关键词: 肝硬化, 血流感染, 革兰阴性菌

Abstract: Objective To investigate the influencing factors, etiological distribution and drug resistance of bloodstream infection in patients with liver cirrhosis. Methods The data of 87 patients with liver cirrhosis who had bloodstream infection were retrospectively analyzed. The general data of a parallel hospitalized patients with cirrhosis who didn't get bloodstream infection during the same period of time were also collected as the control group. The comorbidities,history of invasive treatments, the distribution of pathogens and drug resistance of bloodstream infections in these patients were analyzed. Results Seventy-three of the 87 (83.9%) cirrhotic patients with bloodstream infection were in decompensate stage. Patients in bloodstream infection group were complicated with diseases such as diabetes (21.8%), peritoneal effusion (71.3%), hepatic encephalopathy (20.7%) and gastrointestinal bleeding (24.1%) and invasive procedures such as intravenous indwelling catheter (14.9%), indwelling catheter (16.1%) and abdominal puncture (58.6%), while the incidence of these complications in the control group were 11.9%, 36.8%, 9.0%, 9.6%, 8.3%, 3.8% and 21.5%, respectively. The proportion of patients developing complications in the infection group was significantly higher than that in the control group (All P<0.05). A total of 87 pathogenic bacteria were cultured out, including 59 Gram-negative bacteria (67.8%), which were mainly Escherichia coli (24.1%), Klebsiella pneumoniae (21.8%), and Pseudomonas aeruginosa (5.7%), etc. The resistance rates to ampicillin were 81%, 100% and 80%, respectively; and the sensitivity to imipenem is 100%. Twenty-eight strains (32.2%) were Gram-positive bacteria, which were mainly Staphylococcus aureus (10.3%), Streptococcus (8.0%) and Staphylococcus epidermidis (6.9%). They were all (100%) sensitive to vancomycin, tigecycline and linezolid. Conclusion Bloodstream infections are more common in patients with decompensated cirrhosis, which is closely related to their own comorbidities and invasive procedures. The pathogens of bloodstream infection are mainly Gram-negative bacteria, and antibacterial drugs such as cefoperazone/sulbactam, piperacillin / tazobactam, imipenem can be used as the first empirical medication.

Key words: Liver cirrhosis, Bloodstream infection, Gram-negative bacteria