Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy.
Clin Mol Hepatol. 2021 Jul;27(3):437-445. doi: 10.3350/cmh.2020.0329. Epub 2021 Jan 28.
Patients with cirrhosis are susceptible to develop infections because of immune dysfunction, changes in microbiome and increase in bacterial translocation from the gut to systemic circulation. Bacterial infections can worse the clinical course of the disease, triggering the development of complications such as acute kidney injury, hepatic encephalopathy, organ failures and acute on chronic liver failure. In recent years, the spread of multi drug resistant bacteria made more challenging the management of infections in patients with cirrhosis. Hence, the mortality rate associated to sepsis is increasing in these patients. Therefore, the optimization of the management of infections has a high priority in cirrhosis. Herein we reviewed the recent changes in the epidemiology and the management of bacterial infections in patients with liver cirrhosis.
肝硬化患者由于免疫功能障碍、微生物组变化以及肠道细菌易位增加到全身循环而容易发生感染。细菌感染会使疾病的临床过程恶化，引发急性肾损伤、肝性脑病、器官衰竭和慢加急性肝衰竭等并发症。近年来，多药耐药菌的传播使得肝硬化患者的感染管理更加具有挑战性。因此，这些患者的脓毒症相关死亡率正在增加。因此，优化肝硬化患者感染的管理具有很高的优先级。在此，我们综述了肝硬化患者细菌感染的流行病学和管理方面的最新变化。
