Rossitto Giacomo, Piano Salvatore, Rosi Silvia, Simioni Paolo, Angeli Paolo
Departments of aMedicine (DIMED) bCardiologic Thoracic and Vascular Sciences cUnit of Hepatic Emergencies and Liver Transplantation, University of Padova, Padova, Italy.
Eur J Gastroenterol Hepatol. 2014 Jun;26(6):681-4. doi: 10.1097/MEG.0000000000000087.
Bacterial infections because of multidrug-resistant (MDR) bacteria are spreading worldwide. In patients with advanced liver cirrhosis, healthcare-acquired and hospital-acquired infections are common and are frequently sustained by MDR bacteria. In these settings, tigecycline, a new antibiotic, has been shown to be useful in the treatment of MDR bacteria, and it has been proposed for the treatment of hospital-acquired infections in patients with cirrhosis. Nevertheless, poor data exist on the safety profile of tigecycline in patients with cirrhosis. Here, an experience is reported in a female patient with advanced liver cirrhosis, who developed sepsis by an MDR Stenotrophomonas maltophilia and was treated with tigecycline. She experienced life-threatening side effects consisting of severe coagulopathy with hypofibrinogenaemia and subsequent gastrointestinal haemorrhage. The side effect disappeared after the withdrawal of tigecycline. Therefore, a strict monitoring of coagulation parameters in patients with cirrhosis treated with tigecycline is recommended.
多重耐药（MDR）细菌引起的细菌感染正在全球范围内蔓延。在晚期肝硬化患者中，医疗保健相关感染和医院获得性感染很常见，且常常由MDR细菌引起。在这些情况下，新型抗生素替加环素已被证明可有效治疗MDR细菌，并且已被提议用于治疗肝硬化患者的医院获得性感染。然而，关于替加环素在肝硬化患者中的安全性资料较少。在此，报告了一名晚期肝硬化女性患者的经历，该患者因MDR嗜麦芽窄食单胞菌发生败血症，并接受了替加环素治疗。她出现了危及生命的副作用，包括严重凝血病伴纤维蛋白原血症降低以及随后的胃肠道出血。停用替加环素后副作用消失。因此，建议对接受替加环素治疗的肝硬化患者严格监测凝血参数。
