Clinical impact of multidrug-resistant bacterial infections in patients with cirrhosis.

ABSTRACT

Aim: Recently, the emergency of multidrug-resistant organisms (MDRO) has complicated the management of bacterial infections (BI) in cirrhosis. We aimed to assess their clinical impact on patients with decompensated cirrhosis. Methods: A retrospective study included consecutive cirrhotic patients hospitalized for acute decompensation (AD) between January 2010 and December 2019. Results: A total of 518 AD admissions in 219 patients were included, with 260 BI episodes (50.2%). MDRO prevalence was 38.2% of the total isolates. Recent antibiotic use (OR = 4.91), nosocomial infection (OR = 2.95), and healthcare-associated infection (OR = 3.45) were their main risk factors. MDROs were associated with empiric treatment failure (OR = 23.42), a higher prevalence of sepsis (OR = 4.93), ACLF (OR = 3.42) and mortality. Conclusion: The clinical impact of MDROs was pejorative, with an increased risk of empiric treatment failure, organ failure and death.

In recent years, an increasing spread of multidrug-resistant bacteria had been observed worldwide. The emergence of these strains could represent a major problem in fragile patients such as cirrhotic patients. Over 10 years, our study analyzed the bacteriological profile of cirrhotic patient infections. The multidrug-resistant bacteria prevalence was 38.2%. Exposure to healthcare facilities and recent antibiotic use, were their main risk factors. These strains had a negative impact with an increased risk of treatment failure and death.