Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2020; 8(6): 1042-1055
Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1042
Clinical characteristics and 28-d outcomes of bacterial infections in patients with hepatitis B virus-related acute-on-chronic liver failure
Chen Li, Hai-Bin Su, Xiao-Yan Liu, Jin-Hua Hu
Chen Li, Hai-Bin Su, Xiao-Yan Liu, Jin-Hua Hu, Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Author contributions: All authors helped to perform the research; Li C, Su HB, and Hu JH designed the study; Li C, Su HB, and Liu XY collected and analyzed the data; Li C wrote the first draft with assistance from Su HB, Hu JH, and Liu XY; Su HB and Hu JH edited the final draft; all authors have read and approved the final manuscript.
Supported by Innovation Projects of The Fifth Medical Center of Chinese PLA General Hospital, No. YNKT2014007.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Fifth Medical Center of Chinese PLA General Hospital.
Informed consent statement: Due to the retrospective nature of the study and the anonymous data used, written informed consent could not be obtained from all patients.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
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 NonCommercial (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/
Corresponding author: Hai-Bin Su, MD, MPhil, Doctor, Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, No. 100, West Fourth Ring Road, Beijing 100039, China. suhaibin302@163.com
Received: December 10, 2019
Peer-review started: December 10, 2019
First decision: December 30, 2019
Revised: January 7, 2020
Accepted: March 5, 2020
Article in press: March 5, 2020
Published online: March 26, 2020
Core Tip

Core tip: Bacterial infections (BIs) play pivotal roles in the deterioration of clinical course in patients with acute-on-chronic liver failure (ACLF). This study aimed to investigate the clinical characteristics of first BIs in patients with hepatitis B virus-ACLF, as defined by the Chinese Group on the Study of Severe Hepatitis B. Healthcare-associated and nosocomial BIs were the most common types. Pneumonia was the most common form of BI. Gram-negative bacteria accounted for 83.6%, and multidrug-resistant organisms accounted for 29.5% of bacteria detected. The 28-d transplant-free survival rates of the patients were very low. Chinese Group on the Study of Severe Hepatitis B-ACLF score, acute kidney injury, bloodstream infection, prothrombin activity, and invasive catheterization were the independent predictors of 28-d outcomes.