title: A retrospective study of bacterial infections in cirrhosis.
abstract: OBJECTIVE
  To evaluate the incidence of bacterial infections (BI) in hepatic cirrhosis (HC), the pathogen agents involved, to define the risk factors and impact on prognosis.
  
  
  METHODS
  There was a retrospective study that enrolled a total of 1046 patients with HC admitted in our clinic between 1.10.2008-31.03.2009 (6 months). Clinical, biological and bacteriological data were monitored.
  
  
  RESULTS
  51 patients (4.9%) were found with BI. In one patient BI was located in three sites: peritoneal, blood and urine, and in 7 patients BI was located in 2 sites. BI location was: peritoneal-26 cases, urinary-20 cases, pneumonia - 8 cases, skin - 4 cases and bacteremia -1 case. 43 episodes were community acquired, while 17 episodes were - nosocomial (peritoneal - 3 cases, lung - 6 cases, skin - 2 cases, urinary - 5 cases). Of the 26 cases with bacterial peritonitis, the etiologic agent was identified in three: E. coli, Klebsiella, Alcaligenes. 18% of patients with HC and BI presented upper GI bleeding. 12 cases required admission to the Intensive Care Unit, where the death rate reached 83%. The risk factors for BI in HC were: decompensated HC OR=58,23 (95% CI 8.63÷1141.31), p-value 10-12, Child Pugh score C: OR =1.99 (95% CI 1.04÷3.8), p-value= 0.02.
  
  
  CONCLUSIONS
  In this study the rate of bacterial infections in HC is low compared with the literature (4.9% vs. 15-30%), because the study was retrospective, hence recorded only severe infections. We must actively seek infections in all hospitalized patients with HC, especially in the ones with decompensated cirrhosis and with upper GI bleeding.
authors.affiliation: Centrul de Gastroenterologie si Hepatologie, Institutul Clinic Fundeni, Bucuresti.
authors.forename: Carmen Monica
authors.initials: CM
authors.lastname: Preda
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Ghita
authors.forename: Camelia
authors.initials: C
authors.lastname: Ghita
authors.forename: Cezarina
authors.initials: C
authors.lastname: Mindru
authors.forename: Livia
authors.initials: L
authors.lastname: Vlaicu
authors.forename: Adriana
authors.initials: A
authors.lastname: Andrei
authors.forename: Sorin
authors.initials: S
authors.lastname: Andrei
authors.forename: Mircea
authors.initials: M
authors.lastname: Diculescu