Healthcare-associated infections in hospitalized cirrhotic patients
Keywords:
liver cirrhosis, infections, healthcare-associated infectionsAbstract
Introduction: liver cirrhosis has been confirmed as one of the most common diseases in Cuba. Infection and decompensated cirrhosis constitute the cause of hospitalization.
Objective: to identify the most frequent health care-associated diseases in hospitalized cirrhotic patients.
Method: a cohort study involving 90 hospitalized patients with cirrhosis was conducted at the Hospital General Provincial “Carlos Manuel de Céspedes” in Granma, from January 2017 through September 2020. The total patients underwent study were over 18 years old and both sex. Data were collected from patients´ hospitalization history. Chi-square test was utilized for statistical analysis and to measure its power (the relative risk), a P-value less than 0.05 was used.
Results: most patients were male, decompensated with Child-Pugh class B. All hospitalized patients who underwent health care such as bladder catheter placement, central and peripheral venous approach, as well as endotracheal intubation, alcohol was considered the major etiological factor cause of cirrhosis. The main healthcare-associated infections observed in these patients were phlebitis, bacteremia, urinary tract infection and pneumonia.
Conclusions: the healthcare-associated infections in order of frequency were phlebitis, bacteremia, pyelonephritis, pneumonia and cystitis.
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References
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21. Xie Y, Tu B, Xu Z, Zhang X, Bi J, Zhao M, et al. Bacterial distributions and prognosis of Bloodstream infections in patients with liver cirrhosis. Sci Rep [Internet]. 2017 Sep [citado 20 Sep 2019]; 7(1):11482. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28904387/
22. Wu S, Ren S, Zhao H, Jin H, Xu L, Qia S, et al. Risk factos for central venous catheter-related Bloodstream infections in liver after Gastroenterol surgery. Am J Infec [Internet]. 2017 May [citado 20 Sep 2019]; 45(5):549-50. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28233571/
23. Sentarpia L, Bornamo A, Pagano MC, Alfuci L, Foggia M, Mattale M, et al. Central venous catheter related Bloodstream infections in adult patients in home parenteral nutrition: Prevalence, predictive, factors, therapeutic outcome. Clin Nutr [Internet]. 2016 Dec [citado 20 Sep 2019]; 35(6):1394-98. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27068496/
24. Méndez Guerrero IO, Álvarez Navarro N, Torre Delgadillo A. Impacto del estado nutricional en el pronóstico de pacientes con cirrosis hepática. REDCieN [Internet]. 2020 Ene-Jun [citado 20 Sep 2019]; 3(5):31-40. Disponible en: https://www.researchgate.net/publication/344158830_IMPACTO_DEL_ESTADO_NUTRICIONAL_EN_EL_PRONOSTICO_DE_PACIENTES_CON_CIRROSIS_HEPATICA
/VOLUMEN-COMPLETO-ENERO-JUNIO1-2019.pdf.pdf
2. Sotos Solano FJ. Análisis de los Pacientes Cirróticos Ingresados en las Unidades de Cuidados Intensivos. [Tesis Doctoral]. España: Universidad De Murcia; 2019. [citado 20 Sep 2020]. Disponible: http://hdl.handle.net/10201/67982.
3. Carrillo Esper R, Díaz Carrillo MA, Arch Tirado E, Zepeda Mendoza DZ, Meza Márquez JM, Pérez Calatayud AA. Correlación entre la clasificación Child-Pugh lactato y la mortalidad en pacientes cirróticos internados en la unidad de terapia intensiva. Med Crit [Internet]. 2016 [citado 20 Sep 2020]; 30(5):310-31.http://www.medigraphic.com/medicinacritica
4. Klímová K, Padilla C, Ávila JC, Clemente G, Ochoa A. Epidemiología de las infecciones bacterianas en pacientes con cirrosis hepática, experiencia de un centro español de atención terciaria. Biomédica [Internet]. 2016 [citado 20 Sep 2020]; 36(1):121-32. DOI: https://doi.org/10.7705/biomedica.v36i1.2600
5. Castillo Luna A, Cristina Longo C, Landeira G, et al. Las infecciones por bacterias multirresistentes en la cirrosis modifican el pronóstico de los pacientes. Acta Gastroenterol Latinoam [Internet]. 2017 [citado 20 Sep 2020]; 47(4):243-251. Disponible en: http://www.actagastro.org/numeros-anteriores/2017/Vol-47-N4/Vol47N4-PDF04.pdf
6. Sargenti K, Pritz H, Nilsson E, Kalaitzakis E.Predictors of mortality among patients with compensated and decompensated liver cirrhosis: the role of bacterial infections and infection-related acute-on-chronic liver failure. Scan J Gastroenterol [Internet]. 2015 Jul [citado 20 Sep 2020]; 50(7):875-83. DOI: https://doi.org/10.3109/00365521.2015.1017834
7. Biblioteca Médica Nacional. Cirrosis Hepática. Tratamiento. Bibliomed [Internet]. 2018 Nov [citado 20 Sep 2020]; 25(12):14. Disponible en: http://files.sld.cu/bmn/files/2018/11/bibliomed-noviembre-2018.pdf
8. Nodarse Hernández R. Visión actualizada de las infecciones Intrahospitalarias. Rev Cubana Med Mil [Internet]. 2002 [citado 20 Sep 2019]; 31(3):201-8. Disponible en: http://scielo.sld.cu/pdf/mil/v31n3/mil08302.pdf
9. Fortea JI, Crespo J. Cirrosis hepática. Medicine [Internet]. 2020 [citado 20 Sep 2019]; 13(6):297-307. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7352104
10. Horan TC, MPH, Andrus M, Dudeck MA. CDC/NHSN Surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control [Internet]. 2008 [citado 20 Sep 2019]; 36(5):309-32. DOI: https://doi.org/10.1016/j.ajic.2008.03.002
11. Powell E, Skoien R, Rahman T, Clark PJ, O'Beirne J, Hartel G. Increasing Hospitalization Rates for Cirrhosis: overrepresentation of disadvantaged australians. EClinical Med [Internet]. 2019 Jun [Citado 20 Sep 2019]; 11:44-53. DOI: https://doi.org/10.1016/j.eclinm.2019.05.007
12. Piano S, Singh V, Caraceni P, Maiwall R, Alessandria C, Fernández J, et al. Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide. Gastroenterol [Internet]. 2019 Apr [citado 20 Sep 2019]; 156(5):1-13. DOI: https://doi.org/10.1053/j.gastro.2018.12.005
13. Di Pascoli M, Ceranto E, De Nardi P, Donato D, Gatta A, Angeli P, et al. Hospitalizations Due to Cirrhosis: clinical aspects in a large cohort of italian patients and cost analysis report. Dig Dis [Internet]. 2017 [citado 20 Sep 2019]; 35(5):433-38. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28245467/
14. Marciano S, Díaz JM, Gadano A. Spontaneus bacterial peritonitis in patients with cirrhosis, incidence Outcomes and treatment strategies. Hepat Med: Evidence and Res [Internet]. 2019 Jan [citado 20 Sep 2019]; (11):13-22. DOI: https://doi.org/10.2147/HMER.S164250
15. Wong J, Zhang Z, Yan X, Li M, Xia J, Liu Y, et al. Albumin-Bilirrubin (ALBI) an accurate an simple prognostic score for chronic hepatitis B-related liver cirrhosis. Dig Liver Dis [Internet]. 2019 [citado 20 Sep 2019]; 51(8):1172-78. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30765220/
16. Pen Y, Qi X, Who X. Child-Pugh versus MELD score for the Assesment of prognosis in liver cirrhosis. Medicine (Baltimore) [Internet]. 2016 Feb [Citado 20 Sep 2019]; 95(8):2877. DOI: https://dx.doi.org/10.1097%2FMD.0000000000002877
17. Majead A, Sagar F, Latif A, Hassan H, Iffikar A, Darnuchi RO, et al. Does antimicrobial coating and impregnation of urinary catheters prevent catthter-associated urinary tract Infection. A review of Clinical and preclinical studies. Exp Rev Med Dev [Internet]. 2019 Sep [citado 20 Sep 2019]; 16(9):809-20. DOI: https://doi.org/10.1080/17434440.2019.1661774
18. Yu S, Marshal AP, Li J, Ling F. Interventions and strategies to prevent catheter-associated urinary tract infections with short-term including urinary catheters in hospitalized patients: An integrative review. Int J Ners Pract [Internet]. 2020 [citado 20 Sep 2019]; 26(3):e12834. DOI: https://doi.org/10.1111/ijn.12834
19. Sato A, Nakamura I, Fujita H, Sukimari A, Kobayashi T, Fukushima S, et al. Peripheral venous catheter-related Bloodstream Infection is associated with severe complications and potential deth: a respective observational study. BMC Infec Des [Internet]. 2017 [citado 20 Sep 2019]; 17:434. Disponible en: https://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-017-2536-0.pdf
20. Elzauki AN, Neffati N, Rosaul FA, Abdallah H, Othnem M, Waness A, et al. Increased risk of Spontaneus bacterial peritonitis in cirrhotic patients using proton pump inhibitors. GE Port J Gastroenterol [Internet]. 2019 Mar [citado 20 Sep 2019]; 26(2):83-89. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454390/
21. Xie Y, Tu B, Xu Z, Zhang X, Bi J, Zhao M, et al. Bacterial distributions and prognosis of Bloodstream infections in patients with liver cirrhosis. Sci Rep [Internet]. 2017 Sep [citado 20 Sep 2019]; 7(1):11482. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28904387/
22. Wu S, Ren S, Zhao H, Jin H, Xu L, Qia S, et al. Risk factos for central venous catheter-related Bloodstream infections in liver after Gastroenterol surgery. Am J Infec [Internet]. 2017 May [citado 20 Sep 2019]; 45(5):549-50. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28233571/
23. Sentarpia L, Bornamo A, Pagano MC, Alfuci L, Foggia M, Mattale M, et al. Central venous catheter related Bloodstream infections in adult patients in home parenteral nutrition: Prevalence, predictive, factors, therapeutic outcome. Clin Nutr [Internet]. 2016 Dec [citado 20 Sep 2019]; 35(6):1394-98. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27068496/
24. Méndez Guerrero IO, Álvarez Navarro N, Torre Delgadillo A. Impacto del estado nutricional en el pronóstico de pacientes con cirrosis hepática. REDCieN [Internet]. 2020 Ene-Jun [citado 20 Sep 2019]; 3(5):31-40. Disponible en: https://www.researchgate.net/publication/344158830_IMPACTO_DEL_ESTADO_NUTRICIONAL_EN_EL_PRONOSTICO_DE_PACIENTES_CON_CIRROSIS_HEPATICA
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2021-05-30
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Ricardo-Serrano YM, Rodríguez-Pereira A, Cabrera-Lavernia JO, Martí-Garcés GM, Pelaez-Llorente M. Healthcare-associated infections in hospitalized cirrhotic patients. Rev Inf Cient [Internet]. 2021 May 30 [cited 2025 Apr. 2];100(3):e3455. Available from: https://revinfcientifica.sld.cu/index.php/ric/article/view/3455
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