Epidemiology and Effects of Bacterial Infections in Patients With Cirrhosis Worldwide
| Autor: | Florence Wong, Luis Colombato, Giacomo Zaccherini, Dong Joon Kim, Rita de Cassia Ribeiro Barea, Adrià Juanola, Aleksander Krag, Julio Vorobioff, Javier Romaní Fernández, Jae Seok Hwang, Richard Moreau, Salvatore Piano, Gustavo Romero, Juan Pablo Roblero, Adrián Gadano, Gustavo Navarro, Rakhi Maiwall, Cosmas A. Rinaldi Lesmana, E.L. Yoon, Virendra Singh, M. Marino, Shiv Kumar Sarin, Carlos Brodersen, Carlo Alessandria, François Durand, Victor Vargas, Carmine Gambino, Ji Won Park, Pramod Kumar, Sophie Restellini, M. V. Maevskaya, Nikolaos Pyrsopoulos, Eduardo Fassio, Marcos Girala, Macarena Simón-Talero, Tony Bruns, Paolo Caraceni, Vikas Gautam, Laure Elkrief, Tae Hee Lee, Manuela Merli, Hyoung Su Kim, Tae Hun Kim, Preetam Nath, Ki Tae Suk, Elza Cotrim Soares, Xavier Verhelst, Tiago Sevá-Pereira, Paolo Angeli, C. Toledo, Sebastián Marciano, Barbara Lattanzi, Robert A. de Man, Annette Dam Fialla, Gisela Pinero, Sung Eun Kim, Nicolas M. Intagliata, Hans Van Vlierberghe, Pere Ginès, Kalyan Ram Bhamidimarri, Liane Rabinowich, Do Seon Song, Shivaram Prasad Singh, Michele Bartoletti, Alexander L. Gerbes, Marco Sacco, Laurentius A. Lesmana, Sang Gyune Kim, Jeong Han Kim, Sun Young Yim, Thomas D. Boyer |
|---|---|
| Přispěvatelé: | Piano, Salvatore, Singh, Virendra, Caraceni, Paolo, Maiwall, Rakhi, Alessandria, Carlo, Fernandez, Javier, Soares, Elza Cotrim, Kim, Dong Joon, Kim, Sung Eun, Marino, Monica, Vorobioff, Julio, de Cassia Ribeiro Barea, Rita, Merli, Manuela, Elkrief, Laure, Vargas, Victor, Krag, Aleksander, Singh, Shivaram Prasad, Lesmana, Laurentius Adrianto, Toledo, Claudio, Marciano, Sebastian, Verhelst, Xavier, Wong, Florence, Intagliata, Nicola, Rabinowich, Liane, Colombato, Lui, Kim, Sang Gyune, Gerbes, Alexander, Durand, Francoi, Roblero, Juan Pablo, Bhamidimarri, Kalyan Ram, Boyer, Thomas D, Maevskaya, Marina, Fassio, Eduardo, Kim, Hyoung Su, Hwang, Jae Seok, Gines, Pere, Gadano, Adrian, Sarin, Shiv Kumar, Angeli, Paolo, Gastroenterology & Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
Male 0301 basic medicine Time Factors Cirrhosis Cross-sectional study medicine.medical_treatment Resistance Antibiotics Drug Resistance GLOBAL resistance sepsis stewardship Liver Cirrhosis/epidemiology Liver transplantation Global Health 0302 clinical medicine Risk Factors Drug Resistance Multiple Bacterial Epidemiology Prevalence Hospital Mortality Prospective Studies Incidence (epidemiology) Global Sepsis Stewardship Adult Aged Anti-Bacterial Agents Bacterial Infections Cross-Sectional Studies Female Humans Liver Transplantation Middle Aged Mycoses Prognosis Bacterial Gastroenterology sepsi 030211 gastroenterology & hepatology Multiple medicine.medical_specialty medicine.drug_class 03 medical and health sciences Spontaneous bacterial peritonitis Internal medicine medicine Hepatology business.industry medicine.disease Anti-Bacterial Agents/therapeutic use 030104 developmental biology Mycoses/epidemiology business Bacterial Infections/epidemiology |
| Zdroj: | Gastroenterology, 156(5), 1368-+. W.B. Saunders Piano, S, Singh, V, Caraceni, P, Maiwall, R, Alessandria, C, Fernandez, J, Soares, E C, Kim, D J, Kim, S E, Marino, M, Vorobioff, J, de Cassia Ribeiro Barea, R, Merli, M, Elkrief, L, Vargas, V, Krag, A, Singh, S P, Lesmana, L A, Toledo, C, Marciano, S, Verhelst, X, Wong, F, Intagliata, N, Rabinowich, L, Colombato, L, Kim, S G, Gerbes, A, Durand, F, Roblero, J P, Bhamidimarri, K R, Boyer, T D, Maevskaya, M, Fassio, E, Kim, H S, Hwang, J S, Gines, P, Gadano, A, Sarin, S K, Angeli, P & International Club of Ascites Global Study Group 2019, ' Epidemiology and Effects of Bacterial Infections in Patients With Cirrhosis Worldwide ', Gastroenterology, vol. 156, no. 5, pp. 1368-1380.e10 . https://doi.org/10.1053/j.gastro.2018.12.005 |
| ISSN: | 0016-5085 |
| DOI: | 10.1053/j.gastro.2018.12.005 |
| Popis: | Background & Aims: Bacterial infections are common and life-threatening in patients with cirrhosis. Little is known about the epidemiology of bacterial infections in different regions. We performed a multicenter prospective intercontinental study to assess the prevalence and outcomes of bacterial and fungal infections in patients with cirrhosis. Methods: We collected data from 1302 hospitalized patients with cirrhosis and bacterial or fungal infections at 46 centers (15 in Asia, 15 in Europe, 11 in South America, and 5 in North America) from October 2015 through September 2016. We obtained demographic, clinical, microbiology, and treatment data at time of diagnosis of infection and during hospitalization. Patients were followed until death, liver transplantation, or discharge. Results: The global prevalence of multidrug-resistant (MDR) bacteria was 34% (95% confidence interval 31%–37%). The prevalence of MDR bacteria differed significantly among geographic areas, with the greatest prevalence in Asia. Independent risk factors for infection with MDR bacteria were infection in Asia (particularly in India), use of antibiotics in the 3 months before hospitalization, prior health care exposure, and site of infection. Infections caused by MDR bacteria were associated with a lower rate of resolution of infection, a higher incidence of shock and new organ failures, and higher in-hospital mortality than those caused by non-MDR bacteria. Administration of adequate empirical antibiotic treatment was independently associated with improved in-hospital and 28-day survival. Conclusions: In a worldwide study of hospitalized patients, we found a high prevalence of infection with MDR bacteria in patients with cirrhosis. Differences in the prevalence of MDR bacterial infections in different global regions indicate the need for different empirical antibiotic strategies in different continents and countries. While we await new antibiotics, effort should be made to decrease the spread of MDR bacteria in patients with cirrhosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|