Changes in the epidemiology and management of bacterial infections in cirrhosis

Clin Mol Hepatol. 2021 Jul;27(3):437-445. doi: 10.3350/cmh.2020.0329. Epub 2021 Jan 28.


Patients with cirrhosis are susceptible to develop infections because of immune dysfunction, changes in microbiome and increase in bacterial translocation from the gut to systemic circulation. Bacterial infections can worse the clinical course of the disease, triggering the development of complications such as acute kidney injury, hepatic encephalopathy, organ failures and acute on chronic liver failure. In recent years, the spread of multi drug resistant bacteria made more challenging the management of infections in patients with cirrhosis. Hence, the mortality rate associated to sepsis is increasing in these patients. Therefore, the optimization of the management of infections has a high priority in cirrhosis. Herein we reviewed the recent changes in the epidemiology and the management of bacterial infections in patients with liver cirrhosis.

Keywords: Antimicrobial stewardship; Liver transplantation; Sepsis; Septic shock.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections* / complications
  • Bacterial Infections* / drug therapy
  • Bacterial Infections* / epidemiology
  • Hepatic Encephalopathy / epidemiology
  • Humans
  • Liver Cirrhosis* / complications
  • Liver Cirrhosis* / drug therapy
  • Liver Cirrhosis* / epidemiology
  • Sepsis


  • Anti-Bacterial Agents