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Bacterial Infections in Patients with Cirrhosis

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Complications of Cirrhosis

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Abstract

Bacterial infections are the cause of death in cirrhosis. In Western countries, bacterial infection is the principal identifiable precipitating event of acute-on-chronic liver failure (ACLF) which is associated with high short-term mortality. Bacterial translocation due to increased gut permeability and intestinal bacterial overgrowth/dysbiosis contributes mainly to the susceptibility of cirrhotic patients to develop bacterial infections. The diagnosis of bacterial infection in cirrhosis is challenging due to the lack of sensitive and specific classical clinical and biological parameters. The early diagnosis of bacterial infections and the prompt initiation of adequate antibiotic treatment are the cornerstone of management. Due to the frequent use of broad-spectrum antibiotics and increased invasiveness of procedures, nonclassical pathogen and multiresistant bacteria are increasingly reported. Third generation cephalosporins continue to be the gold-standard antibiotic treatment of many of the infections acquired in the community. By contrast, the empirical treatment of nosocomial infections should be tailored according to the local epidemiological pattern of multiresistant bacteria.

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Authors and Affiliations

  1. INSERM, U1149, Centre de Recherche sur l’Inflammation (CRI), Paris, France

    Thierry Gustot MD, PhD & Richard Moreau MD

  2. Department of Gastroenterology and Hepato-Pancreatology, Erasme Hospital, Brussels, Belgium

    Thierry Gustot MD, PhD

  3. Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Centre de Recherche sur l’Inflammation (CRI), Brussels, Belgium

    Thierry Gustot MD, PhD

  4. UMR_S1149, Univeristé Paris Diderot, Paris, France

    Richard Moreau MD

  5. Département Hospitalo-Univeristaire (DHU) UNITY, Service d’Hépatologie, Hôpital Beaujon, AP-HP, Paris, France

    Richard Moreau MD

  6. Laboratoire d’Excellence (Labex) Inflamex, PRESS Sorbonne Paris Cité, Paris, France

    Richard Moreau MD

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  1. Department of Transplant, Mayo Clinic, Jacksonville, Florida, USA

    Andrew P. Keaveny

  2. Institut de Malalties Digestives i Metaboliques, University of Barcelona, Barcelona, Spain

    Andrés Cárdenas

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Gustot, T., Moreau, R. (2015). Bacterial Infections in Patients with Cirrhosis. In: Keaveny, A., Cárdenas, A. (eds) Complications of Cirrhosis. Springer, Cham. https://doi.org/10.1007/978-3-319-13614-1_24

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