P-1 PREVALENCE AND EPIDEMOLOGY OF BACTERIAL INFECTIONS IN PATIENTS WITH ALCOHOLIC HEPATITIS: A RETROSPECTIVE STUDY OF PATIENTS ADMITTED AT THE SAN RAFAEL DE ALAHUELA HOSPITAL, COSTA RICA

Abstract

Introduction: Bacterial infections in patients with alcoholic hepatitis have a high incidence and can contribute to the developments of organ failure and death. Aims: To determinate the prevalence and epidemiology of bacterial infections in patients with alcoholic hepatitis; to evaluate the epidemiological and clinical characteristics in patients with alcoholic hepatitis; to identify predictive factors associated with infections in patients with alcoholic hepatitis; to determinate the proportions of patients with positive microbiological cultures; and to investigate the mortality in patients with alcoholic hepatitis with and without infection. Methodology: This is a retrospective and observational study that included patients admitted to the San Rafael de Alajuela Hospital-Costa Rica; between November 2019 and February 2020. The medical records of all the patients who met the selection criteria were reviewed. Results: 41 patients (80% male, mean age: 50 years ± 10) were analyzed. A high prevalence of concurrent sepsis was observed (73%, 36% nosocomial), with a proportion of culture positivity of 45%. Only the presence of leukocytosis and neutrophilia was associated with an increased risk of infection. The AUROC of the presence of leucocytosis was 0.86 (95% CI: 0.73-0.98) and the cut-off was 9520/mm3 presented the best diagnostic accuracy (S: 90%, E: 72.7%). Acute on chronic liver failure and severe alcoholic hepatitis was associated with high mortality. Conclusion: The results confirm the high prevalence of bacterial infections in patients with alcoholic hepatitis. Leucocytes value was a risk factor for the development of infection and acute on chronic liver failure was associated with higher mortality.