Bacterial Infection Features in Alcohol-Associated Hepatitis : Review of a 2016-2021 Cohort
Jiménez, Cesar (Hospital Universitari Vall d'Hebron)
Martí-Carretero, Aina (Hospital Universitari Vall d'Hebron)
Villagrasa, Ares (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Aguilar, Anna (Hospital Universitari Vall d'Hebron)
Pérez-Pérez, María (Hospital Universitari Vall d'Hebron)
Ventura-Cots, Meritxell (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Vargas Blasco, Víctor (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2024
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Bacterial infections ; Alcoholic hepatitis ; Alcohol-associated hepatitis ; Risk factors ; Acute-on-chronic liver failure ; Corticosteroids
Publicat a:	Journal of clinical medicine, Vol. 13, Num. 9 (september 2024) , ISSN 2077-0383

DOI: 10.3390/jcm13195693
PMID: 39407753

15 p, 1008.9 KB

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