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 OXA-48 and bla KPC.
Keywords
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Article info
Publication history
Published online: June 19, 2022
Accepted:
May 26,
2022
Received:
March 8,
2022
Footnotes
This work was funded by Petra Fischer's PhD research project (1300/13/01/2017)
Identification
Copyright
© 2022 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
