An Insight into Antibiotic Resistance to Bacterial Infection in Chronic Liver Disease.

Background: End stage liver disease leads to immune dysfunction which predisposes to infection. There has been a rise in antibiotic resistant infections in these patients. There is scanty data f from India or idea regarding the same.

Aim Of The Study: The present study was undertaken to determine the type of infection acquired and the prevalence of antibiotic resistant infections in cirrhotic patients at a tertiary referral center in South India.

Materials And Methods: In this retrospective study, all consecutive cirrhotic patients hospitalized between 2011 and 2013 with a microbiologically-documented infection were enrolled. Details of previous admission and antibiotics if received were noted. In culture positive infections, the source of infection (ascites, skin, respiratory tract: sputum/endotracheal tube aspirate, pleural fluid; urine and blood) and microorganisms isolated and their antibiotic susceptibility was noted.

Results: A total of 92 patients had 240 culture positive samples in the study period. Majority were followed by and in nosocomial and health care associated infections. However, was followed by and in community acquired infections. The antibiotic sensitivity pattern was analyzed for the major causative organisms such as , and . Most common resistant strains were extended spectrum beta lactamase producing enterobacteriacae (ESBL) followed by carbapenemase producing and methicillin resistant .

Conclusion: Noscomial infection is the most common type, with and and there is significant rise in ESBL producing organism.