Antibiotic-resistant Bacterial Infection of Hepatic Patients
Antibiotic-resistant Bacterial Infection of Hepatic Patients
the investigators want to identify the microbial profile, antibiotic resistant bacteria in
 hepatic patients with infections in Liver ICU, and explore risk factors and outcomes in those
 patients with antibiotic resistant bacteria.
Bacterial infection signifies major clinical challenge in cirrhotic patients where about 35%
 of these patients acquire hospital-acquired infections compared with 5% of other hospital
 in-patients without cirrhosis.It is associated with a mortality rate of 38% with a four-fold
 increase compared to individuals without cirrhosis.

 Cirrhotic patients have a high risk for antimicrobial resistance because of chronic use of
 prescribed antibiotics like quinolones in secondary prophylaxis for spontaneous bacterial
 peritonitis. In addition, undergoing invasive procedures and recurrent hospital admissions
 encourage both increased occurrence of antimicrobial resistance and the spread of resistant
 pathogens in these patients.

 Epidemiology, risk factors and clinical outcomes of MDR infections have raised a special
 attention in cirrhosis. Some studies reported bacterial resistance in about 50% of examined
 patients and it is associated with treatment failure, septic shock and hospital mortality
 especially in nosocomial and healthcare related infections
Inclusion Criteria:

 -  Patients with ESLD at Liver ICU. All patients have the diagnostic criteria for liver
 cirrhosis by clinical, biochemical, and ultrasonography findings. The severity of
 liver cirrhosis will be assessed according to the Child-Pugh classification and model
 for end-stage liver disease (MELD) score.

 -  These patients are diagnosed as having infection at admission or acquire infection
 during hospitalization.

 Exclusion Criteria:

 -  Age ≤ 18 years