关键词: 肝硬化, 失代偿期, 医院内感染, 病原菌, 耐药

Abstract: Objective The paper aimed to investigate the prevalence of nosocomial infection and resistance of pathogens in patients with decompensated liver cirrhosis (LC). Methods A total of 67 patients with decompensated liver cirrhosis were enrolled in the Department of Infectious Diseases in our hospital between January 2018 and January 2020, and the prevalence of nosocomial infections were retrieved. The pathogens in patients with nosocomial infection was identified by VITEK-2 Compact full-automatic microbial analysis system. The drug sensitivity tests of pathogens were conducted by KB paper agar diffusion method. Results Of the 67 patients with decompensated cirrhosis, 24 cases (35.8%) were identified as with nosocomial infection, and out of which, the main infection sites were abdominal (45.8%), lung (33.3%) and urinary infection (20.8%); the percentages of younger than 60 years old, with gastrointestinal bleeding, long hospitalization and Child class C in infected patients were significantly higher than in those without infection (P<0.05), while serum albumin level and percentage of preventive administration of antibiotics in infected group were significantly lower than those in non-infected group (P<0.05); it was found by Logistic regression analysis that the age (OR=1.16, 95%CI:1.09-1.24), hospitalization time (OR=1.13, 95%CI: 1.05-1.93), gastrointestinal bleeding (OR=1.50, 95%CI: 1.09-2.09), serum albumin (OR=1.11, 95%CI: 1.02-1.20) and preventive antibiotics (OR=1.48, 95%CI: 1.21-1.81) were the impacting factors of nosocomial infection in patients with decompensated cirrhosis (P<0.05); out of the 24 patients with nosocomial infections, there were 37 strains of pathogens, including 21 strains of Gram-negative bacteria (56.8%), 11 strains of Gram-positive bacteria (29.7%) and 5 strains of fungi (13.5%) separated; the resistance rate of Escherichia Coli was high to ampicillin and piperacillin, the resistance rate of Klebsiella Pneumoniae to antimicrobial agents was lower than 16.7%, and that of Staphylococcus Aureus to gentamicin was higher than 60.0%. Conclusion The risk of nosocomial infection is high in patients with hospitalized decompensated liver cirrhosis, and its influencing factors are many and complex. The common pathogens are mainly Gram-negative bacteria, but the drug resistance of pathogens is also common. In clinical practice, it is necessary to pay more attention to high-risk infection population. When necessary, the preventive administration of sensitive antibacterial agents is of particularly importance to reduce the occurrence of secondary nosocomial infection in patients with decompensated cirrhosis.

Key words: Liver cirrhosis, Nosocomial infection, Pathogens, Drug resistance