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Bacteremia in patients suffering from cirrhosis

Bakteriämie bei Patienten mit Leberzirrhose

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Summary

In a five-year retrospective study, there were 57 episodes of bacteremia among 1623 admissions (3.5%) of patients suffering from cirrhosis. Gram-positive bacteria were found in 70% of the episodes, gram-negative bacteria in 30%. All of the gram-positive bacteria found were fully sensitive to methicillin and to gentamicin. The gram-negative bacteria found were all sensitive to gentamicin, but only 50% were sensitive to ampicillin. The distribution between gram-positive and gram-negative bacteria was the same, irrespective of whether the patients acquired the infection inside or outside the hospital. More than 50% of the patients suffered from one or more of the following complications of cirrhosis: ascites, encephalopathy and haematemesis. Twenty-one patients died within seven days after the bacteremia was diagnosed. Bacteremia is a serious complication of advanced cirrhosis, and it is recommended that adequate antibiotic treatment is started when septicemia is suspected.

Zusammenfassung

Im Rahmen einer retrospektiven Fünfjahres-Studie wurden unter 1623 Einweisungen 57 Bakteriämien bei Patienten mit Zirrhose gefunden (3,5%). Bei 70% der Bakteriämien fanden sich grampositive Bakterien, bei 30% gramnegative Bakterien. Alle isolierten grampositiven Bakterien waren voll empfindlich gegenüber Methicillin und Gentamicin. Gegenüber Gentamicin waren alle gramnegativen Isolate empfindlich, gegenüber Ampicillin jedoch nur 50%. Die Verteilung von grampositiven und gramnegativen Bakterien war unabhängig davon, ob die Infektion im Krankenhaus oder außerhalb erworben war. Eine oder mehrere der folgenden Komplikationen der Zirrhose traten bei mehr als 50% der Patienten auf: Aszites, Enzephalopathie und Hämatemesis. 21 Patienten verstarben innerhalb von sieben Tagen nach Diagnose der Bakteriämie. Die Bakteriämie ist eine ernsthafte Komplikation der fortgeschrittenen Leberzirrhose, und es wird empfohlen, bereits bei Verdacht auf eine Septikämie mit einer adäquaten Antibiotikatherapie zu beginnen.

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Authors and Affiliations

  1. Medical Department A, Rigshospitalet, Division of Hepatology, Copenhagen, Denmark

    T. Almdal M.D. & P. Skinhøj M.D.

  2. Department of Clinical Bacteriology, Institute of Medical Microbiology, University of Copenhagen, Denmark

    H. Friis M.D.

Authors
  1. T. Almdal M.D.
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  2. P. Skinhøj M.D.
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  3. H. Friis M.D.
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Almdal, T., Skinhøj, P. & Friis, H. Bacteremia in patients suffering from cirrhosis. Infection 14, 68–70 (1986). https://doi.org/10.1007/BF01644445

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  • DOI: https://doi.org/10.1007/BF01644445

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