Clinical significance of Staphylococcus aureus bacteremia in patients with liver cirrhosis
- 445 Downloads
Patients with liver cirrhosis (LC) have impaired immunity and thus are predisposed to infections. Few studies have attempted to evaluate Staphylococcus aureus bacteremia (SAB) in LC patients. Therefore, this study prospectively evaluated the clinical characteristics and outcomes of 642 episodes of SAB from August 1, 2008 to September 31, 2010. Of 642 patients with SAB, 109 (17.0 %) were classified as LC patients whereas the remaining 533 (83.0 %) were classified as non-LC patients. The 30-day mortality rate of LC patients was significantly higher than that of patients with other diseases (32 % vs. 22 %, respectively; P = 0.047). The 30-day mortality rates of patients with MSSA bacteremia and MRSA bacteremia were not significantly different among LC patients (35.1 % with MSSA vs. 26.9 % with MRSA; P = 0.41). A univariate analysis of the 30-day mortality rate of LC patients with SAB for survivors and non-survivors showed that rapidly fatal or ultimately fatal according to the criteria of McCabe and Jackson (OR 5.0; 95 % CI 1.60–15.65), septic shock at initial presentation (OR 3.5; 95 % CI 1.18–10.39) and Child-Pugh class C (OR 2.8; 95 % CI 1.20–6.59) were associated with increased mortality. In contrast, the removal of the eradicable focus was associated with decreased mortality (OR 0.14; 95 % CI 0.04–0.52). Disease severity and liver dysfunction may be useful for predicting the prognosis of SAB in LC patients.
KeywordsSeptic Shock Liver Cirrhosis Infective Endocarditis Solid Organ Transplant Recipient Peripheral White Blood Cell
This work was supported by grants 2008–131, 2007–131, and 2001–131 from the Asan Institute for Life Sciences, Seoul, Korea.
Conflict of interest
The authors declare that they have no conflict of interest.
- 6.Terra C, Guevara M, Torre A, Gilabert R, Fernandez J, Martin-Llahi M, Baccaro ME, Navasa M, Bru C, Arroyo V, Rodes J, Gines P (2005) Renal failure in patients with cirrhosis and sepsis unrelated to spontaneous bacterial peritonitis: value of MELD score. Gastroenterology 129(6):1944–1953PubMedCrossRefGoogle Scholar
- 9.Dupeyron C, Campillo SB, Mangeney N, Richardet JP, Leluan G (2001) Carriage of Staphylococcus aureus and of gram-negative bacilli resistant to third-generation cephalosporins in cirrhotic patients: a prospective assessment of hospital-acquired infections. Infect Control Hosp Epidemiol 22(7):427–432PubMedCrossRefGoogle Scholar
- 11.Friedman ND, Kaye KS, Stout JE, McGarry SA, Trivette SL, Briggs JP, Lamm W, Clark C, MacFarquhar J, Walton AL, Reller LB, Sexton DJ (2002) Health care–associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med 137(10):791–797PubMedGoogle Scholar