Bowel Colonization With Carbapenem‐Resistant Bacteria Is Associated With Short‐Term Outcomes in Patients With Acute‐On‐Chronic Liver Failure
Satender Pal Singh, Vikram Bhatia, Pratibha Kale, Guresh Kumar, Vikas Khillan, Rajan VijayaraghavanABSTRACT
Background
Bowel colonization with antimicrobial‐resistant bacteria has been associated with worse clinical outcomes in patients with cirrhosis; however, it has not been studied in patients with acute‐on‐chronic liver failure (ACLF). We evaluated whether fecal isolation of carbapenem‐resistant gram‐negative bacteria (CR‐GNB) among patients with ACLF affects short‐term outcomes.
Methods
Patients of APASL‐ACLF (n = 339) were screened between June 2020 and December 2021, and 150 were included. Stool cultures were carried out at baseline and every 5 days thereafter until discharge or death. All surviving patients were followed until 60 days after discharge.
Results
Mean age was 44.8 (8.8) years, with 86% males and alcohol as etiology in 66%. CR‐GNB organisms were isolated from stool in 42% of hospitalized ACLF patients, with
Conclusions
Hospitalized ACLF patients with CR‐GNB in the stool have a significantly higher risk of extraintestinal infections, in‐hospital mortality, and short‐term mortality up to 60 days.
Trial Number
[NCT04383106].