da0dd194709bf30648f21a044e9b168c pmc_11477389.pdf 23193edb70e4dacc66709bc8c56cdc1de3a9e57f pmc_11477389.pdf 81fa3a69bdbca3f99ad90c1e37822dc3e1920decf92aed8737b2ce154e06577c pmc_11477389.pdf Title: Bacterial Infection Features in Alcohol-Associated Hepatitis: Review of a 2016–2021 Cohort Subject: Background/Objectives: Bacterial infections (BI) are a major cause of mortality in patients with alcohol-associated hepatitis (AH); however, only a few studies have investigated BI in AH in the last decade. Therefore, we aimed to assess the features and outcomes of BI in patients with AH. Methods: This observational descriptive study included patients with AH admitted to a tertiary academic hospital between 2016 and 2021. Clinical and complete microbiological data were recorded and complications, including acute-on-chronic liver failure (ACLF), and mortality over 90-days were compared between infected and noninfected patients. Results: Overall, 115 patients with AH were recruited and 75 had severe AH; among them, 66 started corticosteroid treatment. We identified 69 cases of BI in 44 patients; the incidence of BI upon hospital discharge was 32.2%, which reached 38.2% at 90 days. The predominant infection site was the chest (35%). Among the identified bacteria (52.1%), half were gram positive and half gram negative. A low rate of multidrug-resistant bacteria (14%) was also noted. Infected patients during hospitalization (n = 37) exhibited higher rates of hepatic decompensation and ACLF (p = 0.001) and lower survival (81.8% vs. 95.8%, p = 0.015) than did noninfected patients (n = 78). In-hospital infected patients (n = 22) exhibited worse survival (72.7%) than did those infected upon admission (93.3%) or noninfected patients (94.9%) (p = 0.009). Corticosteroid-treated patients displayed a nonsignificant increase in the total number of BI; however, without greater mortality. Conclusions: BI were common in our cohort of patients with AH. Patients with in-hospital infections commonly experienced serious complications, including high ACLF and death rates. Infections diagnosed upon admission were treated without affecting survival. Keywords: bacterial infections; alcoholic hepatitis; alcohol-associated hepatitis; risk factors; acute-on-chronic liver failure; corticosteroids Author: Cesar Jiménez, Aina Martí-Carretero, Ares Villagrasa, Anna Aguilar, María Pérez-Pérez, Meritxell Ventura-Cots and Victor Vargas Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed Sep 25 10:12:32 2024 CEST ModDate: Wed Sep 25 10:17:38 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1033093 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 UCADLU+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 GIRJPQ+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 GVDEFB+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 NWRUAI+VnURWPalladioL Type 1 Custom yes yes yes 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 51 0 VSPIKV+CMSY10 Type 1 Builtin yes yes yes 68 0 OVNEXW+EURM10 Type 1 Builtin yes yes yes 76 0 BBAHFN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 112 0 BBAHFP+PalatinoLinotype TrueType WinAnsi yes yes no 115 0 BBAHGB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 118 0 BBAHMA+PalatinoLinotype TrueType MacRoman yes yes no 121 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 147 0 BBANEC+Calibri,Bold CID TrueType Identity-H yes yes yes 195 0 BBANGC+Calibri,BoldItalic CID TrueType Identity-H yes yes yes 201 0 BBANPA+Calibri CID TrueType Identity-H yes yes yes 207 0 BBAOBB+Cambria,Bold TrueType WinAnsi yes yes no 213 0 BBAHFN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 216 0 BBAHFP+PalatinoLinotype TrueType WinAnsi yes yes no 219 0 BBAHGB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 222 0 BBANEC+Calibri,Bold CID TrueType Identity-H yes yes yes 282 0 BBANGC+Calibri,BoldItalic CID TrueType Identity-H yes yes yes 288 0 BBANPA+Calibri CID TrueType Identity-H yes yes yes 294 0 BBAOBB+Cambria,Bold TrueType WinAnsi yes yes no 300 0 BBAHFN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 303 0 BBAHFP+PalatinoLinotype TrueType WinAnsi yes yes no 306 0 BBAHGB+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 309 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-30 02:49:01 CET RepresentationInformation: pmc_11477389.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-10-25 02:32:55 CEST Size: 1033093 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 496 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Population Destination: subsection.2.1 Item: Title: Definitions Destination: subsection.2.2 Item: Title: Statistical Analysis Destination: subsection.2.3 Item: Title: Results Destination: section.3 Children: Item: Title: Study Population Destination: subsection.3.1 Item: Title: Infections Destination: subsection.3.2 Item: Title: Bacteria and Sites of Infection Destination: subsection.3.3 Item: Title: Infections upon Admission Destination: subsection.3.4 Item: Title: Infections during Follow-Up Destination: subsection.3.5 Item: Title: Liver-Related Decompensations and ACLF in Infected Patients Compared with Noninfected Patients Destination: subsection.3.6 Item: Title: Mortality and Predictors of Mortality in Infected Patients Destination: subsection.3.7 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Bacterial Infection Features in Alcohol-Associated Hepatitis: Review of a 2016 2021 Cohort Author: Cesar Jiménez, Aina Martí-Carretero, Ares Villagrasa, Anna Aguilar, María Pérez-Pérez, Meritxell Ventura-Cots and Victor Vargas Subject: Background/Objectives: Bacterial infections (BI) are a major cause of mortality in patients with alcohol-associated hepatitis (AH); however, only a few studies have investigated BI in AH in the last decade. Therefore, we aimed to assess the features and outcomes of BI in patients with AH. Methods: This observational descriptive study included patients with AH admitted to a tertiary academic hospital between 2016 and 2021. Clinical and complete microbiological data were recorded and complications, including acute-on-chronic liver failure (ACLF), and mortality over 90-days were compared between infected and noninfected patients. Results: Overall, 115 patients with AH were recruited and 75 had severe AH; among them, 66 started corticosteroid treatment. We identified 69 cases of BI in 44 patients; the incidence of BI upon hospital discharge was 32.2%, which reached 38.2% at 90 days. The predominant infection site was the chest (35%). Among the identified bacteria (52.1%), half were gram positive and half gram negative. A low rate of multidrug-resistant bacteria (14%) was also noted. Infected patients during hospitalization (n = 37) exhibited higher rates of hepatic decompensation and ACLF (p = 0.001) and lower survival (81.8% vs. 95.8%, p = 0.015) than did noninfected patients (n = 78). In-hospital infected patients (n = 22) exhibited worse survival (72.7%) than did those infected upon admission (93.3%) or noninfected patients (94.9%) (p = 0.009). Corticosteroid-treated patients displayed a nonsignificant increase in the total number of BI; however, without greater mortality. Conclusions: BI were common in our cohort of patients with AH. Patients with in-hospital infections commonly experienced serious complications, including high ACLF and death rates. Infections diagnosed upon admission were treated without affecting survival. 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