01 Set Bloodstream infection in cirrhotic patients: a prospective multicenter study (bichrome)
Several aspects of bloodstream infections (BSI) in patients with liver cirrhosis (LC) need to be clarified. In this prospective, multicentre, observational study, conducted form Sep-2014 to Dec-2015 in 16 teaching-hospitals among 5 different countries we enrolled all adult patients with LC developing BSI. The aims of the study were to: (1) clarify the epidemiology and outcome of BSI in LC and (2) to identify risk factors for multidrug-resistant pathogens. Data were collected in an electronic case report form at the study web site and patients were followed-up for 30 days after BSI diagnosis. Overall, a total of 312 patients with a BSI episode were included for a total of 337 isolates identified. Gram-negative bacteria (GNB) accounted for 164/312 BSIs (53%), whereas gram-positive bacteria were found in 146/312 (47%) of episodes. A significant variability of etiology was found among different countries and among patients with different cause of LC. CLIF-SOFA showed the best performance in the identification of patients at risk of 30-day mortality (AUROC 0.733; R2 0.93). Risk factors for multidrug resistant pathogens isolation were previous (<30 days) antibiotic exposure [HR 3.73 (95% CI 2.09-6.66), p<0.001] and previous gastrointestinal bleeding (<30 days) [HR 4.25 (95% CI 1.84-9.84), p=0.001].