RT Journal Article
T1 A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients.
A1 Bartoletti, M
A1 Giannella, M
A1 Lewis, R
A1 Caraceni, P
A1 Tedeschi, S
A1 Paul, M
A1 Schramm, C
A1 Bruns, T
A1 Merli, M
A1 Cobos-Trigueros, N
A1 Seminari, E
A1 Retamar, P
A1 Muñoz, P
A1 Tumbarello, M
A1 Burra, P
A1 Torrani Cerenzia, M
A1 Barsic, B
A1 Calbo, E
A1 Maraolo, A E
A1 Petrosillo, N
A1 Galan-Ladero, M A
A1 D'Offizi, G
A1 Bar Sinai, N
A1 Rodriguez-Baño, J
A1 Verucchi, G
A1 Bernardi, M
A1 Viale, P
K1 Bacterial infections
K1 Bloodstream infections
K1 CLIF-SOFA
K1 Liver cirrhosis
K1 Multidrug-resistant pathogens
AB To describe the current epidemiology of bloodstream infection (BSI) in patients with cirrhosis; and to analyse predictors of 30-day mortality and risk factors for antibiotic resistance. Cirrhotic patients developing a BSI episode were prospectively included at 19 centres in five countries from September 2014 to December 2015. The discrimination of mortality risk scores for 30-day mortality were compared by area under the receiver operator risk and Cox regression models. Risk factors for multidrug-resistant organisms (MDRO) were assessed with a logistic regression model. We enrolled 312 patients. Gram-negative bacteria, Gram-positive bacteria and Candida spp. were the cause of BSI episodes in 53%, 47% and 7% of cases, respectively. The 30-day mortality rate was 25% and was best predicted by the Sequential Organ Failure Assessment (SOFA) and Chronic Liver Failure-SOFA (CLIF-SOFA) score. In a Cox regression model, delayed (>24 hours) antibiotic treatment (hazard ratio (HR) 7.58; 95% confidence interval (CI) 3.29-18.67; p 24 hours) antibiotic treatment (hazard ratio (HR) 7.58; 95% confidence interval (CI) 3.29-18.67; p  MDRO account for nearly one-third of BSI in cirrhotic patients, often resulting in delayed or inadequate empirical antimicrobial therapy and increased mortality rates. Our data suggest that improved prevention and treatment strategies for MDRO are urgently needed in the liver cirrhosis patients.
PB Elsevier Ltd
YR 2017
FD 2017-08-14
LK http://hdl.handle.net/10668/11517
UL http://hdl.handle.net/10668/11517
LA en
NO Bartoletti M, Giannella M, Lewis R, Caraceni P, Tedeschi S, Paul M, et al.  A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients. Clin Microbiol Infect. 2018 May;24(5):546.e1-546.e8.
DS RISalud
RD Apr 5, 2025