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dc.creatorMartínez, Javieres
dc.creatorHernández-Gea, Virginiaes
dc.creatorRodríguez de Santiago, Enriquees
dc.creatorTéllez, Luises
dc.creatorProcopet, Bogdanes
dc.creatorGiráldez, Álvaroes
dc.creatorRomero Gómez, Manueles
dc.creatorAlbillos, Agustínes
dc.date.accessioned2023-01-12T15:15:19Z
dc.date.available2023-01-12T15:15:19Z
dc.date.issued2021-08
dc.identifier.citationMartínez, J., Hernández-Gea, V., Rodríguez de Santiago, E., Téllez, L., Procopet, B., Giráldez, Á.,...,Albillos, A. (2021). Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis. Journal of Hepatology, 75 (2), 342-350. https://doi.org/10.1016/j.jhep.2021.03.026.
dc.identifier.issn0168-8278;1600-0641es
dc.identifier.urihttps://hdl.handle.net/11441/141249
dc.description.abstractBackground & Aims Antibiotic prophylaxis reduces the risk of infection and mortality in patients with cirrhosis and acute variceal bleeding (AVB). This study examines the incidence of, and risk factors for, bacterial infections during hospitalization in patients with AVB on antibiotic prophylaxis. Methods A post hoc analysis was performed using the database of an international, multicenter, observational study designed to examine the role of pre-emptive transjugular intrahepatic portosystemic shunts in patients with cirrhosis and AVB. Data were collected on patients with cirrhosis hospitalized for AVB (n = 2,138) from a prospective cohort (October 2013-May 2015) at 34 referral centers, and a retrospective cohort (October 2011-September 2013) at 19 of these centers. The primary outcome was incidence of bacterial infection during hospitalization. Results A total of 1,656 patients out of 1,770 (93.6%) received antibiotic prophylaxis; third-generation cephalosporins (76.2%) and quinolones (19.0%) were used most frequently. Of the patients on antibiotic prophylaxis, 320 patients developed bacterial infection during hospitalization. Respiratory infection accounted for 43.6% of infections and for 49.7% of infected patients, and occurred early after admission (median 3 days, IQR 1-6). On multivariate analysis, respiratory infection was independently associated with Child-Pugh C (odds ratio [OR] 3.1; 95% CI 1.4-6.7), grade III-IV encephalopathy (OR 2.8; 95% CI 1.8-4.4), orotracheal intubation for endoscopy (OR 2.6; 95% CI 1.8-3.8), nasogastric tube placement (OR 1.7; 95% CI 1.2-2.4) or esophageal balloon tamponade (OR 2.4; 95% CI 1.2-4.9). Conclusion Bacterial infections develop in almost one-fifth of patients with AVB despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade. Lay summary Bacterial infections develop during hospitalization in close to 20% of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory bacterial infections are the most frequent and occur early after admission. Respiratory infection is associated with advanced liver disease, severe hepatic encephalopathy and a need for a nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.es
dc.formatapplication/pdfes
dc.format.extent10 p.es
dc.language.isoenges
dc.publisherElsevier Sciencees
dc.relation.ispartofJournal of Hepatology, 75 (2), 342-350.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectCirrhosises
dc.subjectAcute variceal bleedinges
dc.subjectAntibiotic prophylaxises
dc.subjectBacterial infectiones
dc.subjectRespiratory infectiones
dc.titleBacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxises
dc.typeinfo:eu-repo/semantics/articlees
dcterms.identifierhttps://ror.org/03yxnpp24
dc.type.versioninfo:eu-repo/semantics/publishedVersiones
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Medicinaes
dc.relation.projectIDSAF-2016-75767-Res
dc.relation.projectIDSAF 2017-86343-Res
dc.relation.projectIDPIE 15/00027es
dc.relation.projectIDAGAUR SGR 2017es
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0168827821002300?via%3Dihubes
dc.identifier.doi10.1016/j.jhep.2021.03.026es
dc.journaltitleJournal of Hepatologyes
dc.publication.volumen75es
dc.publication.issue2es
dc.publication.initialPage342es
dc.publication.endPage350es
dc.contributor.funderMinisterio de Ciencia e Innovación SAF-2016-75767-R, SAF 2017-86343-Res
dc.contributor.funderInstituto de Salud Carlos III PIE 15/00027es
dc.contributor.funderGeneralitat de Catalunya AGAUR SGR 2017es

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