P-18 PREVALENCE AND EPIDEMIOLOGICAL CHARACTERISTICS OF INFECTIONS IN PATIENTS WITH CHRONIC LIVER DISEASE: RETROSPECTIVE ANALYSIS FROM A GENERAL HOSPITAL IN MONTERREY, NUEVO LEON, MEXICO

Introduction

Chronic liver disease (CLD) associated with infections has a high short-term mortality. Infections are the first cause of mortality in CLD patients. The information of these patients in Mexico is limited.

Objective

Identify the prevalence of infections in CLD patients in a hospital in Monterrey, Mexico.

Methods

Data was obtained from one hospital (August 2017-October 2019). Patients ≥18 years old with CLD diagnosis by clinical, biochemical, imaging and/or histological criteria were included. Exclusion criteria were patients with incomplete information, antibiotic use <7 days before hospitalization, cancer, or use of immunosuppressant drugs.

Data included demography, clinical presentation, diagnosis, prognostic scores (Child-Turcotte-Pugh -CTP- and the Model for End-Stage Liver Disease-Sodium -MELD-Na-), infections, and in-hospital mortality. Infectious Diseases Society of America (IDSA) criteria were used to define infections.

Descriptive statistics, Chi squared test, Mann-Whitney U test, and Logistic regression were used to analyze data.

Results

393 patients aged 55 years old (54.6±11.4) were included, 81% male patients. 79% were diagnosed with CLD in hospitalization. 55% were CTP Class C and 69% had a MELD-Na >17.

92 patients had an infection. 76% were community acquired. The main cause of infections was spontaneous bacterial peritonitis (30.4%). 212 cultures were obtained, but only 22 isolated a microorganism; 50% reported E. Coli, and 54% were multidrug-resistant bacteria.

Mortality was 25%. Patients with infections had a higher mortality. Infections were related with a worst prognostic score: CTP class C (OR 3.78, CI 95% [1.10–12.93]; p=0.034); MELD-Na >17 (OR 2.07, CI 95% [1.16–3.68]; p=0.013). Infections had a higher risk of death (OR 4.38, CI 95% [2.41–6.75]; p<0.0001).

Conclusion

Prevalence of infections in CLD patients is similar to other countries. These infections are associated with a worst CLD prognosis and have a four-fold risk of mortality.