2018, Number 2
Rev Med MD 2018; 9.10 (2)
Velarde-Ruiz V JA, Lazcano-Becerra M, Tapia-Calderón DK, Mercado-Jáuregui LA, Alonzo-García CJ, González-Ruiz R, Morel-Cerda EC, Barajas-Correa DI, Aldana-Ledesma JM, Filio-Hermosillo AC, Pérez-Gómez HR, Rangel-Orozco MF, Bocaletti-García MM, Olivares-Guzmán LO, García-Jiménez ESVelarde-Ruiz V JA, Lazcano-Becerra M, Tapia-Calderón DK, Mercado-Jáuregui LA, Alonzo-García CJ, González-Ruiz R, Morel-Cerda EC, Barajas-Correa DI, Aldana-Ledesma JM, Filio-Hermosillo AC, Pérez-Gómez HR, Rangel-Orozco MF, Bocaletti-García MM, Olivares-Guzmán LO, García-Jiménez ES
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ABSTRACTIntroduction. Bacterial infections are very common in patients with hepatic cirrhosis, especially in decompensated stages; prevalence of bacterial infections in cirrhosis ranges from 32 to 44%. The most common sites of infection are spontaneous bacterial peritonitis (25-31%), urinary tract infections (20-25%), pneumonia (15-21%), bacteremia (12%) and wounds (11%). Almost 75% of bacterial infections are caused by Gram negative bacteria like E. coli, Klebsiella spp, and Enterobacer spp. In recent studies, infections caused by Gram positive bacteria have increased due to the use of antibiotics and realization of invasive procedures. Our objective was to describe the clinical, biochemical and microbiologic characteristics of hospitalized patients with liver cirrhosis in a third level hospital in Mexico.
Material and Methods. We recollected data and performed cultures on 194 patients previously diagnosed with cirrhosis at Hospital Civil “Fray Antonio Alcalde” from June 2016 to July 2017; we analyzed the cultures made upon the entry.
Results. The most frequent site of bacterial isolation was in the urine with 39 positive cultures, the most frequent pathogen isolated was E. coli extended-spectrum beta-lactamases (ESBL) producer in 14 cultures. The second most common site of microbiological isolation were bloodcultures with 23 cultures. Cultures of ascites fluid were the third most common with 16 positive cultures, in 9 E. coli was isolated and 5 of them with ESBL spectrum.
Discussion. The findings of this study are consistent with previous studies, in which microbiological isolates in the urinary tract and in ascitic fluid are the most frequent sites of infection in patients with decompensated CH, with the bacilli G- being the most frequent microbial agents. isolated No association was established between the infection and the clinical results of the patient since the main objective was only to describe the etiology of the infections.