P- 71 BACTERIAL INFECTIONS IN CIRRHOTIC PATIENTS: ARE WE FACING AN EPIDEMIOLOGICAL CHANGE?

Abstract

Introduction and Objectives: Infections in cirrhotic patients are frequent. Early diagnosis and treatment are essential to minimize the risk of serious complications. Currently, an epidemiological change in the causal bacterial agents is being evidenced. This study aimed to identify the involved bacterial infections in cirrhotic patients to determine the prevalence of multi and extremely-resistant and quinolone bacterial-resistant infections and to evaluate the mortality rate of these patients. Materials and Methods: Retrospective, descriptive and observational study including hospitalized patients older than 18 years with liver cirrhosis from September 2018 to October 2020. All of them were studied in a third-level of complexity hospital in Rosario, Argentina and admitted to suffering bacterial infections. Results: 70 patients were analyzed. The mean age was 47 years, male sex was 59%. The most frequent cause of cirrhosis was alcoholic (47%). Healthcare-associated infections predominated (44%). The most frequent infection was spontaneous bacterial peritonitis (21%). The most frequently isolated germs were Gram-negative (65%), with a predominance of E. Coli (45%). Gram-positive germs were recovered in 43%. Bacteria with high antibiotic resistance were isolated in 59.5% (E. coli, K. pneumoniae, enterococci) and 23% were associated with extremely resistant germs. No significant results were obtained when we compared the prophylactic use of quinolones, rifaximin, proton pump inhibitors, and previous use of antibiotics with the finding of resistant bacteria. The isolation of resistant germs was associated with a greater need for hemodialysis (p 0.034) and the presence of encephalopathy (p 0.044). Deaths (21%) were higher in those patients linked to systemic inflammatory response syndrome (SIRS) (p 0.036), in-hospital infections (p 0.017) and associated with resistant bacteria (p 0.02). Conclusions: A high percentage of both resistant and extremely resistant bacteria to treatment were found in our study. A high number of them were associated with gram-positive germs. These data indicate a change in the epidemiological behavior of cirrhotic infections.