Distribution And Antimicrobial Drug Resistance Of Bacterial Infections In Patients With Liver Cirrhosis

Background and Objective Bacterial infections are one of the mostfrequent complications in cirrhosis and result in high mortality rates.Episodes of infections are more frequent in patients with decompensatedcirrhosis than those with compensated liver disease. Because thesepatients receive long-term prophylactic antibiotic treatments, invasiveoperations and treatments cause the pathogen to change unceasingly andmake it more resistant to antibiotics. Therefore, this retrospective studyinvestigated the distribution and antimicrobial susceptibility of bacteriapathogens in liver cirrhosis patients.Methods A retrospective survey was conducted in289bacterialinfection cases in hospitalized patients with liver cirrhosis admitted to theFirst Hospital of Jilin University from January2010to December2012.This retrospective study assessed the common infection sites, bacterialspecies and local drug susceptibility in patients with liver cirrhosis. Invitro susceptibilities were determined using the disk diffusion method.Susceptibility profiles were determined using zone diameter interpretivecriteria according to the Clinical and Laboratory Standards Institute(CLSI) in2010-2012(M100-S21-M100-S23). Results The most common infections were spontaneous bacterialperitonitis (SBP)(49.2%), sepsis (18.8%), and pneumonia (13.9%) inpatients with liver cirrhosis. The three most frequent pathogenic bacteriaover the3-year period were CNS, E. coli and KPN. Coagulase-negativestaphylococci (CNS), Escherichia coli (E. coli), Streptococcus viridans,Enterococcus, and Klebsiella pneumoniae (KPN) contributed to60.6%ofSBP cases, whereas gram-positive cocci accounted for53.7%.Gram-negative bacilli, especially KPN and E. coli, were the main causesof sepsis (63.3%) and pneumonia (93.9%). CNS was the most common(41.2%) cause of pleural infections. E. coli accounted for52.9%ofurinary tract infections. E. coli (27.3%) and gram-positive cocciEnterococcus (18.2%) were the most frequently identified organisms inpatients with biliary tract infections. Resistance to antimicrobial agentswas less than10%for gram-negative bacilli and less than30%forgram-positive cocci. The resistance of bacterial Infections in nosocomialwere higher compared to community acquired.Conclusion The most common infections were SBP, sepsis, andpneumonia in patients with liver cirrhosis. Gram-positive cocci-relatedinfections have markedly increased in cirrhosis patients compared toprevious research. Resistance to antimicrobial agents was very low forboth gram-negative bacilli and gram-positive cocci. The resistance of bacterial Infections in nosocomial were higher compared to communityacquired.