Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis

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Standard

Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis. / Int Variceal Bleeding Observationa; Baveno Cooperation.

I: Journal of Hepatology, Bind 75, Nr. 2, 2021, s. 342-350.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Int Variceal Bleeding Observationa & Baveno Cooperation 2021, 'Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis', Journal of Hepatology, bind 75, nr. 2, s. 342-350. https://doi.org/10.1016/j.jhep.2021.03.026

APA

Int Variceal Bleeding Observationa, & Baveno Cooperation (2021). Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis. Journal of Hepatology, 75(2), 342-350. https://doi.org/10.1016/j.jhep.2021.03.026

Vancouver

Int Variceal Bleeding Observationa, Baveno Cooperation. Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis. Journal of Hepatology. 2021;75(2):342-350. https://doi.org/10.1016/j.jhep.2021.03.026

Author

Int Variceal Bleeding Observationa ; Baveno Cooperation. / Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis. I: Journal of Hepatology. 2021 ; Bind 75, Nr. 2. s. 342-350.

Bibtex

@article{215025e482b74366962595b2631fbdc7,
title = "Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis",
abstract = "Background & Aims: Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.Methods: A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.Results: A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).Conclusion: Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.Lay summary: Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. (C) 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.",
keywords = "Cirrhosis, Acute variceal bleeding, Antibiotic prophylaxis, Bacterial infection, Respiratory infection, CIRRHOTIC-PATIENTS, PORTAL-HYPERTENSION, CONSENSUS WORKSHOP, MULTICENTER, HEMORRHAGE, RISK, CARE",
author = "Javier Martinez and Virginia Hernandez-Gea and Enrique Rodriguez-de-Santiago and Luis Tellez and Bogdan Procopet and Alvaro Giraldez and Lucio Amitrano and Candid Villanueva and Dominique Thabut and Luis Ibanez-Samaniego and Gilberto Silva-Junior and Joan Genesca and Christophe Bureau and Jonel Trebicka and Rafael Banares and Aleksander Krag and Elba Llop and Wim Laleman and {Maria Palazon}, Jose and Jose Castellote and Susana Rodrigues and Gluud, {Lise L.} and Carlos Noronha-Ferreira and Nuria Canete and Manuel Rodriguez and Arnulf Ferlitsch and Remy Schwarzer and Mundi, {Jose Luis} and Henning Gronbaek and Manuel Hernandez-Guerra and Romano Sassatelli and Alessandra Dell'Era and Marco Senzolo and Abraldes, {Juan G.} and Manuel Romero-Gomez and Alexander Zipprich and Meritxell Casas and Helena Masnoun and Massimo Primignani and Frederik Nevens and {Luis Calleja}, Jose and Christian Jansen and Robic, {Marie Angele} and Irene Conejo and {Vega Catalina}, Maria and Marika Rudler and Edilmar Alvarado and Valeria Perez-Campuzano and Guardascione, {Maria Anna} and Petra Fischer and {Int Variceal Bleeding Observationa} and {Baveno Cooperation}",
year = "2021",
doi = "10.1016/j.jhep.2021.03.026",
language = "English",
volume = "75",
pages = "342--350",
journal = "Journal of Hepatology, Supplement",
issn = "0169-5185",
publisher = "Elsevier",
number = "2",

}

RIS

TY - JOUR

T1 - Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis

AU - Martinez, Javier

AU - Hernandez-Gea, Virginia

AU - Rodriguez-de-Santiago, Enrique

AU - Tellez, Luis

AU - Procopet, Bogdan

AU - Giraldez, Alvaro

AU - Amitrano, Lucio

AU - Villanueva, Candid

AU - Thabut, Dominique

AU - Ibanez-Samaniego, Luis

AU - Silva-Junior, Gilberto

AU - Genesca, Joan

AU - Bureau, Christophe

AU - Trebicka, Jonel

AU - Banares, Rafael

AU - Krag, Aleksander

AU - Llop, Elba

AU - Laleman, Wim

AU - Maria Palazon, Jose

AU - Castellote, Jose

AU - Rodrigues, Susana

AU - Gluud, Lise L.

AU - Noronha-Ferreira, Carlos

AU - Canete, Nuria

AU - Rodriguez, Manuel

AU - Ferlitsch, Arnulf

AU - Schwarzer, Remy

AU - Mundi, Jose Luis

AU - Gronbaek, Henning

AU - Hernandez-Guerra, Manuel

AU - Sassatelli, Romano

AU - Dell'Era, Alessandra

AU - Senzolo, Marco

AU - Abraldes, Juan G.

AU - Romero-Gomez, Manuel

AU - Zipprich, Alexander

AU - Casas, Meritxell

AU - Masnoun, Helena

AU - Primignani, Massimo

AU - Nevens, Frederik

AU - Luis Calleja, Jose

AU - Jansen, Christian

AU - Robic, Marie Angele

AU - Conejo, Irene

AU - Vega Catalina, Maria

AU - Rudler, Marika

AU - Alvarado, Edilmar

AU - Perez-Campuzano, Valeria

AU - Guardascione, Maria Anna

AU - Fischer, Petra

AU - Int Variceal Bleeding Observationa

AU - Baveno Cooperation

PY - 2021

Y1 - 2021

N2 - Background & Aims: Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.Methods: A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.Results: A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).Conclusion: Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.Lay summary: Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. (C) 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

AB - Background & Aims: Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis.Methods: A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization.Results: A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9).Conclusion: Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.Lay summary: Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. (C) 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

KW - Cirrhosis

KW - Acute variceal bleeding

KW - Antibiotic prophylaxis

KW - Bacterial infection

KW - Respiratory infection

KW - CIRRHOTIC-PATIENTS

KW - PORTAL-HYPERTENSION

KW - CONSENSUS WORKSHOP

KW - MULTICENTER

KW - HEMORRHAGE

KW - RISK

KW - CARE

U2 - 10.1016/j.jhep.2021.03.026

DO - 10.1016/j.jhep.2021.03.026

M3 - Journal article

C2 - 33845059

VL - 75

SP - 342

EP - 350

JO - Journal of Hepatology, Supplement

JF - Journal of Hepatology, Supplement

SN - 0169-5185

IS - 2

ER -

ID: 286921980