BACTERIAL INFECTIONS IN PATIENTS WITH LIVER CIRRHOSIS
Abstract
Bacterial infections are often found in patients with liver cirrhosis, the most common infections being spontaneous bacterial peritonitis, pneumonia, and urinary tract infection. Patients with liver cirrhosis are immunocompromised and have increased susceptibility to spontaneous bacterial infections such as spontaneous bacterial peritonitis (SBP). Non-SBP infections constitute a heterogeneous group regarding clinical course and prognosis. Gram-negative enterobacteria, especially Escherichia coli, are the most common organisms responsible for community acquired infections. Gram-positive cocci are the most commonly isolated organisms in subjects with nosocomial infections. Up to 30 % of pathogens causing hospital associated infections are multidrug resistant bacteria. Once infection has developed, the excessive production of pro-inflammatory cytokines and a pre-existing hemodynamic derangement characteristic of cirrhosis overlap and predispose further development of serious complications such as shock, acuteon-chronic liver failure, renal failure, and death. Infections constitute the main cause of death in patients with advanced cirrhosis.
References
1. Acute-on-chronic liver failure / R. Jalan [et al.] //J. Hepatol. – 2012. – Vol. 57 (6). – P. 1336-1348.
2. Acute-on-chronic liver failure: a new syndrome that will reclassify cirrhosis / V. Arroyo [et al.] // J. Hepatol. – 2015. – Vol. 62 (1). – P. 131-143.
3. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis / R. Moreau [et al.] // Gastroenterology. – 2013. – Vol. 144 (7). – P. 1426-1437.
4. A dvances in basic and clinical research on liver cirrhosis in 2016 / C. Gu [et al.] // Zhonghua Gan Zang Bing Za Zhi [Chinese journal of hepatology]. – 2017. – Vol. 25 (1). – P. 5-8.
5. Antibiotic prophylaxis for GI endoscopy / S. Banerjee [et al.] // Gastrointest. Endosc. – 2008. – Vol. 67 (6). – P. 791-798.
6. Antibiotic prophylaxis in cirrhosis: Good and bad / J. Fernández [et al.] // Hepatology. – 2016. – Vol. 63 (6). – P. 2019-2031.
7. Bacterial infections in cirrhosis. A position statement based on the EASL Special Conference 2013 / R. Jalan [et al.] // J. Hepatol. – 2014. – Vol. 60 (6). – P. 1310-1324.
8. Bloodstream infections in patients with liver cirrhosis / M. Bartoletti [et al.] // Virulence. – 2016. – Vol. 7 (3). – P. 309-319.
9. Bremmer, D. N. Spontaneous fungal peritonitis: a devastating complication of cirrhosis / D. N. Bremmer, J. M. Garavaglia, R. K. Shields // Mycoses. – 2015. – Vol. 58 (7). – P. 387-393.
10. Bunchorntavakul, C. Bacterial infections in cirrhosis: A critical review and practical guidance / C. Bunchorntavakul, N. Chamroonkul, D. Chavalitdhamrong // World J. Hepatol. – 2016. – Vol. 8 (6). – P. 307-321.
11. Clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease / J. K. Park [et al.] // J. Korean. Med. Sci. – 2015. – Vol. 30 (5). – P. 598-605.
12. Clinical course and short-term mortality of cirrhotic patients with infections other than spontaneous bacterial peritonitis / J. Fernández [et al.] // Liver Int. – 2017. – Vol. 37 (3). – P. 385-395.
13. Comparison of clinical characteristics and outcomes of spontaneous bacterial peritonitis and culture negative neutrocytic ascites / S. H. Na [et al.] // Scand. J. Gastroenterol. – 2017. – Vol. 52 (2). – P. 199-203.
14. Current efficacy of recommended empiric antibiotic therapy in patients with cirrhosis and bacterial infection / J. Acevedo [et al.] // J. Hepatol. – 2009. – Vol. 50 (1). – P. 5.
16. De Franchis, R. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension / R. de Franchis // J. Hepatol. – 2010. – Vol. 53 (4). – P. 762-768.
17. Decreasing mortality among patients hospitalized with cirrhosis in the United States from 2002 through 2010 / M. L. Schmidt [et al.] // Gastroenterology. – 2015. – Vol. 148 (5). – Р. 967-977.
18. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites / P. Angeli [et al.] // J. Hepatol. – 2015. – Vol. 62 (4). – P. 968-974.
19. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club / A. Rimola [et al.] // J. Hepatol. – 2000. – Vol. 32(1). – P. 142-153.
20. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis / P. Ginès [et al.] // J. Hepatol. – 2010. – Vol. 53(3). – P. 397-417.
21. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis / P. Sort [et al.] // N. Engl. J. Med. – 1999. – Vol. 341. – P. 403-409.
22. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice / S. Angeloni [et al] // World J. Gastroenterol. – 2008. – Vol. 14 (17). – P. 2757- 2762.
23. Emergency department visits related to cirrhosis: a retrospective study of the nationwide emergency department sample 2006 to 2011 / C. Pan [et al.] // Medicine (Baltimore). – 2015. – Vol. 94 (1): e308.
24. Epidemiology of bacterial infections in patients with liver cirrhosis. Experience in a Spanish tertiary health center / K. Klímová [et al.] // Biomedica. – 2016. – Vol. 36 (1). – P. 121-132.
25. Evidence of neutrophil functional defect despite inflammation in stable cirrhosis / Tritto G. [et al.] // J. Hepatol. – 2011. – Vol. 55 (3). – P. 574-581.
26. Fernandez, J. Management of bacterial infections in cirrhosis / J. Fernandez, T. Gustot // J. Hepatol. – 2012. – Vol. 56 (1). – P. 1-12.
27. Fiore, M. Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective / M. Fiore, S. Leone // World J. Gastroenterol. – 2016. – Vol. 22(34). – P. 7742-7747.
28. Fungal peritonitis: underestimated disease in critically ill patients with liver cirrhosis and spontaneous peritonitis / T. Lahmer [et al.] // PLoS One. – 2016. – Vol. 11. – e0158389. – DOI: 10.1371/journal.pone.0158389.
29. Garcia-Tsao, G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis // Gastroenterology. – 2001. – Vol. 120 (4). – P. 726-748.
30. Gines, P. Renal Failure in Cirrhosis / P. Gines, R.W. Schrier // N. Engl. J. Med. – 2009. – Vol. 361 (13). – P. 1279-90.
31. Gut flora and bacterial translocation in chronic liver disease / J. Almeida [et al.] // World. J. Gastroenterol. – 2006. – Vol. 12 (10). – P. 1493-1502.
32. Infections in patients with cirrhosis increase mortality fourfold and should be used in determining prognosis / V. Arvaniti [et al.] // Gastroenterology. – 2010. – Vol. 139 (4). – P. 1246-1256.
33. Intestinal permeability in a patient with liver cirrhosis / J. M. Aguirre Valadez [et al.] // Ther. Clin. Risk Manag. – 2016. – Vol. 12. – P. 1729-1748.
34. Leon, D. A. Liver cirrhosis mortality rates in Britain from 1950 to 2002: an analysis of routine data / D. A. Leon, J. McCambridge // Lancet. – 2006. – Vol. 367 (9504). – P. 52-56.
35. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure / D. Thabut [et al.] // Hepatology. – 2007. – Vol. 46 (6). – P. 1872-1882.
36. Nosocomial spontaneous bacterial peritonitis and bacteremia in cirrhotic patients: impact of isolate type on prognosis and characteristics of infection / B. Campillo [et al.] // Clin Infect Dis. – 2002. – Vol. 35 (1). – P. 1-10.
37. Patients with acute on chronic liver failure display “sepsis-like” immune paralysis / H. E. Wasmuth [et al.] // J. Hepatol. – 2005. – Vol. 42 (2). – P. 195-201.
38. Patients with cirrhosis in the ED: early predictors of infection and mortality / [A.Q. Farias [et al.] // Am. J. Emerg. Med. – 2016. – Vol. 34 (1). – P. 25-29.
39. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: A prospective study / J. Fernández [et al.] // Hepatology. – 2012. – Vol. 55 (5). – P. 1551-1561.
40. Runyon, B.A. Management of adult patients with ascites due to cirrhosis: update 2012 / B.A. Runyon // Hepatology. – 2009. – Vol. 49 (6). – P. 2087-2107.
41. Sajjad, M. Ascitic fluid culture in cirrhotic patients with spontaneous bacterial peritonitis / M. Sajjad, Z. A. Khan, M. S. Khan // J. Coll Physicians Surg Pak. – 2016. – Vol. 26 (8). – P. 658-661.
42. Sepsis in cirrhosis: Report on the 7th meeting of the international ascites club / F. Wong [et al.] // Gut. – 2005. – Vol. 54 (5). – P. 718-725.
43. Severe sepsis in cirrhosis / T. Gustot [et al.] // Hepatology. – 2009. – Vol. 50 (6). – P. 2022-2033.
44. Sheer, T.A. Spontaneous bacterial peritonitis / T. A. Sheer, B. A. Runyon // Dig. Dis. – 2005. – Vol. 23 (1). – P. 39-46.
45. Solà, E. Acute-on-Chronic Liver Failure: The Role of Precipitating Illness / E. Solà, J. Fernandez, P. Ginès // Semin Liver Dis. – 2016. – Vol. 36(2). – P. 117-122.
46. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure / J. Clària [et al.] // Hepatology. – 2016. – Vol. 64 (4). – P. 1249-1264.
47. The effect of the first spontaneous bacterial peritonitis event on the mortality of cirrhotic patients with ascites: A Nationwide Population-Based Study in Taiwan / T. H. Hung [et al.] // Gut Liver. – 2016. – Vol. 10 (5). – P. 803-807.
48. The impact of infection by multidrug-resistant agents in patients with cirrhosis. A multicenter prospective study // F. Salerno [et al.] // Liver Int. – 2017. – Vol. 37 (1). – P. 71-79.
49. The Periscreen strip is highly efficient for the exclusion of spontaneous bacterial peritonitis in cirrhotic outpatients // Am. J. Gastroenterol. – 2016 . – Vol. 111(10). – P. 1402-1409.
50. Wong F. Acute kidney injury in liver cirrhosis: new definition and application // Clin. Mol. Hepatol. – 2016. – Vol. 22 (4). – P. 415-422.
51. Zhou Z. Hepatocytes: a key cell type for innate immunity / Z. Zhou, M.-J. Xu, B. Gao // Cell Mol. Immunol. – 2016;13(3):301-315.
