Investigation into bacteremia and spontaneous bacterial peritonitis in patients with liver cirrhosis in Japan.
OBJECTIVE
Liver cirrhosis patients tend to develop bacteremia, but relatively little has been reported about the situation in Japan. Therefore, we investigated the microorganisms involved and the outcome among liver cirrhosis patients with bacteremia, including spontaneous bacterial peritonitis.


METHODS
The subjects were 236 patients who underwent a total of 377 blood cultures and 30 patients diagnosed with spontaneous bacterial peritonitis, among 6,096 inpatients with liver cirrhosis admitted to several hospitals during the period 1991-2009.


RESULTS
The rate of positive blood culture was 37.1% (140/377), and the isolated microorganisms were predominantly Gram-negative bacteria. In patients with confirmed bacteremia, the Child-Pugh score and serum blood urea nitrogen and creatinine levels were significantly higher than in non-bacteremia cases. Moreover, short-term mortality (within 1 month) was 48.2% (53/110), being significantly higher than that among non-bacteremia cases (18.8%; 22/117). Among spontaneous bacterial peritonitis cases, mortality within one month was 33.3% (10/30). Again, the Child-Pugh score and serum blood urea nitrogen and creatinine levels were significantly higher among the fatalities than among survivors.


CONCLUSIONS
These results indicate that severity of liver dysfunction and severity of renal dysfunction are both important determinants of short-term mortality among liver cirrhosis patients with bacteremia and spontaneous bacterial peritonitis in Japan.
Department of Physiology, School of Medicine Tokai University, 143 Shimokasuya, Isehara, Kanagawa, Japan. shizuma@is.icc.u-tokai.ac.jp
Toru
T
Shizuma
Naoto
N
Fukuyama
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology* / Q000401:mortality*; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006530:Hepatorenal Syndrome / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000382:microbiology* / Q000401:mortality*; D012720:Severity of Illness Index
D003404:Creatinine