Dataset Information

High prevalence of antibiotic-resistant bacterial infections among patients with cirrhosis at a US liver center.

ABSTRACT:

Background & aims

There are limited data on the prevalence or predictors of antibiotic-resistant bacterial infections (AR-BI) in hospitalized patients with cirrhosis in North America. Exposure to systemic antibiotics is a risk factor for AR-BI; however, little is known about the effects of the increasingly used oral nonabsorbed antibiotics.

Methods

We analyzed data from patients with cirrhosis and bacterial infections hospitalized in a liver unit at a US hospital between July 2009 and November 2010. Multivariate logistic regression was used to determine predictors of AR-BI. Data were analyzed on the first bacterial infection of each patient (n = 115), and a sensitivity analysis was performed on all infectious episodes per patient (n = 169).

Results

Thirty percent of infections were nosocomial. Urinary tract infections (32%) and spontaneous bacterial peritonitis (24%) were most common. Of the 70 culture-positive infections, 33 (47%) were found to be antibiotic resistant (12 were vancomycin-resistant Enterococci, 9 were extended-spectrum ?-lactamase-producing Enterobacteriaceae, 7 were quinolone-resistant gram-negative rods, and 5 were methicillin-resistant Staphylococcus aureus). Exposure to systemic antibiotics within 30 days before infection was associated independently with AR-BI, with an odds ratio (OR) of 13.5 (95% confidence interval [CI], 2.6-71.6). Exposure to only nonabsorbed antibiotics (rifaximin) was not associated with AR-BI (OR, 0.4; 95% CI, 0.04-2.8). In a sensitivity analysis, exposure to systemic antibiotics within 30 days before infection and nosocomial infection was associated with AR-BI (OR, 5.2; 95% CI, 1.5-17.7; and OR, 4.2; 95% CI, 1.4-12.5, respectively).

Conclusions

The prevalence of AR-BI is high in a US tertiary care transplant center. Exposure to systemic antibiotics within 30 days before infection (including those used for prophylaxis of spontaneous bacterial peritonitis), but not oral nonabsorbed antibiotics, is associated with development of an AR-BI.

SUBMITTER: Tandon P

PROVIDER: S-EPMC3891826 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Publications

High prevalence of antibiotic-resistant bacterial infections among patients with cirrhosis at a US liver center.

Tandon Puneeta P Delisle Angela A Topal Jeffrey E JE Garcia-Tsao Guadalupe G

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 20120817 11

<h4>Background & aims</h4>There are limited data on the prevalence or predictors of antibiotic-resistant bacterial infections (AR-BI) in hospitalized patients with cirrhosis in North America. Exposure to systemic antibiotics is a risk factor for AR-BI; however, little is known about the effects of the increasingly used oral nonabsorbed antibiotics.<h4>Methods</h4>We analyzed data from patients with cirrhosis and bacterial infections hospitalized in a liver unit at a US hospital between July 2009 ...[more]

PMID: 22902776

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Dataset Information

High prevalence of antibiotic-resistant bacterial infections among patients with cirrhosis at a US liver center.

Background & aims

Methods

Results

Conclusions

Publications

High prevalence of antibiotic-resistant bacterial infections among patients with cirrhosis at a US liver center.

Similar Datasets

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