Abstracts of the 2023 Annual Meeting of the ALEH
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Introduction and ObjectivesInfections are a frequent cause of decompensation in patients with liver cirrhosis (LC). Understanding local microbiology is important for the correct choice of antibiotics and achieving good clinical outcomes. Objective: To evaluate the microbiology of infections in patients with cirrhosis who were hospitalized in our institution between 2015 and 2022.
Patients / Materials and MethodsA retrospective, observational, and analytical study of LC patients hospitalized for any reason between 2015 and 2022. Positive cultures in LC patients (1036 in total) were reviewed, focusing on blood cultures, ascitic fluid cultures, and other types (bronchial secretions, devices and pleural fluid). Urine cultures, non-infection-related episodes, and contamination cases were excluded. Clinical characteristics of patients in each episode, as well as antimicrobial resistance of each organism, were analyzed. STATA 13.0 was used for data analysis with significance set at < 0.05.
Results and DiscussionA total of 494 episodes of positive cultures from 187 LC patients were included; median age was 61 years (20-81), with 62% male. In 41% of episodes, the patient was immunosuppressed, and 47% were on prophylactic antibiotics. Forty percent of cultures were blood cultures, 20% ascitic fluid, and 40% other types of cultures. The most frequently isolated microorganisms were Enterobacteriaceae and Gram-positive bacteria. Resistance to extended-spectrum beta-lactamases, Vancomycin, and carbapenemases was evaluated, with Vancomycin resistance being the most frequent, only evaluated in enterococci. Immunosuppression was significantly associated with antibiotic resistance (56% vs 25%; p=0.001), whereas prior use of prophylactic antibiotics did not show a significant association (40% in both groups).
ConclusionsThe results suggest the need for empirical therapies for our patients and emphasize the importance of rational antibiotic use.
