Evaluate the bacterial infections in Indian cirrhotic patients: a prospective study

Abstract

Background: Bacterial infections (BI) are more prevalent in liver cirrhosis (LC), high among hospitalized patients. The aim of the study was to explore epidemiological pattern of BI in hospitalized patients with LC with identification of the causative agents. Objective of the study was evaluation of therapeutic/empirical approaches for infections.Methods: Inputs from the body fluid analysis and culture reports were recorded. Child Pugh score (CPS) was used to assess the severity of liver disease. Antibiotic treatment strategy was analysed, prescribed antibiotics were checked for contraindications using Lexicomp software.Results: Of 60 enrolled patients, four had mixed infection and 55% were culture positive. There was a male preponderance (83.3%). BI was more frequent in those aged 51-60 years (38.3%) and >60 years (35%). Higher proportion of patients (60%) belonged to class C of CPS followed by class B (31.7%). The most common causative organisms identified were E. coli (28.5%), K. pneumonia (14.2%), Enterococcus spp (11.4 %) and less common were K. oxytoca, Coagulase-negative staphylococci, Staphylococcus aureus, gram-positive cocci, gram-negative cocci, P. aeruginosa, S. hemolyticus, ß-hemolytic streptococcus spp. Majority of subjects had spontaneous bacterial peritonitis (36.7%) followed by urinary tract infection (21%), lower respiratory tract infection (18.3%), Sepsis (13.3%), cellulitis (3.3%) and acute gastroenteritis (1.7%). Cephalosporin's (61.7%), (rifaximin) (51.7%), penicillin and β lactamase inhibitors (36.7%) were the common prescribed antimicrobials.Conclusions: There is a positive association between the risk of BI and severity of liver damage.