Epidemiological investigation of non-fermentative bacterial infection in cirrhotic patients

ABSTRACT

Background: This study aimed to describe the clinical characteristics of NFGNB in patients with cirrhosis as well as the risk factors for short-term mortality.

Methods: A retrospective analysis was performed in patients with cirrhosis and NFGNB infections from 2011 to 2016 .

Results: 144 episodes in 134 patients with liver cirrhosis and NFGNB infections were found in total. Of these, 81.2% were hospital-acquired or healthcare- associated infections, while only 18.8% of NFGNB infections originated from the community. A. baumannii were the most frequently isolated bacteria (39 episodes), followed by S. maltophilia (38 episodes) and P. aeruginosa (31 episodes). MDR- and non-MDR-NFGNB comprised 62.5% and 37.5% of infections respectively. The Kaplan-Meier survival curve showed no significant difference between MDR and non-MDR NFGNB patients (74.1% vs 75.5%, P = 0.811). Neither MDR or the subgroup of common NFGNB (P. aeruginosa, A. baumannii, S. maltophilia) was associated with the 28-day mortality (all P >0.05). Low albumin levels and high Tbil levels were both independent risk factors for 28-day mortality (HR = 0.930, 95%CI (0.869, 0.995), P = 0.035; HR = 1.003, 95%CI (1.002, 1.005), P < 0.001, respectively).

Conclusions: Diabetes increased 28-day mortality significantly, however, MDR status, site of infection and bacteria type did not.

KEYWORDS:

• Cirrhosis
• non-fermentative bacteria
• infection
• multidrug-resistant
• risk factors

Article highlights

• Increased NFGNB infection is a rising challenge in recent years

• The antibiotic resistance rate is higher in NFGNB infections, however, MDR status did not increase short-term mortality

• Type 2 diabetes is an independent risk factor for short term mortality for cirrhotic patients infected with NFGNB.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

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Additional information

Funding

This paper was funded by the Zheijiang Provincial Natural Science Foundation of China, grant number: LY16H160006; and the National S&T Major Project, grant number: 2018ZX10715-013-033.