OBJECTIVETo study clinic character of liver failure complicated with bacterium and fungous infection.

METHODSThe patients with liver failure complicated with bacterial and fungous infection who were treated in our hospital from January 1986 to June 2006 were studied. All patients had clinical manifestation and positive of bacterium. The data were statistical analysis.

RESULTS507 patients diagnosed with fungous infection were found from January 1986 to June 2006 in which 132 patients were diagnosed with bacterial and fungous infection. There were 85 patients (64.39%) with chronic severe hepatitis and 40 patients (30.3%) with decompensation cirrhosis. Bacterial infection happened in 153 cases in which the rate of nosocomial infections was 54.90%. 204 bacterial strains were separated in which 143 strains (70.10%) were gram-negative bacterium and 61 (29.90%) strains were gram-positive bacterium. The main sites of bacterial infection were abdominal cavity (122 cases) and lung (30 cases). Fungous infection happened in 143 cases in which the rate of nosocomial infections was 86.71%. 155 fungous strains were separated in which 90 strains (58.06%) were Candida albicans, 17 strains (10.97%) were Aspergillus fumigatus and 25 (16.13%) strains were non-Candida albicans. The main sites of fouguns infection were lung (94 cases) and mouth (53 cases). 84 patients (63.64%) were ineffective and died after treatment.

CONCLUSIONThe patients with decompensation cirrhosis and chronic severe liver hepatitis were easy to be infected by bacterial and fungous. the rate of fungous nosocomial infections is higher than that of bacterium. The prognosis is bad in patients who had secondary fungous infection.

Adolescent ; Adult ; Aged ; Bacteria ; isolation & purification ; Bacterial Infections ; complications ; microbiology ; Cross Infection ; microbiology ; Female ; Fungi ; isolation & purification ; Humans ; Liver Failure ; complications ; pathology ; Male ; Middle Aged ; Mycoses ; complications ; microbiology ; Retrospective Studies ; Young Adult

Spontaneous bacterial peritonitis (SBP) is an ascitic fluid infection as a complication of end stage liver disease. The outcome is related to the severity of hepatorenal function, gastrointestinal bleeding, and many others; however it is not well known whether the infection acquisition sites have an effect on the prognosis of SBP. In order to identify the prognostic significance of the acquisition sites, we studied 106 patients who were diagnosed as culture positive SBP between October 1998 and August 2003. Thirty-two episodes were nosocomial and 74 were community acquired. Gramnegative bacilli such as Escherichia coli were dominant in both of the nosocomial and community-acquired SBPs. Despite significantly higher resistance to cefotaxime in nosocomial isolates compared to community-acquired isolates (77.8% vs. 13.6%, p=0.001), no difference was found regarding short or long term prognosis. Infection acquisition sites were not related to short or long term prognosis either. Shock, gastrointestinal bleeding and renal dysfunction were related to short term prognosis. Only Child-Pugh class C was identified as an independent prognostic factor of long-term survival.
Time Factors ; Survival Rate ; Shock/etiology/mortality ; Prognosis ; Peritonitis/complications/microbiology/*pathology ; Multivariate Analysis ; Middle Aged ; Male ; Klebsiella pneumoniae/drug effects/growth & development ; Kidney Diseases/etiology/mortality ; Humans ; Gastrointestinal Hemorrhage/etiology/mortality ; Female ; Escherichia coli/drug effects/growth & development ; Drug Resistance, Bacterial ; Cross Infection/complications/microbiology/pathology ; Community-Acquired Infections/complications/microbiology/pathology ; Ciprofloxacin/pharmacology ; Cefotaxime/pharmacology ; Bacterial Infections/complications/microbiology/*pathology ; Anti-Bacterial Agents/pharmacology ; Aged

Adult ; Aged ; Antifungal Agents ; administration & dosage ; adverse effects ; classification ; Candida ; drug effects ; isolation & purification ; Carcinoma ; pathology ; therapy ; Cross Infection ; microbiology ; therapy ; Drug Resistance, Multiple, Fungal ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Mycoses ; microbiology ; therapy ; Patient Care Management ; methods ; Pulmonary Disease, Chronic Obstructive ; complications ; therapy ; Surgical Wound Infection ; microbiology ; therapy ; Symptom Flare Up ; Treatment Outcome