INVESTIGADORES
MARCIANO Sebastian
artículos
Título:
Spontaneous bacteremia and spontaneous bacterial peritonitis share similar prognosis in patients with cirrhosis: a cohort study
Autor/es:
MARCIANO, SEBASTIÁN; DIRCHWOLF, MELISA; BERMUDEZ, CARLA S.; SOBENKO, NATALIA; HADDAD, LEILA; GENRE BERT, FEDERICO; BARCÁN, LAURA; SMUD, ASTRID; POSADAS-MARTÍNEZ, MARIA LOURDES; GIUNTA, DIEGO; GADANO, ADRIÁN
Revista:
HEPATOLOGY INTERNATIONAL
Editorial:
SPRINGER
Referencias:
Año: 2017 vol. 12 p. 181 - 190
ISSN:
1936-0533
Resumen:
Background and aimsSpontaneous bacteremia is a poorly characterized infection in patients with cirrhosis. We compared the incidence of mortality and acute kidney injury in patients with spontaneous bacterial peritonitis and spontaneous bacteremia, and identified risk factors for mortality and acute kidney injury in patients with spontaneous bacteremia.MethodsWe performed a retrospective cohort study of patients with cirrhosis and spontaneous bacteremia or spontaneous bacterial peritonitis from 2008 to 2016 at Hospital Italiano, Buenos Aires. We compared the cumulative incidence of acute kidney injury and death between the two infections, and identified risk factors for these outcomes in patients with spontaneous bacteremia.ResultsSeventy-one patients with spontaneous bacteremia and 55 patients with spontaneous bacterial peritonitis were included. Most infections were nosocomial. Overall, 26% of bacteria were resistant and 11% multi-resistant. We found no significant association between acute kidney injury [subhazard ratio (sHR) 1.05 (95% confidence interval, CI 0.67?1.63, p = 0.83)] or death [sHR 1.15 (95% CI 0.60?2.20, p = 0.68)] and type of spontaneous infection in multivariate analyses adjusting for basal Model for End-Stage Liver Disease (MELD) score. In patients with spontaneous bacteremia, baseline MELD score was independently associated with acute kidney injury [sHR 1.07 (95% CI 1.03?1.11, p = 0.001)] and death [sHR 1.07 (95% CI 1.02?1.15, p = 0.03)].ConclusionsShort-term acute kidney injury and mortality rates were similar in patients with spontaneous bacteremia and spontaneous bacterial peritonitis. Risk assessment of patients with spontaneous bacteremia can be performed with baseline MELD score.
