title: PREVALENCE OF BACTERIAL RESISTANCE IN HOSPITALIZED CIRRHOTIC PATIENTS IN SOUTHERN BRAZIL: A NEW CHALLENGE.
abstract: OBJECTIVE
  An increased frequency of infections by multiresistant bacteria has been described in hospitalized patients. The aim of this study was to evaluate the bacterial resistance profile in cirrhotic patients.
  
  
  METHODS
  This is a retrospective observational study. We assessed the antimicrobial susceptibility of 5,839 bacterial isolates from patients with and without cirrhosis. Regarding the multidrug resistance, we evaluated 4,505 bacterial isolates from 2,180 patients.
  
  
  RESULTS
  Two hundred and fifty-one patients had cirrhosis (mean age 57.6 ± 11 years; 61.8% were male, 47.8% of cases associated with hepatitis C virus). Of the isolates of patients with and without cirrhosis, 174/464 (37.5%) and 1,783/4,041 (44.1%) were multiresistant, respectively (p = 0.007). E. coli was the most common multiresistant bacteria in both groups. Approximately 20% of E. coli and Klebsiella sp. isolates were ESBL-producers and 44% of S. aureus isolates were methicillin-resistant in cirrhotic patients. In cirrhotic patients admitted to the emergency department, hospital ward, and intensive care unit, 28.3%, 50% and 40% had multiresistant isolates, respectively. In patients with and without cirrhosis, 36.2% and 33.5% of isolates were resistant to third-generation cephalosporins, respectively.
  
  
  CONCLUSIONS
  The empirical treatment of infections in hospitalized patients using broad-spectrum antibiotics should consider the observed pattern of bacterial resistance.
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil, anemicheli@yahoo.com.br, angeloamattos@gmail.com.
authors.forename: Ane Micheli
authors.initials: AM
authors.lastname: Costabeber
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil, anemicheli@yahoo.com.br, angeloamattos@gmail.com.
authors.forename: Angelo Alves de
authors.initials: AA
authors.lastname: Mattos
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil, teresa@santacasa.tche.br.
authors.forename: Teresa Cristina Teixeira
authors.initials: TC
authors.lastname: Sukiennik
mesh_terms: D001424:Bacterial Infections / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors