PDF(Pubmed)
Abstract：
Acute-on-chronic liver failure (ACLF) is a distinct condition characterized by the abrupt exacerbation of pre-existing chronic liver disease, often leading to multi-organ failures and significant short-term mortalities. Bacterial infection is one of the most frequent triggers for ACLF and a common complication following its onset. The impact of bacterial infections on the clinical course and outcome of ACLF underscores their critical role in the pathogenesis of systemic inflammation and organ failures. In addition, the evolving epidemiology and increasing prevalence of multidrug-resistant bacteria in cirrhosis and ACLF highlight the importance of appropriate empirical antibiotic use, as well as accurate and prompt microbiological diagnosis. This review provided an update on recent advances in the epidemiology, diagnosis, pathogenesis, and management of bacterial infections in ACLF.
摘要：
急性慢性肝衰竭（ACLF）是一种独特的疾病，其特征是预先存在的慢性肝病突然恶化，通常导致多器官衰竭和显著的短期死亡率。细菌感染是ACLF最常见的诱因之一，也是其发作后的常见并发症。细菌感染对ACLF的临床过程和结果的影响强调了它们在全身性炎症和器官衰竭的发病机理中的关键作用。此外,不断发展的流行病学和多药耐药菌在肝硬化和ACLF中的患病率增加，突出了适当经验性抗生素使用的重要性，以及准确和及时的微生物诊断。这篇综述提供了流行病学最新进展的最新信息，诊断,发病机制，以及ACLF中细菌感染的管理。
