Oncotarget

Research Papers:

Investigation on outcomes and bacterial distributions of liver cirrhosis patients with gram-negative bacterial bloodstream infection

Yangxin Xie, Bo Tu, Xin Zhang, Jingfeng Bi, Lei Shi, Peng Zhao, Weiwei Chen, Suxia Liu, Dongping Xu and Enqiang Qin _

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Oncotarget. 2018; 9:3980-3995. https://doi.org/10.18632/oncotarget.23582

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Abstract

Yangxin Xie1,2,*, Bo Tu2,*, Xin Zhang2, Jingfeng Bi3, Lei Shi2, Peng Zhao2, Weiwei Chen2, Suxia Liu4, Dongping Xu3 and Enqiang Qin1

1Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China

2Chinese PLA General Hospital, Medical School, Beijing, China

3Research Center for Clinical and Translational Medicine, Beijing 302 Hospital, Beijing, China

4Treatment and Research Center for Liver Failure, Beijing 302 Hospital, Beijing, China

*These authors have contributed equally to this work

Correspondence to:

Dongping Xu, email: [email protected]

Enqiang Qin, email: [email protected]

Keywords: liver cirrhosis; gram-negative bacterial bloodstream infection; nosocomial infection

Received: March 15, 2017     Accepted: June 04, 2017     Published: December 22, 2017

ABSTRACT

Objective: The study aimed at analyzing the epidemiology and outcomes of liver cirrhosis patients undergoing gram-negative bacterial bloodstream infection.

Results: Totally 508 eligible patients were collected, with 25.79% 30-day mortality, and 58.86% patients were confirmed as nosocomial infection. The most common isolates were Escherichia coli (48.29%) and Klebsiella pneumoniae (19.29%), and multidrug-resistant isolates accounted for 36.61%. The bacterial distributions were similar between survivors and non-survivors (P>0.05), but showed close association with acquisition sites of infection (P<0.05). Nosocomial infection (HR=1.589, 95% CI=1.004-2.517), Child-Pugh grade (HR=2.471, 95% CI=1.279-4.772), septic shock (HR=1.966, 95% CI=1.228-3.146), complications (HR=3.529, 95% CI=2.140-5.818), and WBC (HR=1.065, 95% CI=1.018-1.114) were independent indicators for 30-day mortality. β-lactamase inhibitor antibiotics exerted a high antibacterial activity.

Methods: The inpatients with liver cirrhosis developed gram-negative bacterial bloodstream infection were collected. The clinical characteristics, bacterial distribution and drug sensitivity results of patients were compared according to their 30-day survival status and acquisition sites of infections. Cox regression model was applied to evaluate the risk factors for 30-day mortality.

Conclusion: Escherichia coli and Klebsiella pneumoniae are frequently isolated from gram-negative bacterial bloodstream infection episodes in cirrhosis patients. Acquisition site of infection can influence clinical characteristics and etiological distribution. β-lactamase inhibitor antibiotics may be the first choice for empirical treatments.


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