AI Article Synopsis
- Multidrug-resistant organisms, particularly carbapenem-resistant Enterobacteriaceae, are a growing concern for ICU patients with decompensated cirrhosis.
- A study found that 46% of bacteria found at admission and 60% during ICU stay were multiresistant, with a notable increase in carbapenem-resistant strains over time.
- The length of ICU stay and previous carbapenem antibiotic usage were significant risk factors for acquiring second infections in these patients, highlighting the urgent need for monitoring and better treatment strategies.
Article Abstract
Background: Multidrug-resistant organisms are an increasing concern in patients with decompensated cirrhosis.
Aim: We aimed to evaluate the prevalence of infections with carbapenem-resistant Enterobacteriaceae in patients with decompensated cirrhosis.
Methods: Patients with decompensated cirrhosis admitted to ICU were included. The isolated Enterobacteriaceae strains were tested for carbapenemase-producing genes using the Roche LightMix® Modular VIM/IMP/NDM/GES/KPC/OXA48-carbapenemase detection kit.
Results: 48 culture-positive infections were registered in 75 patients with acutely decompensated cirrhosis. Thirty patients contracted a second infection. 46% of bacteria isolated at admission and 60% of bacteria responsible for infections identified during ICU-stay were multiresistant. ESBL+ Enterobacteriaceae were predominant at admission, while carbapenem-resistance was dominant in both Enterobacteriaceae and Non-Fermenting-Gram-Negative Bacteria responsible for infections diagnosed during hospitalisation. OXA 48 or KPC type carbapenemases were present in 30% of the analyzed Enterobacteriaceae and in 40% of the phenotypically carbapenem-resistant Klebsiella pneumoniae strains. The length of ICU stay was a risk-factor for a second infection (p=0.04). Previous carbapenem usage was associated with occurence of infections with carbapenem-resistant Gram-negative bacteria during hospitalization (p=0.03).
Conclusion: The prevalence of infections with carbapenem-resistant Enterobacteriaceae is high in patients with decompensated cirrhosis admitted to ICU. Carbapenemase-producing genes in Enterobacteriaceae in our center are bla and bla.
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| http://dx.doi.org/10.1016/j.dld.2022.05.011 | DOI Listing |
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