title: Role of Infections in Acute-on-Chronic Liver Failure.
abstract: Patients with cirrhosis are prone to developing bacterial infections. Moreover, bacterial infection is the most common identifiable trigger of acute-on-chronic liver failure (ACLF), which is characterized by organ failures and a high risk of death. There is evidence of an excessive immune response of the host as a major mechanism leading to the development of organ failures in patients with cirrhosis. However, a role for direct tissue damage caused by bacterial toxins and virulence factors cannot be excluded. Failed tolerance mechanisms may also contribute to organ failures, although the involved mechanisms are unclear. A proportion of patients with infection-related ACLF have a prolonged stay in the intensive care unit. These patients have immune suppression, increased risk of superinfection and poor outcome. Immune suppression might be a consequence of the first infection episode that has led patients to be admitted to hospital.
authors.affiliation: Inserm, U1149, Centre de Recherche sur l'Inflammation (CRI), Université Paris Diderot-Paris 7, Paris, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Moreau
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000276:immunology / Q000382:microbiology* / Q000401:mortality; D001424:Bacterial Infections / Q000276:immunology* / Q000382:microbiology / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D007108:Immune Tolerance; D008103:Liver Cirrhosis / Q000150:complications*; D009102:Multiple Organ Failure / Q000276:immunology / Q000382:microbiology* / Q000401:mortality; D015163:Superinfection / Q000276:immunology / Q000382:microbiology / Q000401:mortality