gastrointestinal Bleeding. Wen-Jen Hsieh; Han-Chieh Lin; Shinn-Jang Hwang; Ming-Chih Hou; Fa-Yauh Lee; Full-Young Chang; Shou-Dong Lee // American Journal of Gastroenterology;Jun1998, Vol. 93 Issue 6, p962 

    Objectives: Cirrhotic patients with upper gastrointestinal bleeding are prone to bacterial infection. The aim of this study was to investigate the efficacy of prophylactic intestinal decontamination with oral ciprofloxacin for the prevention of bacterial infections in cirrhotic patients with...

  • Spontaneous bacterial peritonitis due to Listeria monocytogenes: importance of enrichment culture. Saroj Jayasinghe // Journal of Clinical Pathology;Sep2010, Vol. 63 Issue 9, p835 

    A case of Listeria monocytogenes induced spontaneous bacterial peritonitis (SBP) is reported in a patient with primary biliary cirrhosis. It is an indolent illness and may not show a neutrophil reaction in peritoneal fluid. Enrichment broth was required to isolate L monocytogenes in the patient....

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics