БАКТЕРИАЛЬНЫЕ ИНФЕКЦИИ У ПАЦИЕНТОВ С ЦИРРОЗОМ ПЕЧЕНИ
Аннотация
Бактериальные инфекции распространены у пациентов с циррозом печени, и наиболее частые – спонтанный бактериальный перитонит, пневмония, инфекция мочевыводящих путей. Пациенты с циррозом печени имеют ослабленный иммунитет и повышенную восприимчивость к спонтанным бактериальным инфекциям, – таким как спонтанный бактериальный перитонит (СБП). Не-СБП инфекции представляют собой разнородную по клиническим проявлениям и прогнозу группу. Грамотрицательные энтеробактерии, в первую очередь Escherichia coli, являются наиболее распространенными возбудителями внебольничных инфекций; грамположительные кокки наиболее часто определяются при нозокомиальных инфекциях. До 30% возбудителей нозокомиальных инфекций характеризуются как полирезистентные. После развития инфекции чрезмерная продукция провоспалительных цитокинов наслаивается на существующие при циррозе печени гемодинамические расстройства, что далее предопределяют развитие серьезных осложнений, таких как шок, «острая-на-хроническую» печеночная недостаточность, почечная недостаточность и смерть. Инфекции являются основной причиной смерти пациентов с прогрессирующим циррозом печени.
Литература
1. Acute-on-chronic liver failure / R. Jalan [et al.] //J. Hepatol. – 2012. – Vol. 57 (6). – P. 1336-1348.
2. Acute-on-chronic liver failure: a new syndrome that will reclassify cirrhosis / V. Arroyo [et al.] // J. Hepatol. – 2015. – Vol. 62 (1). – P. 131-143.
3. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis / R. Moreau [et al.] // Gastroenterology. – 2013. – Vol. 144 (7). – P. 1426-1437.
4. A dvances in basic and clinical research on liver cirrhosis in 2016 / C. Gu [et al.] // Zhonghua Gan Zang Bing Za Zhi [Chinese journal of hepatology]. – 2017. – Vol. 25 (1). – P. 5-8.
5. Antibiotic prophylaxis for GI endoscopy / S. Banerjee [et al.] // Gastrointest. Endosc. – 2008. – Vol. 67 (6). – P. 791-798.
6. Antibiotic prophylaxis in cirrhosis: Good and bad / J. Fernández [et al.] // Hepatology. – 2016. – Vol. 63 (6). – P. 2019-2031.
7. Bacterial infections in cirrhosis. A position statement based on the EASL Special Conference 2013 / R. Jalan [et al.] // J. Hepatol. – 2014. – Vol. 60 (6). – P. 1310-1324.
8. Bloodstream infections in patients with liver cirrhosis / M. Bartoletti [et al.] // Virulence. – 2016. – Vol. 7 (3). – P. 309-319.
9. Bremmer, D. N. Spontaneous fungal peritonitis: a devastating complication of cirrhosis / D. N. Bremmer, J. M. Garavaglia, R. K. Shields // Mycoses. – 2015. – Vol. 58 (7). – P. 387-393.
10. Bunchorntavakul, C. Bacterial infections in cirrhosis: A critical review and practical guidance / C. Bunchorntavakul, N. Chamroonkul, D. Chavalitdhamrong // World J. Hepatol. – 2016. – Vol. 8 (6). – P. 307-321.
11. Clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease / J. K. Park [et al.] // J. Korean. Med. Sci. – 2015. – Vol. 30 (5). – P. 598-605.
12. Clinical course and short-term mortality of cirrhotic patients with infections other than spontaneous bacterial peritonitis / J. Fernández [et al.] // Liver Int. – 2017. – Vol. 37 (3). – P. 385-395.
13. Comparison of clinical characteristics and outcomes of spontaneous bacterial peritonitis and culture negative neutrocytic ascites / S. H. Na [et al.] // Scand. J. Gastroenterol. – 2017. – Vol. 52 (2). – P. 199-203.
14. Current efficacy of recommended empiric antibiotic therapy in patients with cirrhosis and bacterial infection / J. Acevedo [et al.] // J. Hepatol. – 2009. – Vol. 50 (1). – P. 5.
16. De Franchis, R. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension / R. de Franchis // J. Hepatol. – 2010. – Vol. 53 (4). – P. 762-768.
17. Decreasing mortality among patients hospitalized with cirrhosis in the United States from 2002 through 2010 / M. L. Schmidt [et al.] // Gastroenterology. – 2015. – Vol. 148 (5). – Р. 967-977.
18. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites / P. Angeli [et al.] // J. Hepatol. – 2015. – Vol. 62 (4). – P. 968-974.
19. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club / A. Rimola [et al.] // J. Hepatol. – 2000. – Vol. 32(1). – P. 142-153.
20. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis / P. Ginès [et al.] // J. Hepatol. – 2010. – Vol. 53(3). – P. 397-417.
21. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis / P. Sort [et al.] // N. Engl. J. Med. – 1999. – Vol. 341. – P. 403-409.
22. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice / S. Angeloni [et al] // World J. Gastroenterol. – 2008. – Vol. 14 (17). – P. 2757- 2762.
23. Emergency department visits related to cirrhosis: a retrospective study of the nationwide emergency department sample 2006 to 2011 / C. Pan [et al.] // Medicine (Baltimore). – 2015. – Vol. 94 (1): e308.
24. Epidemiology of bacterial infections in patients with liver cirrhosis. Experience in a Spanish tertiary health center / K. Klímová [et al.] // Biomedica. – 2016. – Vol. 36 (1). – P. 121-132.
25. Evidence of neutrophil functional defect despite inflammation in stable cirrhosis / Tritto G. [et al.] // J. Hepatol. – 2011. – Vol. 55 (3). – P. 574-581.
26. Fernandez, J. Management of bacterial infections in cirrhosis / J. Fernandez, T. Gustot // J. Hepatol. – 2012. – Vol. 56 (1). – P. 1-12.
27. Fiore, M. Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective / M. Fiore, S. Leone // World J. Gastroenterol. – 2016. – Vol. 22(34). – P. 7742-7747.
28. Fungal peritonitis: underestimated disease in critically ill patients with liver cirrhosis and spontaneous peritonitis / T. Lahmer [et al.] // PLoS One. – 2016. – Vol. 11. – e0158389. – DOI: 10.1371/journal.pone.0158389.
29. Garcia-Tsao, G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis // Gastroenterology. – 2001. – Vol. 120 (4). – P. 726-748.
30. Gines, P. Renal Failure in Cirrhosis / P. Gines, R.W. Schrier // N. Engl. J. Med. – 2009. – Vol. 361 (13). – P. 1279-90.
31. Gut flora and bacterial translocation in chronic liver disease / J. Almeida [et al.] // World. J. Gastroenterol. – 2006. – Vol. 12 (10). – P. 1493-1502.
32. Infections in patients with cirrhosis increase mortality fourfold and should be used in determining prognosis / V. Arvaniti [et al.] // Gastroenterology. – 2010. – Vol. 139 (4). – P. 1246-1256.
33. Intestinal permeability in a patient with liver cirrhosis / J. M. Aguirre Valadez [et al.] // Ther. Clin. Risk Manag. – 2016. – Vol. 12. – P. 1729-1748.
34. Leon, D. A. Liver cirrhosis mortality rates in Britain from 1950 to 2002: an analysis of routine data / D. A. Leon, J. McCambridge // Lancet. – 2006. – Vol. 367 (9504). – P. 52-56.
35. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure / D. Thabut [et al.] // Hepatology. – 2007. – Vol. 46 (6). – P. 1872-1882.
36. Nosocomial spontaneous bacterial peritonitis and bacteremia in cirrhotic patients: impact of isolate type on prognosis and characteristics of infection / B. Campillo [et al.] // Clin Infect Dis. – 2002. – Vol. 35 (1). – P. 1-10.
37. Patients with acute on chronic liver failure display “sepsis-like” immune paralysis / H. E. Wasmuth [et al.] // J. Hepatol. – 2005. – Vol. 42 (2). – P. 195-201.
38. Patients with cirrhosis in the ED: early predictors of infection and mortality / [A.Q. Farias [et al.] // Am. J. Emerg. Med. – 2016. – Vol. 34 (1). – P. 25-29.
39. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: A prospective study / J. Fernández [et al.] // Hepatology. – 2012. – Vol. 55 (5). – P. 1551-1561.
40. Runyon, B.A. Management of adult patients with ascites due to cirrhosis: update 2012 / B.A. Runyon // Hepatology. – 2009. – Vol. 49 (6). – P. 2087-2107.
41. Sajjad, M. Ascitic fluid culture in cirrhotic patients with spontaneous bacterial peritonitis / M. Sajjad, Z. A. Khan, M. S. Khan // J. Coll Physicians Surg Pak. – 2016. – Vol. 26 (8). – P. 658-661.
42. Sepsis in cirrhosis: Report on the 7th meeting of the international ascites club / F. Wong [et al.] // Gut. – 2005. – Vol. 54 (5). – P. 718-725.
43. Severe sepsis in cirrhosis / T. Gustot [et al.] // Hepatology. – 2009. – Vol. 50 (6). – P. 2022-2033.
44. Sheer, T.A. Spontaneous bacterial peritonitis / T. A. Sheer, B. A. Runyon // Dig. Dis. – 2005. – Vol. 23 (1). – P. 39-46.
45. Solà, E. Acute-on-Chronic Liver Failure: The Role of Precipitating Illness / E. Solà, J. Fernandez, P. Ginès // Semin Liver Dis. – 2016. – Vol. 36(2). – P. 117-122.
46. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure / J. Clària [et al.] // Hepatology. – 2016. – Vol. 64 (4). – P. 1249-1264.
47. The effect of the first spontaneous bacterial peritonitis event on the mortality of cirrhotic patients with ascites: A Nationwide Population-Based Study in Taiwan / T. H. Hung [et al.] // Gut Liver. – 2016. – Vol. 10 (5). – P. 803-807.
48. The impact of infection by multidrug-resistant agents in patients with cirrhosis. A multicenter prospective study // F. Salerno [et al.] // Liver Int. – 2017. – Vol. 37 (1). – P. 71-79.
49. The Periscreen strip is highly efficient for the exclusion of spontaneous bacterial peritonitis in cirrhotic outpatients // Am. J. Gastroenterol. – 2016 . – Vol. 111(10). – P. 1402-1409.
50. Wong F. Acute kidney injury in liver cirrhosis: new definition and application // Clin. Mol. Hepatol. – 2016. – Vol. 22 (4). – P. 415-422.
51. Zhou Z. Hepatocytes: a key cell type for innate immunity / Z. Zhou, M.-J. Xu, B. Gao // Cell Mol. Immunol. – 2016;13(3):301-315.
