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World J Gastroenterol. Jun 21, 2014; 20(23): 7252-7259
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7252
New determinants of prognosis in bacterial infections in cirrhosis
Juan Acevedo, Javier Fernández
Juan Acevedo, Department of Gastroenterology and Hepatology, Hospital of Calella, 08370 Barcelona, Catalunya, Spain
Javier Fernández, Liver Unit, Hospital Clínic, University of Barcelona, 08150 Barcelona, Catalunya, Spain
Javier Fernández, Institut d’Investigacions Biomèdiques August-Pi-Sunyer (IDIBAPS), 08036 Barcelona, Spain
Javier Fernández, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHED), 08150 Barcelona, Spain
Author contributions: Acevedo J designed and wrote the review; and Fernández J revised critically the manuscript.
Correspondence to: Juan Acevedo, MD, PhD, Department of Gastroenterology and Hepatology, Hospital of Calella, Carrer de Sant Jaume 209-217, 08370 Barcelona, Catalunya, Spain. jacevedoharo@salutms.cat
Telephone: +34-937-667400 Fax: +34-937-695466
Received: November 15, 2013
Revised: February 9, 2014
Accepted: May 12, 2014
Published online: June 21, 2014
Processing time: 218 Days and 8.4 Hours
Core Tip

Core tip: Despite major advances in the management of cirrhosis, it still carries high morbidity and mortality. Bacterial infection is one of the major causes of decompensation. This review deals with the new determinants of prognosis in patients with cirrhosis and bacterial infection reported recently. It summarizes the existing evidence for emergence of multiresistant bacteria, endothelial dysfunction, and relative adrenal insufficiency; and resultant changes in medical practice are given.