Bacterial infections in Indian cirrhotic patients: a prospective study

Authors

  • Deepak C. Gopinath Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India
  • Bhat Rashmi Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India
  • Sivichan Sonia Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India
  • Sharon Mary Stanly Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India
  • Shalumol Jose Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India
  • Ranjan Amit Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India
  • Nicole R. Pereira Department of Pharmacology, Fr Muller Medical College, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20212076

Keywords:

Bacterial infection, Child pugh score, Liver cirrhosis, Spontaneous bacterial peritonitis

Abstract

Background: Bacterial infections (BI) are more prevalent in liver cirrhosis (LC), high among hospitalized patients. The aim of this study was to explore the epidemiological pattern of BI in hospitalized patients with LC, and identification the causative agents. Objective of the study was evaluation of therapeutic/empirical approaches for these infections.

Methods: Inputs from the body fluid analysis and culture reports were recorded. The Child Pugh score (CPS) was used to assess the severity of liver disease. Antibiotic treatment strategy was analysed, prescribed antibiotics were checked for contraindications using Lexicomp software.

Results: Of 60 enrolled patients, four had mixed infection and 55% were culture positive. There was a male preponderance (83.3%). BI was more frequent in those aged 51-60 years (38.3%) and >60 years (35%). Higher proportion of patients (60%) belonged to class C of CPS followed by class B (31.7%). The most common causative organisms identified were E. coli (28.5%), K. pneumonia (14.2%), Enterococcus spp (11.4 %) and less common were K. oxytoca, Coagulase-negative staphylococci, Staphylococcus aureus, gram-positive cocci, gram-negative cocci, P. aeruginosa, S. hemolyticus, ß-hemolytic streptococcus spp. Majority of the subjects had spontaneous bacterial peritonitis (36.7%) followed by urinary tract infection (21%), lower respiratory tract infection (18.3%), sepsis (13.3%), cellulitis (3.3%) and acute gastroenteritis (1.7%). Cephalosporin (61.7%), rifaximin (51.7%), penicillin and β lactamase inhibitors (36.7%) were the common prescribed antimicrobials.

Conclusions: There is a positive association between the risk of BI and severity of liver damage.

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Author Biographies

Deepak C. Gopinath, Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India

Dept of Pharmacy Practice,

Karavali College of Pharmacy, Mangalore, India

Bhat Rashmi, Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India

Dept of Pharmacy Practice,

Karavali College of Pharmacy, Mangalore, India

Sivichan Sonia, Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India

Dept of Pharmacy Practice,

Karavali College of Pharmacy, Mangalore, India

Sharon Mary Stanly, Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India

Dept of Pharmacy Practice,

Karavali College of Pharmacy, Mangalore, India

Shalumol Jose, Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India

Dept of Pharmacy Practice,

Karavali College of Pharmacy, Mangalore, India

Ranjan Amit, Department of Pharmacy Practice, Karavali College of Pharmacy, Mangalore, Karnataka, India

Dept of Pharmacy Practice,

Karavali College of Pharmacy, Mangalore, India

Nicole R. Pereira, Department of Pharmacology, Fr Muller Medical College, Mangalore, Karnataka, India

Associate Professor

Dept of Pharmacology

 

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Published

2021-05-25

How to Cite

Gopinath, D. C., Rashmi, B., Sonia, S., Stanly, S. M., Jose, S., Amit, R., & Pereira, N. R. (2021). Bacterial infections in Indian cirrhotic patients: a prospective study. International Journal of Basic & Clinical Pharmacology, 10(6), 668–674. https://doi.org/10.18203/2319-2003.ijbcp20212076

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Original Research Articles