Background and aim: Infection in patients with decompensated liver cirrhosis is a leading cause of mortality in developing countries such as Egypt; this has paralleled the increase in antibiotics resistance. Knowledge of local antimicrobial susceptibility patterns is critical to decreasing morbidity, hospitalization cost and mortality associated with these infections. Our aim was to evaluate the bacterial resistance profile in ICU admitted patients with decompensated liver cirrhosis.
Methods: This study included 1339 samples from patients with decompensated liver cirrhosis and suspected infection admitted to the intensive care unit - department of Tropical medicine, Zagazig University hospitals, Egypt, between August 2018 and August 2019. Demographical, clinical, microbiological and antimicrobial susceptibility were evaluated.
Results: Out of 1339 total samples collected, 237 positive cultures were obtained; the majority (60.4%) had urinary tract infection, 18.1% had sepsis, 9.3% had chest infection, 8.4% had spontaneous bacterial peritonitis (SBP), 3.8% had other infections. One hundred and ninety-nine (199) of the 237 isolates were multi drug resistant (MDR). Among them 72.4% were gram negative organisms (GNO); Extended Spectrum Beta Lactamase (ESBL) Ecoli and Klebsiella Sp. were 32.2%, and 83.3% of acinetobacter were MDR. GNO represent 70.9% and Gram positive organisms (GPO) 29.1% of isolated bacteria, GPO were 27.6% of total MDR organisms, mostly Staphlycoccus haemolyticus followed by enterococcus fecalis and fecium. All isolated staphylococcus aureus are methicillin resistant and 25% of them are MDR.
Conclusion: In patients with decompensated liver cirrhosis and suspected infection, high frequency of multidrug resistance was recorded. Gram negative bacteria showed high resistance to 3rd generation cephalosporins and quinolones.