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Colegio de Medicos y Cirujanos República de Costa Rica

2020, Number 630

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Rev Med Cos Cen 2020; 86 (630)

Prevalencia y epidemiología de las infecciones bacterianas en pacientes con hepatitis alcoh lica: estudio descriptivo de pacientes hospitalizados en el hospital san rafael de alajuela

Ochoa PA, Coste MP, Moreno AJ

Language: Spanish
References: 14
Page: 16-26
PDF size: 283.55 Kb.


ABSTRACT

Introduction and aims: Bacterial infections in patients with alcoholic hepatitis (AH) have a high incidence and can contribute to the development of organ failure and death. The aims of this study were: (1) to determinate the prevalence and epidemiology of bacterial infections in patients with AH; (2) to evaluate the epidemiological and clinical characteristics in patients with AH; (3) to identify predictive factors associated with infections in patients with AH; (4) to determine the proportion of patients with positive microbiological cultures; and (5) to investigate the mortality in patients with AH with and without infection.
Material and methods: 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. All medical records of patients who met the selection criteria were review.
Results: There were analyzed 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%, and equivalence between gram-positive and gram-negative microorganisms. Only the presence of leukocytosis and neutrophilia was associated with an increased risk of infection. The model with leucocytes values alone was the best predictive model for the presence of infection. The area under the ROC curve of the presence of leukocytosis 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 (ACLF) and severe AH was associated with high mortality.
Conclusions: The results confirm the high prevalence of bacterial infections in patients with AH. Leukocytes value was a marker related with the development of infection and ACLF was associated with higher mortality.


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