BACTERIAL INFECTIONS IN PATIENTS WITH LIVER CIRRHOSIS
Abstract
Bacterial infections are often found in patients with liver cirrhosis, the most common infections being spontaneous bacterial peritonitis, pneumonia, and urinary tract infection. Patients with liver cirrhosis are immunocompromised and have increased susceptibility to spontaneous bacterial infections such as spontaneous bacterial peritonitis (SBP). Non-SBP infections constitute a heterogeneous group regarding clinical course and prognosis. Gram-negative enterobacteria, especially Escherichia coli, are the most common organisms responsible for community acquired infections. Gram-positive cocci are the most commonly isolated organisms in subjects with nosocomial infections. Up to 30 % of pathogens causing hospital associated infections are multidrug resistant bacteria. Once infection has developed, the excessive production of pro-inflammatory cytokines and a pre-existing hemodynamic derangement characteristic of cirrhosis overlap and predispose further development of serious complications such as shock, acuteon-chronic liver failure, renal failure, and death. Infections constitute the main cause of death in patients with advanced cirrhosis.
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