Analysis Of Clinical Features And Risk Factors Of End-stage Liver Disease With Bacterial Infection

Objective To analyze the risk factors of bacterial infection in patients with end-stage liver disease and the effect of infection on the short-term prognosis of end-stage liver disease.Methods We conducted a retrospective case-control study.The Patients with end-stage liver disease(liver failure,decompensated cirrhosis and advanced liver cancer)admitted to Ningxia Medical University General Hospital from January 2010 to January 2018 were divided into infection group and non-infection group according to whether or not they bacterial infection.Result There were499 patients with end-stage liver disease complicated with bacterial infection,the incidence rate of infection was 82.9%,605 cases of infection occurred,106 cases of infection in 2 or more sites,accounting for 21.24% of the total number of infections.Common infection sites included 232 cases of pulmonary infection(38.35%),214 cases of spontaneous peritonitis(35.37%),81 cases of biliary infection(13.39%),29 cases of urinary tract infection(4.79%),27 cases of bacteremia(4.46%),etc.The detection rate of pathogenic bacteria was 24.45%,including 35 cases of Escherichia coli(28.68%),followed by 17 cases of Klebsiella pneumoniae(13.93%),15 cases of Enterococcus faecium(12.30%),12 cases of coagulase-negative staphylococci(9.84%),9 cases of Staphylococcus aureus(7.38%),7 cases of Acinetobacter baumannii(5.74%),7 cases of non-Lactococcus pneumoniae(5.74%)pneumoniae(4.10%),Pseudomonas aeruginosa(3.28%).Logistic regression analysis revealed that plasma albumin,MELD score,use ofproton pump inhibitors,ascites in complications,hepatic encephalopathy,and hyponatremia were independent risk factors for infection in ESLD patients.Hospital fatality rate(16.6%)in infected group was significantly higher than that in non-infected group(1.2%)(P<0.05%).more sites of infection,the worse the prognosis of end-stage liver disease(P<0.05).Conclusion The infection rate of end-stage liver disease with bacterial infection was82.89%,the most common infection sites were lung,abdominal cavity and biliary system,the incidence rate was 38.35%(232/605),35.37%(214/605)and 13.39%(81/605),respectively.A total of 122 strains(24.45%)were obtained,the majority of which were Escherichia coli28.68%(35/122),Klebsiella pneumoniae 13.93%(17/122).plasma albumin,MELD score,use of proton pump inhibitors,ascites in complications,hepatic encephalopathy,and hyponatremia are independent risk factors for inducing infection in ESLD patients.patients with end-stage liver disease with infection have worse prognosis.