A prospective study of bacterial infections in patients with cirrhosis.
One hundred and seventy hospitalized patients with cirrhosis were included in a prospective and sequential study, to verify the prevalence and most frequent causes of bacterial infection. The differences in clinical and laboratory data between the two groups were analyzed: group I--80 patients who developed bacterial infection and group II--90 patients without bacterial infection. The prevalence or cumulative frequency of the development of bacterial infection during one hospitalization was 47.06%. Among these, the most frequent types of infection were: spontaneous bacterial peritonitis (SBP): 31.07%, urinary tract infection (UTI): 25.24% and pneumonia: 21.37%. Community infections were more frequent (56.25%) than nosocomial infections (32.50%) and they occurred sequentially in 11.25% of the cases. The agents responsible were gram negative bacteria in 72.34% of the cases. Clinical and biochemical parameters in bacterial infection were generally correlated with the severity of liver disease. Child-Pugh classification showed a predominance of class C in infected cirrhotic patients compared to non-infected ones. During hospitalization, the mortality rate of group I was 30% whereas in group II it was 5.55% (P = 0.0001). SBP and pneumonia were the most severe types of infection, with high mortality rates, 31.25% and 40.91%, respectively. These results indicate that bacterial infection is a severe complication in the course of cirrhosis.
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Clinic of Gastroenterology, Heliópolis Hospital, São Paulo, Brazil.
Strauss
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D013291:Streptococcus; D014552:Urinary Tract Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality