Clinical characteristics in patients with liver cirrhosis complicated with bacterial infection

Objective To study the distribution and drug resistance of pathogens in patients with liver cirrhosis complicated with bacterial infection, so as to provide guidance for reasonable use of antibiotics. Methods The medical records of 471 cases of liver cirrhosis complicated with bacterial infection from August 2011 to August 2016 in Department of Infectious Diseases of Nanjing Medical University were reviewed. The kinds and distribution of pathogens, and drug resistance to commonly used antimicrobial agents were statistically analyzed. Results A total of 61 patients in 471 liver cirrhosis patients with positive bacterial cultures. Seventy-four strains of pathogens were isolated from 61 patients, including 45 gram-negative bacteria, and 29 gram-positive bacteria. E.coli (18 strains) and K.pneumoniae (13 strains) were the main gram-negative bacteria. E.coli had higher drug resistance rate to ampicillin and piperacillin, which were 8/10 and 11/18, respectively; while K.pneumoniae had higher drug resistance rate to cefazolin and ceftriaxone, which were 7/13 and 3/8. Staphylococcus aureus (5 strains) and coagulase negative Staphylococcus aureus (15 strains) were the main gram-positive bacteria, and they were highly resistant to penicillin (80.0%) , yet were susceptible to linezolid, tigecycline and vancomycin. A total of 9 multi-drug resistant strains were isolated, including 2 extensive-drug resistant strains of A.baumannii, 1 carbapenem-resistant Enterobacteriaceae strain of K. pneumoniae, 3 ESBLs-positive strains of E.coli, 1 ESBLs-positive strain of K.pneumoniae, and 2 methicillin-resistant coagulase-negative staphylococcus strains. Conclusions The gram-negative bacteria are still dominant strains in patients with liver cirrhosiscomplicated with bacterial infection, and the muti-drug resistant bacteria are increasing. The surveillance of antibiotics resistance should be strengthened, and reasonable use of antibiotics is necessary. Key words: Liver cirrhosis; Bacterial infection; Pathogens; Drug resistance