Sepsis in liver failure patients: Diagnostic challenges and recent advancements

Table 1 Prevalence of bacterial infections amongacute liver failure or acute-on-chronic liver failure patients in different countries

Ref.	Country	Patients	n	Overall infection	Remarks
Cai et al[32], 2017	China	ACLF	389	81.2%	Pneumonia 49.4%, SBP 37.3%, UTI 13.3%. Gram positive sepsis 59.8%, Gram negative 55.3%
Fernández et al[18], 2018	Europe	ACLF	407	66.1%	BI at diagnosis 37%, BI during follow-up 46%. BI was associated with higher inflammation and worse outcomes
Karvellas et al[30], 2009	Canada	ALF	206	35%	Gram positive organisms in 44% of isolates, gram negatives in 52%, and 4% was fungal
Kaur et al[8], 2024	India	ALF	143	64%	Overall infection was 77% including fungal infection in 17.3%, MDR 70%
Liu et al[33], 2021	China	ACLF	140	69.2%	SBP 36.1%, pneumonia 23.7%, and multi-site infection 22.7%. Gram-negative bacteria 68.4%, and Gram-positive 31.6%
Moreau et al[35], 2013	Europe	ACLF	303	32.6%	SBP 10.6%, Pneumonia 61%, UTI 6.1%
Mücke et al[19], 2018	Europe	ACLF	173	41%	SBP 32.4%, pneumonia 25.4%
Rolando et al[29], 1990	England	ALF	50	80%	Respiratory tract infection 47%,and gram-positive bacteria 69.8%
Shalimar et al[31], 2017	India	ALF	540	49%	BI at diagnosis 22.2%, BI during follow-up 34%
Shalimar et al[34], 2018	India	ACLF	572	66.7%	Gram negative sepsis 91.6%. Pneumonia 45%, SBP 21.1%, UTI (15.2%)
Zhai et al[43], 2020	China	ACLF	289	64%	Gram negative sepsis 58.3%, Pneumonia 55.7%, SBP 47.6%
Zhang et al[37], 2022	China	ACLF	539	58.8%	SBP 31.54%, UTI 26.53%, Pneumonia 12.9%. Gram-positive sepsis 23.76%, Gram-negative sepsis 62.87%
Zider et al[28], 2016	United States	ALF	150	41%	One site infection 60%, multi-site infection 40%. Pneumonia 64% and UTI 55%

ALF: Acute liver failure; ACLF: Acute-on-chronic liver failure; BI: Bacterial infection; MDR: Multi-drug resistance; SBP: Spontaneous bacterial peritonitis; UTI: Urinary tract infection.