Prevalence and Predictors of Bacterial Infection in Hospitalized Patients with Liver Cirrhosis

Abstract

Background

Infections adversely affect the prognosis of patients with liver cirrhosis. The study aimed to analyze the prevalence and the predictors of infections in patients admitted with cirrhosis.

Methods

After obtaining ethical approval, this retrospective study was conducted at a tertiary care center between April 2021 and January 2024. All the patients admitted with cirrhosis were included. Infections were identified according to the standard definitions.

Results

Of the 417 patients (mean age: 54.28 ± 12.61 years; male: 299 [71.70%]), 375 (89.92%) had alcohol-related cirrhosis. The mean Child–Turcotte–Pugh (CTP), Model for End-Stage Liver Disease (MELD), and Model for End-Stage Liver Disease with sodium (MELD-Na) scores were 9.6 ± 2.2, 18.3 ± 8.3, and 20.1 ± 8.3, respectively. Infections were seen in 62 (14.86%) patients. The most prevalent infections were urinary tract infection (26 [6.23%]), spontaneous bacterial peritonitis (18 [4.31%]), bloodstream infection (7 [1.67%]), pneumonia (5 [1.19%]), cellulitis (4 [0.95%]), tuberculosis (3 [0.71%]), and upper respiratory tract infection (2 [0.47%]). Patients with infection had significantly high MELD (p = 0.01) and MELD-Na (p = 0.00) scores, and low albumin (p = 0.04) and sodium (p < 0.001) levels. On univariate analysis, ascites (odds ratio [OR]: 1.85; 95% confidence interval [CI]: 1.07–3.19; p = 0.02), gastrointestinal bleeding (OR: 0.50; 95% CI: 0.26–0.98; p = 0.04), MELD (OR: 1.04; 95% CI: 1.00–1.07; p = 0.01), MELD-Na (OR: 1.05; 95% CI: 1.01–1.08; p < 0.001), albumin (OR: 0.59; 95% CI: 0.36–0.98; p = 0.04), and sodium (OR: 0.93; 95% CI: 0.89–0.98; p < 0.001) predicted the presence of infection. On multivariate analysis, ascites (OR: 2.95; 95% CI: 1.06–8.17; p = 0.03) and the presence of comorbidity (OR: 2.74; 95% CI: 1.02–7.31; p = 0.04) were the only predictors of infection.

Conclusion

Infections were present in approximately 15% of the patients with cirrhosis. The presence of ascites and comorbidities predicted infection in admitted cirrhotic patients.

Keywords

infections - liver cirrhosis - peritonitis - predictor - prevalence

Ethical Approval

The institute review committee (IRC) approved this study (approval number: CMC-IRC/080/081–089).

Consent to Participate

Since this was a retrospective study, consent was not required.

Authors' Contributions

M.K.R. was involved in conceptualization, data collection, supervision, data analysis, manuscript writing, revision, and editing. P.N., B.M., and R.K.Y. contributed to data collection, literature review, data analysis, manuscript writing, and editing. A.S., H.S., N.P., and A.T. were responsible for data collection, literature review, data analysis, and manuscript writing.

Data Availability Statement

The data can be obtained from the corresponding author, provided there is a genuine request.

Publikationsverlauf

Eingereicht: 28. Dezember 2024

Angenommen: 23. Februar 2025

Artikel online veröffentlicht:
22. Mai 2025

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