Schneitler S, Schneider C, Casper M, Lammert F, Krawczyk M, Becker SL, Reichert MC. Retrospective study of the incidence, risk factors, treatment outcomes of bacterial infections at uncommon sites in cirrhotic patients. World J Hepatol 2024; 16(3): 418-427 [PMID: 38577541 DOI: 10.4254/wjh.v16.i3.418]
Corresponding Author of This Article
Sophie Schneitler, MD, Consultant Physician-Scientist, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße 100, Homburg 66421, Germany. sophie.schneitler@uks.eu
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Mar 27, 2024; 16(3): 418-427 Published online Mar 27, 2024. doi: 10.4254/wjh.v16.i3.418
Retrospective study of the incidence, risk factors, treatment outcomes of bacterial infections at uncommon sites in cirrhotic patients
Sophie Schneitler, Christina Schneider, Markus Casper, Frank Lammert, Marcin Krawczyk, Sören L Becker, Matthias Christian Reichert
Sophie Schneitler, Sören L Becker, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg 66421, Germany
Christina Schneider, Markus Casper, Frank Lammert, Marcin Krawczyk, Matthias Christian Reichert, Department of Medicine II, Saarland University Medical Center, Homburg 66421, Germany
Frank Lammert, Health Sciences, Hannover Medical School, Hannover 30625, Germany
Marcin Krawczyk, Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Centre for Preclinical Research, Medical University of Warsaw, Warsaw 02-097, Poland
Author contributions: Reichert MC, Schneitler S, Lammert F, and Becker SL designed the study; Reichert MC, Casper M, Schneider C, and Schneitler S participated in the acquisition of clinical data, drafted the manuscript, and together with Krawczyk M and Becker SL, analyzed the data and finalized the manuscript, which was then revised by all authors; the final draft of the manuscript was approved by all authors.
Institutional review board statement: The study was conducted according to the Declaration of Helsinki and Good Clinical Practice (European guidelines). Institutional review board approval was obtained by the Ethikkommission der Ärztekammer des Saarlandes (approval 71/11).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All authors declare that they do not have anything to disclose regarding conflicts of interest with respect to this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sophie Schneitler, MD, Consultant Physician-Scientist, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße 100, Homburg 66421, Germany. sophie.schneitler@uks.eu
Received: December 6, 2023 Peer-review started: December 6, 2023 First decision: December 19, 2023 Revised: January 2, 2024 Accepted: February 8, 2024 Article in press: February 8, 2024 Published online: March 27, 2024 Processing time: 107 Days and 13.9 Hours
ARTICLE HIGHLIGHTS
Research background
Typical infections in patients with liver cirrhosis have standardized diagnostic algorithms and are therefore recognized and treated quickly. Clinically, however, unusual infections are also more frequent in patients with cirrhosis. These are not included in guidelines and are therefore often not adequately addressed in diagnostic and therapeutic algorithms.
Research motivation
The study aimed to analyze a cirrhosis cohort for typical and atypical infections. The aim is to derive improved diagnostic and therapeutic algorithms from these analyses in the future.
Research objectives
The main aim is to identify the most common pathogens for atypical infections and their resistance patterns in relation to the stage of liver cirrhosis. Algorithms for the improved detection of infections, including atypical situations, can then be developed.
Research methods
For the analysis, data were analyzed in relation to the research question in a cirrhosis cohort.
Research results
The cohort showed that atypical infections are not so rare overall and should be clinically investigated more frequently in order to initiate the correct diagnosis and treatment. It was also shown that the pathogen spectrum recorded did not always correspond correctly with the empirical therapy, and that microbiological diagnostics are therefore particularly relevant in this patient population.
Research conclusions
We were able to show that the stage of cirrhosis is associated with a change in infections and that this needs to be taken into account. The relevance of these findings must be considered in the light of the increasing role of liver disease and its sequelae in the global burden of disease.
Research perspectives
Confirmation of these results in larger multicenter studies and development of corresponding algorithms.
