Provided by Healio
May 20, 2013
ORLANDO, Fla. — Most infections among patients with cirrhosis were nosocomial or health care-associated infections, according to study findings presented here at Digestive Disease Week. In addition, use of proton pump inhibitors was an independent predictor of these infections.
“Hospital-acquired and health care-associated infections are considered common in cirrhosis, but population-based data on the occurrence of these infections and their potential impact on outcome are limited,” Konstantina Sargenti, MD, of the department of gastroenterology at Skåne University Hospital in Sweden, said during a presentation. “Acute kidney injury and systemic inflammatory response syndrome indicate poor prognosis in cirrhosis, but it is unclear if they are more common in the presence of these infections.”
Sargenti and colleagues conducted a retrospective study that included all patients diagnosed with liver cirrhosis from 2000 to 2010, in an area with a population of approximately 250,000. They reviewed the patients’ medical records for information on infections, proton pump inhibitor use, acute kidney injury and systemic inflammatory response syndrome, and followed the patients until death, transplantation or the end of 2011.
Among the 344 patients with liver cirrhosis, 122 patients developed 230 bacterial infections: 66 were community-acquired (29%), 119 were health care-associated (51%) and 45 were nosocomial (20%). The most common infections were urinary tract infections (26%), spontaneous bacterial peritonitis (19%), pneumonia (16%) and spontaneous bacteremia (16%).
The researchers found that proton pump inhibitor use (OR=2.07; 95% CI, 1.05-4.06) and decompensated patient status (OR=1.78; 95% CI, 0.57-5.56) were related to nosocomial and health care-associated infections. These infections were not associated with inpatient mortality or systemic inflammatory response syndrome.
“Nosocomial infections appeared to have an impact on outcome as they were related to the occurrence of acute kidney injury and a prolonged length of hospital stay compared to health care-associated or community-acquired infections,” Sargenti said.
For more information:
Sargenti K. #515. Presented at: Digestive Disease Week; May 18-21, 2013; Orlando, Fla.
Disclosure: Sargenti reports no relevant financial disclosures.
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