P-54 STUDY OF BACTERIAL INFECTIONS IN 134 HOSPITALIZATIONS OF PATIENTS WITH LIVER CIRRHOSIS

Background

In cirrhotic, bacterial infections are frequent and demands 25-40% of hospitalizations, can trigger decompensations, organ failure, even death. Spontaneous bacterial peritonitis (SBP), urinary tract infection (UTI), pulmonary and skin are recurrent foci. Thus, preventive measures, early diagnosis and proper management are crucial to reduce morbidity and mortality.

Objectives

Analyze the epidemiology of admitted cirrhoticsat tertiary hospital, their infection, prognosis and mortality.

Methods

Retrospective observational study by analyzing 134 hospitalizations (103 patients) from 06/01/2018 to 05/31/2019. Inclusion: diagnosed cirrhotics (clinic/image). Exclusion: elective hospitalization.

Results

71 men and 32 women. Mediumage 58.4 ± 12.3. Etiologies: alcoholic 46 patients; NAFLD 22; hepatitis C 12. Of all, 45 admissions (33.58%) had community infections - prevalent UTI followed by SBP. Among this 45 hospitalizations, 12 (26.66%) reinfected during the stay. Overall death rate was 31%. Deaths: 2 without infection (71 hospitalizations); 30 infected (63 hospitalizations). In-hospital infections: 18 hospitalizations (13.4%), UTI principally, of which 11 patients died, 8 (72.72%) due to infection. Admission's Child-Pugh (CP) and Meld scores, by site: pulmonary (CP 11 ± 2.05; Meld 27 ± 10.02); 2 focus (CP 10.1 ± 1.86; Meld 23.8 ± 2.92); indeterminate (CP 10.1 ± 2.63; Meld 23.3 ± 8.31); urinary (CP 10.2 ± 2.64; Meld 21.5 ± 10.50); PBE (CP 9.8 ± 1.39; Meld 20.8 ± 4.21); intestinal (CP 9.8 ± 2.31; Meld 21.8 ± 7.68); cutaneous (CP 9.4 ± 0.89; Meld 18.2 ± 2.38); bloodstream (C 7.5 ± 0.70; Meld 16 ± 9.89). Death rate by site: indeterminate 83.3%; 2 sites 71.4%; pulmonary 60%; bloodstream 50%; UTI 35.3%; Intestinal 33.3%; SBP 30%; cutaneous 20%.

Conclusion

The most admitted cirrhotics are men and alcoholic etiology. Undetermined focus infections, 2 sites and lungs had higher mortality and CP/Meld scores on admission. Therefore, broad-spectrum empirical antibiotic therapy and semi-intensive care to this population are recommended.