The latest issue of the Clinical Gastroenterology & Hepatology reports a high prevalence of antibiotic-resistant bacterial infections among patients with cirrhosis at a liver center in the USA.
-47% were found to be antibiotic resistant
There are limited data on the prevalence or predictors of antibiotic-resistant bacterial infections in hospitalized patients with cirrhosis in North America.
Exposure to systemic antibiotics is a risk factor for antibiotic-resistant bacterial infections.
However, little is known about the effects of the increasingly used oral nonabsorbed antibiotics.
Dr Guadalupe Garcia–Tsao and colleagues from Connecticut, USA analyzed data from patients with cirrhosis and bacterial infections hospitalized in a liver unit at a US hospital between 2009 and 2010.
Multivariate logistic regression was used to determine predictors of antibiotic-resistant bacterial infections.
Data were analyzed on the first bacterial infection of each patient, and a sensitivity analysis was performed on all infectious episodes per patient.
The researchers found that 30% of infections were nosocomial.
The team noted that urinary tract infections, and spontaneous bacterial peritonitis were most common.
Of the 70 culture-positive infections, 47% were found to be antibiotic resistant.
The research team found that exposure to systemic antibiotics within 30 days before infection was associated independently with antibiotic-resistant bacterial infections, with an odds ratio of 14.
The team observed that exposure to only nonabsorbed antibiotics (rifaximin) was not associated with antibiotic-resistant bacterial infections.
In a sensitivity analysis, exposure to systemic antibiotics within 30 days before infection and nosocomial infection was associated with antibiotic-resistant bacterial infections.
Dr Garcia-Tsao's team concluded, "The prevalence of antibiotic-resistant bacterial infections is high in a US tertiary care transplant center."
"Exposure to systemic antibiotics within 30 days before infection, but not oral nonabsorbed antibiotics, is associated with development of an antibiotic-resistant bacterial infections."
| Clin Gastroenterol Hepatol 2012: 10(11):
1291-1298 30 October 2012 |
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