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Bacterial infections in alcoholic and nonalcoholic liver cirrhosis

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Sargenti, Konstantina ; Prytz, Hanne ; Bertilsson, Sara ; Kalaitzakis, Evangelos. / Bacterial infections in alcoholic and nonalcoholic liver cirrhosis. In: European journal of gastroenterology & hepatology. 2015 ; Vol. 27, No. 9. pp. 1080-6.

Bibtex

@article{bb833d4dac524f859be6d786d8c10dee,
title = "Bacterial infections in alcoholic and nonalcoholic liver cirrhosis",
abstract = "OBJECTIVES: Longitudinal, population-based data on the occurrence, localization, and severity of bacterial infections over time in patients with alcoholic compared with nonalcoholic cirrhosis are limited.MATERIALS AND METHODS: All patients with incident cirrhosis diagnosed in 2001-2010 (area of 600,000 inhabitants) were retrospectively identified. All bacterial infections resulting in or occurring during an inpatient hospital episode during this period were registered. The etiology of cirrhosis (alcoholic vs. nonalcoholic), infection localization, and outcome as well as bacterial resistance patterns were analyzed. Patients were followed until death, transplant, or the end of 2011.RESULTS: In all, 633 cirrhotics (363 alcoholic, 270 nonalcoholic) experienced a total of 398 infections (2276 patient-years). Among patients diagnosed with cirrhosis each year from 2001 to 2010, increasing trends were noted in the occurrence of infection (from 13 to 27%, P<0.001) and infection-related in-hospital mortality (from 2 to 7%, P=0.05), the latter mainly in the alcoholic group. Although alcoholic etiology was related to the occurrence of more frequent infection (Kaplan-Meier, P<0.001), this relationship was not significant after adjustment for confounders in Cox regression analysis (P=0.056). Resistance to piperacilin-tazobactam and carbapenems was more common in infections occurring in alcoholic versus nonalcoholic cirrhosis (13 vs. 5%, P=0.057 and 12 vs. 2%, P=0.009). Alcoholic etiology predicted pneumonia and infections caused by Gram-positive bacteria in multivariate analysis (P<0.05 for both).CONCLUSION: In a population-based cirrhotic cohort, bacterial infections increased over time, which, in the case of alcoholic cirrhosis, was associated with pneumonia and bacterial resistance to antibiotics. However, alcoholic etiology was not related indepedently to the occurrence of bacterial infections.",
keywords = "Aged, Anti-Bacterial Agents, Bacterial Infections, Drug Resistance, Bacterial, Female, Humans, Incidence, Kaplan-Meier Estimate, Liver Cirrhosis, Liver Cirrhosis, Alcoholic, Liver Transplantation, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Sweden, Time Factors, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't",
author = "Konstantina Sargenti and Hanne Prytz and Sara Bertilsson and Evangelos Kalaitzakis",
year = "2015",
month = sep,
doi = "10.1097/MEG.0000000000000396",
language = "English",
volume = "27",
pages = "1080--6",
journal = "European Journal of Gastroenterology and Hepatology",
issn = "0954-691X",
publisher = "Lippincott Williams & Wilkins",
number = "9",

}

RIS

TY - JOUR

T1 - Bacterial infections in alcoholic and nonalcoholic liver cirrhosis

AU - Sargenti, Konstantina

AU - Prytz, Hanne

AU - Bertilsson, Sara

AU - Kalaitzakis, Evangelos

PY - 2015/9

Y1 - 2015/9

N2 - OBJECTIVES: Longitudinal, population-based data on the occurrence, localization, and severity of bacterial infections over time in patients with alcoholic compared with nonalcoholic cirrhosis are limited.MATERIALS AND METHODS: All patients with incident cirrhosis diagnosed in 2001-2010 (area of 600,000 inhabitants) were retrospectively identified. All bacterial infections resulting in or occurring during an inpatient hospital episode during this period were registered. The etiology of cirrhosis (alcoholic vs. nonalcoholic), infection localization, and outcome as well as bacterial resistance patterns were analyzed. Patients were followed until death, transplant, or the end of 2011.RESULTS: In all, 633 cirrhotics (363 alcoholic, 270 nonalcoholic) experienced a total of 398 infections (2276 patient-years). Among patients diagnosed with cirrhosis each year from 2001 to 2010, increasing trends were noted in the occurrence of infection (from 13 to 27%, P<0.001) and infection-related in-hospital mortality (from 2 to 7%, P=0.05), the latter mainly in the alcoholic group. Although alcoholic etiology was related to the occurrence of more frequent infection (Kaplan-Meier, P<0.001), this relationship was not significant after adjustment for confounders in Cox regression analysis (P=0.056). Resistance to piperacilin-tazobactam and carbapenems was more common in infections occurring in alcoholic versus nonalcoholic cirrhosis (13 vs. 5%, P=0.057 and 12 vs. 2%, P=0.009). Alcoholic etiology predicted pneumonia and infections caused by Gram-positive bacteria in multivariate analysis (P<0.05 for both).CONCLUSION: In a population-based cirrhotic cohort, bacterial infections increased over time, which, in the case of alcoholic cirrhosis, was associated with pneumonia and bacterial resistance to antibiotics. However, alcoholic etiology was not related indepedently to the occurrence of bacterial infections.

AB - OBJECTIVES: Longitudinal, population-based data on the occurrence, localization, and severity of bacterial infections over time in patients with alcoholic compared with nonalcoholic cirrhosis are limited.MATERIALS AND METHODS: All patients with incident cirrhosis diagnosed in 2001-2010 (area of 600,000 inhabitants) were retrospectively identified. All bacterial infections resulting in or occurring during an inpatient hospital episode during this period were registered. The etiology of cirrhosis (alcoholic vs. nonalcoholic), infection localization, and outcome as well as bacterial resistance patterns were analyzed. Patients were followed until death, transplant, or the end of 2011.RESULTS: In all, 633 cirrhotics (363 alcoholic, 270 nonalcoholic) experienced a total of 398 infections (2276 patient-years). Among patients diagnosed with cirrhosis each year from 2001 to 2010, increasing trends were noted in the occurrence of infection (from 13 to 27%, P<0.001) and infection-related in-hospital mortality (from 2 to 7%, P=0.05), the latter mainly in the alcoholic group. Although alcoholic etiology was related to the occurrence of more frequent infection (Kaplan-Meier, P<0.001), this relationship was not significant after adjustment for confounders in Cox regression analysis (P=0.056). Resistance to piperacilin-tazobactam and carbapenems was more common in infections occurring in alcoholic versus nonalcoholic cirrhosis (13 vs. 5%, P=0.057 and 12 vs. 2%, P=0.009). Alcoholic etiology predicted pneumonia and infections caused by Gram-positive bacteria in multivariate analysis (P<0.05 for both).CONCLUSION: In a population-based cirrhotic cohort, bacterial infections increased over time, which, in the case of alcoholic cirrhosis, was associated with pneumonia and bacterial resistance to antibiotics. However, alcoholic etiology was not related indepedently to the occurrence of bacterial infections.

KW - Aged

KW - Anti-Bacterial Agents

KW - Bacterial Infections

KW - Drug Resistance, Bacterial

KW - Female

KW - Humans

KW - Incidence

KW - Kaplan-Meier Estimate

KW - Liver Cirrhosis

KW - Liver Cirrhosis, Alcoholic

KW - Liver Transplantation

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Prognosis

KW - Proportional Hazards Models

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Severity of Illness Index

KW - Sweden

KW - Time Factors

KW - Comparative Study

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1097/MEG.0000000000000396

DO - 10.1097/MEG.0000000000000396

M3 - Journal article

C2 - 26011234

VL - 27

SP - 1080

EP - 1086

JO - European Journal of Gastroenterology and Hepatology

JF - European Journal of Gastroenterology and Hepatology

SN - 0954-691X

IS - 9

ER -

ID: 50645953