关键词: 肝硬化, 失代偿期, 多重耐药菌, 感染, 危险因素

Abstract:

Objective To investigate the risk factors for concurrent multidrug-resistant bacterial infections in patients with decompensated cirrhosis. Methods A retrospective cohort study was conducted on the clinical data of 133 patients with decompensated cirrhosis hospitalized from January 2017 to December 2020, in which 33 cases who developed multidrug-resistant bacterial infections were set up as the infected group, and the remaining 100 cases who did not develop multidrug-resistant bacterial infections were set up as the non-infected group. All the clinical features and biochemical indicators that might cause multi-drug resistant bacteria infection were collected, and the risk factors for the development of multi-drug resistant bacteria infection in decompensated cirrhosis patients were analyzed by univariate and multivariate Logistic regression analyses. Results Among the 133 study subjects, 33 (24.81%) had multidrug-resistant bacterial infections, and the dominant (16 cases) was infected with Carbapenem-resistant Acinetobacter baumannii (CRAB). Univariate analysis showed that the length of stay, mechanical ventilation, ICU admission, hormone use, invasive operation, comorbid septic shock, and albumin level were significantly associated with multidrug-resistant organisms (MDRO)(P<0.05). Multivariate logistic regression analysis further concluded that the length of stay≥10 d and the comorbid septic shock were independent risk factors for multidrug-resistant bacterial infections. Conclusion Patients with decompensated cirrhosis who are hospitalized for ≥10 d or in septic shock are at a greater risk of multidrug-resistant bacterial infections, and they should be evaluated for early interventions in clinical practice.

Key words: liver cirrhosis, decompensation period, multidrug-resistant bacterial, infections, risk factors