Bacteremia in patients with liver cirrhosis

Abstract

Bacteremic infections are more frequent in patients with cirrhosis, as their immune system is compromised. Series of cirrhotic patients with bacteremia has seldom been reported in Chile. We retrospectively collected, from 2005 to 2008, 59 episodes of bacteremia in cirrhotics representing 9% of the overall number of bacteremic episodes seen in our center in the period. Spontaneous bacteremia accounted for 29% followed by those of pulmonary origin (22%). Grampositive cocci and gramnegative bacilli were responsible in 52% and 48% respectively, however gramnegative rods predominated in nosocomial bacteremias. Overall, the most frequent organisms were Staphylococcus aureus (24%) and Escherichia coli (22%). Mortality in bacteremic patients was significantly higher compared with all cirrhotic patients hospitalized in the period (37.0 vs 9.4%; p < 0.001) and MELD score was significantly correlated with mortality. Conclusion: bacteremia is a severe complication of cirrhosis and MELD score could be a useful tool to stratify risk in these patients.