A prospective study of bacterial infections in patients with cirrhosis

J Hepatol. 1993 Jul;18(3):353-8. doi: 10.1016/s0168-8278(05)80280-6.

Abstract

One hundred and seventy hospitalized patients with cirrhosis were included in a prospective and sequential study, to verify the prevalence and most frequent causes of bacterial infection. The differences in clinical and laboratory data between the two groups were analyzed: group I--80 patients who developed bacterial infection and group II--90 patients without bacterial infection. The prevalence or cumulative frequency of the development of bacterial infection during one hospitalization was 47.06%. Among these, the most frequent types of infection were: spontaneous bacterial peritonitis (SBP): 31.07%, urinary tract infection (UTI): 25.24% and pneumonia: 21.37%. Community infections were more frequent (56.25%) than nosocomial infections (32.50%) and they occurred sequentially in 11.25% of the cases. The agents responsible were gram negative bacteria in 72.34% of the cases. Clinical and biochemical parameters in bacterial infection were generally correlated with the severity of liver disease. Child-Pugh classification showed a predominance of class C in infected cirrhotic patients compared to non-infected ones. During hospitalization, the mortality rate of group I was 30% whereas in group II it was 5.55% (P = 0.0001). SBP and pneumonia were the most severe types of infection, with high mortality rates, 31.25% and 40.91%, respectively. These results indicate that bacterial infection is a severe complication in the course of cirrhosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / complications*
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / mortality
  • Escherichia coli
  • Escherichia coli Infections / complications
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / mortality
  • Female
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / mortality
  • Male
  • Middle Aged
  • Peritonitis / complications
  • Peritonitis / epidemiology
  • Peritonitis / mortality
  • Pneumonia / complications
  • Pneumonia / epidemiology
  • Pneumonia / mortality
  • Prevalence
  • Prospective Studies
  • Streptococcal Infections / complications
  • Streptococcal Infections / epidemiology
  • Streptococcal Infections / mortality
  • Streptococcus
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / mortality