Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013.

Jalan, Rajiv; Fernandez, Javier; Wiest, Reiner; Schnabl, Bernd; Moreau, Richard; Angeli, Paolo; Stadlbauer, Vanessa; Gustot, Thierry; Bernardi, Mauro; Canton, Rafael; Albillos, Agustin; Lammert, Frank; Wilmer, Alexander; Mookerjee, Rajeshwar; Vila, Jordi; Garcia-Martinez, Rita; Wendon, Julia; Such, José; Cordoba, Juan; Sanyal, Arun; ... (2014). Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013. Journal of hepatology, 60(6), pp. 1310-1324. Elsevier 10.1016/j.jhep.2014.01.024

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Bacterial infections are very common and represent one of the most important reasons of progression of liver failure, development of liver-related complications, and mortality in patients with cirrhosis. In fact, bacterial infections may be a triggering factor for the occurrence of gastrointestinal bleeding, hypervolemic hyponatremia, hepatic encephalopathy, kidney failure, and development of acute-on-chronic liver failure. Moreover, infections are a very common cause of repeated hospitalizations, impaired health-related quality of life, and increased healthcare costs in cirrhosis. Bacterial infections develop as a consequence of immune dysfunction that occurs progressively during the course of cirrhosis. In a significant proportion of patients, infections are caused by gram-negative bacteria from intestinal origin, yet gram-positive bacteria are a frequent cause of infection, particularly in hospitalized patients. In recent years, infections caused by multidrug-resistant bacteria are becoming an important clinical problem in many countries. The reduction of the negative clinical impact of infections in patients with cirrhosis may be achieved by a combination of prophylactic measures, such as administration of antibiotics, to reduce the occurrence of infections in high-risk groups together with early identification and management of infection once it has developed. Investigation on the mechanisms of altered gut microflora, translocation of bacteria, and immune dysfunction may help develop more effective and safe methods of prevention compared to those that are currently available. Moreover, research on biomarkers of early infection may be useful in early diagnosis and treatment of infections. The current manuscript reports an in-depth review and a position statement on bacterial infections in cirrhosis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Wiest, Reiner

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0168-8278

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

20 Apr 2015 14:55

Last Modified:

06 Nov 2015 09:42

Publisher DOI:

10.1016/j.jhep.2014.01.024

PubMed ID:

24530646

Uncontrolled Keywords:

Bacterial infection; Cirrhosis; Diagnosis; Multiresistant bacteria

BORIS DOI:

10.7892/boris.67068

URI:

https://boris.unibe.ch/id/eprint/67068

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