ArticleJHEP reports : innovation in hepatology2023
Burden, risk factors, and outcomes of multidrug-resistant bacterial colonisation at multiple sites in patients with cirrhosis.
Article in JHEP reports : innovation in hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 19 citations in OpenAlex.
- Critical care hepatology: A narrative review of current concepts and management.World journal of critical care medicine · 2026Review
- [Advances in the diagnosis and treatment of patients with multidrug-resistant bacterial infections combined with severe liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Gut colonization with multidrug-resistant organisms in hospitalized patients with gastrointestinal illness: A single-centre, cross-sectional study.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- Article
- Multidrug-resistant colonization in decompensated cirrhosis outside the ICU predicts infection and poor outcomes.JHEP reports : innovation in hepatology · 2026Article
- Multidrug-resistant organism colonization in critically ill cirrhotic patients: Marker or mediator of mortality?World journal of hepatology · 2026Article
- Drug-resistant bacterial infections in end-stage liver disease: immune imbalance and intervention advances.Frontiers in immunology · 2026Review
- Clinical impact of multidrug-resistant organisms in liver cirrhosis: A retrospective cohort study in the intensive care setting.World journal of gastroenterology · 2025Article
- Cost-benefit analysis of pharmacist early active consultation in patients with multidrug-resistant bacteria in China.International journal of clinical pharmacy · 2025Article
- Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features.Gut pathogens · 2025Article
- Bacterial resistance profile and its association with poor outcome among cirrhosis patients attending a tertiary care referral center in northern India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Observational
- Towards unraveling antimicrobial resistance dynamics: a longitudinal exploration of rectal swab metagenomes.BMC microbiology · 2025Article
- Genomic analysis of non-carbapenem drug-resistant Gram-negative bacteria from advanced chronic liver disease (ACLD) patients suggests no evidence for in-house transmissions.Frontiers in microbiology · 2025Article
- The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden.Antibiotics (Basel, Switzerland) · 2024Review
- Predictors and Outcomes of Infections in ICU Patients With Cirrhosis: A Single-Center Observational Study.Cureus · 2023Article
- Silent Carriers, Severe Consequences: The Hidden Threat of Carbapenem-Resistant Enterobacteriaceae Colonization in Liver Transplantation.Journal of clinical and experimental hepatologyArticle
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Authors and funding
15 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: The reported burden of multidrug-resistant organism (MDRO) infections is highest in patients with cirrhosis from India. We evaluated whether colonisation at multiple barriers predisposes to such infections and poor outcomes in patients with cirrhosis. Methods: We prospectively performed swab cultures, antimicrobial susceptibility testing (AST), and genotype testing for MDROs from various sites (rectum, nose, composite-skin, and central-line) in patients with cirrhosis (2020-2021) on admission and follow-up at a tertiary institute. We analysed clinical data, risk factors for MDROs, and patient outcomes. Results: Of 125 patients aged 49 years, 85.6% males, 60.8% with acute-on-chronic liver failure, 99 (79.2%) were identified as 'colonisers'. MDRO-colonisation at rectum, nose, skin, or central line was observed in 72.7% (88/121), 30.0% (36/120), 14.9% (18/121), and 3.3% (4/121) patients, respectively. Patients were colonised with the following types of bacteria: extended-spectrum beta-lactamase (71/125), carbapenem-resistant Enterobacterales (67/125), MDR- Conclusions: A strikingly high burden of MDRO colonisation among patients with cirrhosis in India necessitates urgent control measures. Multiple-site colonisation increases the risk of MDR-infections, multi-organ failure, and mortality in patients with cirrhosis. Impact and Implications: Infections by bacteria resistant to multiple antibiotics are an emerging cause of death in cirrhosis. We showed that ∼70-80% of critically ill hospitalised patients with cirrhosis carry such bacteria with the highest rate in the rectum, nose, skin, and central line port. Carbapenem-resistant and vancomycin-resistant bacteria were amongst the most common colonising bacteria. The presence of these bacteria at multiple sites increased the risk of multidrug-resistant infections, multiple organ failures, and death in patients with cirrhosis.
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