title: Clinical characteristics and outcomes of pneumococcal bacteremia in adult patients with liver cirrhosis.
abstract: Few studies have assessed the clinical characteristics and outcomes of invasive pneumococcal diseases in cirrhotic patients. We reviewed the medical records of adult cirrhotic patients with pneumococcal bacteremia from January 1997 to April 2006. During this time, 62 episodes of pneumococcal bacteremia occurred in 59 patients with liver cirrhosis, 45 (76.3%) of whom were classified as Child-Pugh grade C. The most common source of infection was spontaneous bacterial peritonitis (SBP) (45.8%), followed by primary bacteremia (40.7%) and pneumonia (10.1%). The 30-day mortality rate was 16.9%, with all fatalities in patients classified as Child-Pugh grade C. The median model for end-stage liver disease score of patients who died was significantly higher than that of survivors (26.5 versus 17.0, P=0.001). Pneumococcal bacteremia in adult cirrhotic patients was more commonly associated with SBP than with pneumonia. Most cases of bacteremia and fatal outcomes occurred in patients with advanced cirrhosis.
authors.affiliation: Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Hyun-Gu
authors.initials: HG
authors.lastname: Park
authors.forename: Jae Bum
authors.initials: JB
authors.lastname: Jun
authors.forename: Sang-Oh
authors.initials: SO
authors.lastname: Lee
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D002439:Cefotaxime / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D011008:Pneumococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D018709:Statistics, Nonparametric
chemical_list: D000900:Anti-Bacterial Agents; D002439:Cefotaxime