Bacterial infections in patients with liver cirrhosis

Clinical Microbiology and Antimicrobial Chemotherapy. 2017; 19(4):284-295

Journal article


Patients with liver cirrhosis are at substantial risk of bacterial infections. Bacterial complications account for more than 30% of hospitalizations and contribute significantly to mortality among cirrhotic patients. The most common bacterial infections in that patient population are spontaneous bacterial peritonitis, pneumonia, urinary tract infection, and skin and soft tissue infections. This article describes the key underlying pathophysiologic mechanisms predisposing cirrhotic patients to bacterial infections. Etiology of bacterial complications is presented. Specific inflammatory and immune responses in liver cirrhosis as well as clinical and laboratory signs of bacterial infections in cirrhotic patients are considered. Empiric antibacterial treatment regimens and principles of antimicrobial prophylaxis in patients with spontaneous bacterial peritonitis are also provided.

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