Bacterial infections in liver cirrhosis
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ARDELEANU, Denis, TCACIUC, Eugen, BERLIBA, Elina, BUGOR, Kalina, TCACIUC, Angela, COJUHARI, Maria. Bacterial infections in liver cirrhosis. In: Journal of Gastrointestinal and Liver Diseases, 2019, nr. S2(28), pp. 82-83. ISSN 1841-8724.
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Journal of Gastrointestinal and Liver Diseases
Numărul S2(28) / 2019 / ISSN 1841-8724 /ISSNe 1842-1121

Bacterial infections in liver cirrhosis


Pag. 82-83

Ardeleanu Denis1, Tcaciuc Eugen2, Berliba Elina2, Bugor Kalina1, Tcaciuc Angela2, Cojuhari Maria1
 
1 Timofei Moșneaga Republican Clinical Hospital,
2 ”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
 
Disponibil în IBN: 24 august 2022


Rezumat

Introduction. Bacterial infection is a common and it counts for the major morbidity and mortality in liver cirrhosis (LC). Common types of infections in patients with cirrhosis include spontaneous bacterial peritonitis in 25-31% (SBP), urinary tract infection (UTI) (20%-25%), pneumonia (15%21%), bacteremia (12%), and soft tissue infection (11%). [1,2,3] Objectives. Analysis of the epidemiology, particular clinical and laboratory features of bacterial infection at patients with liver cirrhosis. Materials and methods. There were included 423 patients in our study, selected from 1654 of patients hospitalized with LC in Clinical Republican Hospital of Republic of Moldova from 01.09.2017 to 01.03.2019. There was collected the following data: the etiology of cirrhosis, Child-Pugh Score, the type of infection that has been developed in all patients, the frequency of these infections and the sensitivity of protein C-reactive (PCR) as well as the amount of leukocytes in the blood. Results. Bacterial infection was in amount of 25.6 % (n=423) among the patients with LC. Cirrhosis etiology of patients was: mixed etiology (alcoholic and viral) – 161 cases (38%), followed by alcoholic cirrhosis – 156 patients (37%) and viral etiology – 106 cases (25%) out of which viral infection with HBV – 15 patients, HCV – 39 patients, HDV – 52 patients. In our study, the most common infections were UTI 40% (n=168) and pneumonia 34% (n=145), followed by mixt infection 20% (83 cases- from which with: pneumonia and UTI- 48 cases ; pneumonia and SBP - 18 cases; UTI and SBP - 4 cases and all of these infections included – 13 patients), other types of infections 4% (n=16) and bacteremia 2% (n=6). According to the Child- Pugh Score, the patients with Child-Pugh C counted 60%, those with Child B – 34% and the ones with Child A – 6%. The mortality rate was 8% (n=34). The amount of the increased white cells was found in 76 cases (18%), while PCR plasma levels were increased in 262 patients (62%). Discussions. LC determines sensibility and insufficient specificity of clinical and laboratory parameters conventionally used for diagnosis of bacterial infection and its septic complications. This phenomenon is caused by immunodeficiency developed due to cirrhosis itself, fact proven in many clinical studies [1-3]. Conclusions. There is a high rate suspicion of infectious process in patients with liver cirrhosis. Clinical manifestations of bacterial infections and inflammatory biomarkers are expressed less in patients with LC, and new specific diagnostic tests are the necessity of finding for termination of pneumonia in patients with LC. Key words: Bacteria, Infection, Liver cirrhosis, CRP. References 1. Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D. Bacterial infections in cirrhosis: A critical review and practical guidance. World J Hepatol. 2016;8(6):307–321. doi:10.4254/wjh.v8.i6.307 2. Maria Lagadinou and Charalambos A. Gogos. Bacterial infections in cirrhosis patients: a retrospective epidemiologic study in a greek university hospital. Bacterial infections in cirrhosis patients: a retrospective epidemiologic study in a greek university hospital Clinical Hepatology and Hepatitis Reports 2015. 3. Botwin, G.J. & Morgan, T.R. Hepatol Int (2014) 8(Suppl 2): 467. https:// doi.org/10.1007/s12072-014-9522-z.

Cuvinte-cheie
Bacteria, infection, liver cirrhosis, CRP