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Abstract：
BACKGROUND: Multidrug-resistant organisms (MDROs) are a reality that can alter the paradigm of treatment and prevention of infection in patients with liver cirrhosis (LC).
OBJECTIVE: Identify risk factors for the occurrence of MDROs in patients with LC.
METHODS: Prospective study from October 2017 to March 2018 in consecutively hospitalized patients with decompensated LC with infection. Blood, urine and ascitic fluid cultures were analyzed. A p-value ≤0.05 was considered statistically significant.
RESULTS: MDROs isolated in 18 of 52 episodes of infection. MDROs were associated with the use of proton pump inhibitors (PPIs) (p=0.0312), antibiotic therapy in the last 90 days (p=0.0033) and discharge within preceding 30 days or current hospitalization above 48h (p=0.0082). There was higher 90-day mortality in patients with MDROs infection (71.4% versus 35.7%, p=0.0316).
CONCLUSIONS: MDROs infections were prevalent in this cohort and associated with 90-day mortality. Use of PPIs and antibiotics increased the risk of MDROs infections, suggesting that its prescription should be restricted to formal indication. Hospitalization was associated with the onset of MDROs, so LC patients should stay at the hospital the least possible. It is relevant to investigate other factors predisposing to the emergence of these microorganisms, in order to prevent it.
OBJECTIVE: Identify risk factors for the occurrence of MDROs in patients with LC.
METHODS: Prospective study from October 2017 to March 2018 in consecutively hospitalized patients with decompensated LC with infection. Blood, urine and ascitic fluid cultures were analyzed. A p-value ≤0.05 was considered statistically significant.
RESULTS: MDROs isolated in 18 of 52 episodes of infection. MDROs were associated with the use of proton pump inhibitors (PPIs) (p=0.0312), antibiotic therapy in the last 90 days (p=0.0033) and discharge within preceding 30 days or current hospitalization above 48h (p=0.0082). There was higher 90-day mortality in patients with MDROs infection (71.4% versus 35.7%, p=0.0316).
CONCLUSIONS: MDROs infections were prevalent in this cohort and associated with 90-day mortality. Use of PPIs and antibiotics increased the risk of MDROs infections, suggesting that its prescription should be restricted to formal indication. Hospitalization was associated with the onset of MDROs, so LC patients should stay at the hospital the least possible. It is relevant to investigate other factors predisposing to the emergence of these microorganisms, in order to prevent it.
摘要：
背景：多药耐药生物体（MDRO）是可以改变肝硬化（LC）患者治疗和预防感染的范例的现实。
目的：确定LC患者发生MDROs的危险因素。
方法：2017年10月至2018年3月连续住院的失代偿性LC合并感染患者的前瞻性研究。血，分析尿液和腹水培养物。P值≤0.05被认为具有统计学意义。
结果：在52次感染发作中的18次分离出MDRO。MDRO与质子泵抑制剂（PPI）的使用有关（p=0.0312），最后90天的抗生素治疗（p=0.0033）和在过去30天内出院或当前住院超过48小时（p=0.0082）。MDROs感染患者的90天死亡率更高（71.4%对35.7%，p=0.0316)。
结论：MDRO感染在该队列中普遍存在，并与90天死亡率相关。使用PPI和抗生素会增加MDROs感染的风险，建议其处方应仅限于正式适应症。住院与MDRO的发作有关，因此，LC患者应尽量不住院。它与调查其他因素有关，这些微生物的出现，为了防止它。
目的：确定LC患者发生MDROs的危险因素。
方法：2017年10月至2018年3月连续住院的失代偿性LC合并感染患者的前瞻性研究。血，分析尿液和腹水培养物。P值≤0.05被认为具有统计学意义。
结果：在52次感染发作中的18次分离出MDRO。MDRO与质子泵抑制剂（PPI）的使用有关（p=0.0312），最后90天的抗生素治疗（p=0.0033）和在过去30天内出院或当前住院超过48小时（p=0.0082）。MDROs感染患者的90天死亡率更高（71.4%对35.7%，p=0.0316)。
结论：MDRO感染在该队列中普遍存在，并与90天死亡率相关。使用PPI和抗生素会增加MDROs感染的风险，建议其处方应仅限于正式适应症。住院与MDRO的发作有关，因此，LC患者应尽量不住院。它与调查其他因素有关，这些微生物的出现，为了防止它。
