Multidrug-resistant colonization in decompensated cirrhosis outside the ICU predicts infection and poor outcomes - PubMed
6 hours ago
- #decompensated cirrhosis
- #infection prediction
- #MDRO colonization
- Multidrug-resistant (MDRO) and extensively drug-resistant (XDRO) organism colonization is common in decompensated cirrhosis patients outside the ICU.
- Baseline rectal MDRO colonization rates were 23% in ward patients and 17% in ICU patients, increasing to 39% and 43% respectively at 1 year.
- Colonization in ward patients was associated with higher MDRO infection rates (52% vs. 19%) and increased mortality (60% vs. 22%).
- Baseline and follow-up colonization independently predicted infection (HR 9.6 and 4.4) and mortality (HR 2.07).
- Recent acute-on-chronic liver failure predicted both colonization (HR 2.5) and infection (HR 2.8).
- The study suggests extending targeted surveillance and antibiotic stewardship beyond ICU to reduce infection-related morbidity and mortality.