[The clinical features and prognosis of Aeromonas septicaemia in hepatic cirrhosis: a report of 50 cases].

ABSTRACT

OBJECTIVE: Aeromonas septicaemia complicating cirrhosis is not a common infectious disease. To enhance the knowledge in this aspect, we analysed the clinical features, pathogenetic factors, resistance, treatment and prognosis of Aeromonas septicaemia in 50 cases of hepatic cirrhosis. METHODS: We cultured the bacteria from infected patients with BacT/Alert120 automation instrument made in AKsu and identified the bacteria with the Vitek-AMS60 made in Biomerieux company. We then tested the susceptibility of Aeromonas to 13 antimicrobial agents. RESULTS: A total of 50 cases of Aeromonas septicaemia occurred in severe hepatic cirrhosis. The majority of them had severe complications. Aeromonas hydrophila was the most common species isolated (52.0%). Nosocomial infection was the predominant way of infection. The major clinical manifestations of Aeromonas septicaemia were fever (100%), chill (64.0%), abdominal pain (60.0%), diarrhoea (32.0%) and shock (24.0%). The susceptive rate of Aeromonas to third generation cephalosporin, quinolones and aminoglycoside antibiotics was more than 80%. The cure rate and mortality attributed to Aeromonas septicaemia after treating with third generation cephalosporin, levofloxacin and their combination were 64.3%, 75.0%, 57.1% and 28.6%, 12.5%, 35.7% respectively. CONCLUSION: Aeromonas septicaemia tends to befall patients with severe hepatic cirrhosis and causes a rapidly fatal outcome. Aeromonas should be considered an important pathogen for septicemia in patients with liver cirrhosis. It is suggested that we should emphasize the clinical features and laboratory diagnosis so as to have proper antimicrobial treatment.