Bacterial infections in patients with liver cirrhosis

Abstract

Introduction. Liver cirrhosis is characterized by a reduced defensive reaction to bacterial infections and patients with cirrhosis are at increased risk of developing infections, sepsis and death. The most common bacterial infections in these patients are spontaneous bacterial peritonitis, urinary tract infection, pneumonia, skin and soft tissue infection and bacteremia. The most common causes are Gram negative bacteria. The aim of this study was to determine the prevalence, localization and etiology of bacterial infections in hospitalized patients with liver cirrhosis. Material and Methods. This retrospective study included 401 patients with liver cirrhosis hospitalized at the Department of Infectious Diseases, Clinical Center of Vojvodina Novi Sad in the period from 2006 to 2010. Bacterial infection was diagnosed according to clinical examination, laboratory findings, radiological examination and bacterial positive culture. Results. The prevalence of bacterial infection was 38.15% (153/401). The most common infections were pneumonia (21.56%), urinary tract infection (20.91%), and spontaneous bacterial peritonitis (18.95%). Localization of infection remained undetermined in as many as 37 patients (24.18%). Bacterial cultures were positive in 32 patients (20.91%), Gram negative bacteria were commonly isolated, mostly Escherichia coli (71.87%). The mortality rate among patients with bacterial infections was 31.37% (48/153). Conclusion. Bacterial infections are often found in patients with liver cirrhosis, the most frequent being pneumonia, urinary tract infection and spontaneous bacterial peritonitis. Gram negative bacteria, especially Escherichia coli were predominant in the etiology. The extent to which bacterial infections are taken into consideration in cases with liver cirrhosis is rather high; however, they are not proved etiologically to the satisfactory level.