The Importance of Knowing the Local Epidemiology When a Patient With Cirrhosis Acquires a Bacterial Infection

MARCIANO, SEBASTIÁN; VALVERDE, MARCELO; DIRCHWOLF, MELISA; GUTIERREZ-ACEVEDO, MARÍA NELLY; GADANO, ADRIÁN

Clinical Liver Disease

John Wiley and Sons Inc

Año: 2020 vol. 16 p. 87 - 90

There is abundant evidence that bacterial infections are severe complications in patients with cirrhosis, being the most frequent trigger of acute‐on‐chronic liver failure1 and causing death in one of every four patients during hospitalization.2 For these reasons, primary and secondary antibiotic prophylaxes are advised when appropriate,3 and early diagnosis and effective treatment of infections are mandatory to improve patient outcomes.2However, treating physicians are challenged in daily practice because diagnosis of bacterial infections is not always straightforward. This situation might lead to delayed antibiotic initiation or prescription of ineffective regimens that is associated with poor outcomes.2, 4 In contrast, prescription of broad‐spectrum antibiotics to all patients in whom bacterial infections are suspected might favor bacterial resistance development. This is currently a major concern given the alarming proportion of infections being caused by multidrug‐resistant microorganisms (MDROs) worldwide.5 In patients with cirrhosis, infections caused by MDROs have been associated with longer hospital stays and higher morbidity and mortality.2