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Published in: Current Treatment Options in Gastroenterology 2/2019

01-06-2019 | Bacterial Peritonitis | Liver (J Bajaj, Section Editor)

Infections in Cirrhosis

Authors: Sirina Ekpanyapong, MD, K. Rajender Reddy, MD

Published in: Current Treatment Options in Gastroenterology | Issue 2/2019

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Abstract

Purpose of review

Patients with cirrhosis are at high risk of developing serious infections. Bacterial infections remain the most common cause of morbidity and mortality in these patients. This review is focused on the prevalence of infections in those with cirrhosis, including multidrug-resistant (MDR) pathogens, pathogenesis of infection-related acute-on-chronic liver failure (ACLF), current treatment recommendations, and prophylactic strategies in patients with cirrhosis.

Recent findings

Recent epidemiological studies have noted an emerging prevalence of MDR bacterial infections and associated with poor prognosis, and a high rate of treatment failure and mortality. Therefore, new recommendations on empirical antibiotic use based on epidemiological data have been developed in order to improve outcomes.

Summary

Spontaneous bacterial peritonitis (SBP) and urinary tract infection (UTI) are the most frequent infections followed by pneumonia, cellulitis, and bacteremia, while pneumonia carries the highest risk of mortality. The incidence of MDR bacterial infections has been increasing, especially in healthcare-associated settings. Second infections that develop during hospitalization, multiple organ failures, and high MELD score are associated with poor survival. Preventive measures, early diagnosis, and adequate treatment of infections are essential key concepts in minimizing morbidity and mortality in patients with cirrhosis.
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Metadata
Title
Infections in Cirrhosis
Authors
Sirina Ekpanyapong, MD
K. Rajender Reddy, MD
Publication date
01-06-2019
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 2/2019
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-019-00229-2

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