{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:31:42Z","timestamp":1782891102907,"version":"3.54.5"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,22]],"date-time":"2016-07-22T00:00:00Z","timestamp":1469145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001690","name":"Atsumi International Scholarship Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Bacterial strains resistant to antibiotics are a serious clinical challenge. We assessed the antibiotic susceptibility of bacteria isolated from infections in patients with cirrhosis by a multicentre investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred and thirteen culture\u2010positive infections (173 community acquired [<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>] and 140 hospital acquired [<jats:styled-content style=\"fixed-case\">HA<\/jats:styled-content>]) were identified in 308 patients. Urinary tract infections, spontaneous bacterial peritonitis and bacteremias were the most frequent. Quinolone\u2010resistant Gram\u2010negative isolates were 48%, 44% were extended\u2010spectrum beta\u2010lactamase producers and 9% carbapenem resistant. In 83\/313 culture\u2010positive infections (27%), multidrug\u2010resistant agents (<jats:styled-content style=\"fixed-case\">MDRA<\/jats:styled-content>) were isolated. This prevalence did not differ between <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HA<\/jats:styled-content> infections. <jats:styled-content style=\"fixed-case\">MDRA<\/jats:styled-content> were identified in 17 of 37 patients on quinolone prophylaxis, and in 46 of 166 not on prophylaxis (45% vs 27%; <jats:italic>P<\/jats:italic>&lt;.03). In 287 cases an empiric antibiotic therapy was undertaken, in 37 (12.9%) this therapy failed. The in\u2010hospital mortality rate of this subset of patients was significantly higher compared to patients who received an effective broad(er)\u2010spectrum therapy (<jats:italic>P<\/jats:italic>=.038). During a 3\u2010month follow\u2010up, 56\/203 culture\u2010positive patients (27.6%) died, 24\/63 who have had <jats:styled-content style=\"fixed-case\">MDRA<\/jats:styled-content>\u2010related infections (38%) and 32\/140 who have had antibiotic\u2010susceptible infections (22.8%) (<jats:italic>P<\/jats:italic>=.025). Multivariate analysis disclosed <jats:styled-content style=\"fixed-case\">MDRA<\/jats:styled-content> infection, age, hepatocellular carcinoma, bilirubin, international normalized ratio and the occurrence of portal hypertension\u2010related complications independent predictors of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Infection by <jats:styled-content style=\"fixed-case\">MDRA<\/jats:styled-content> is frequent in patients with cirrhosis and the prognosis is severe, especially in patients unresponsive to empiric antibiotic therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13195","type":"journal-article","created":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T08:56:39Z","timestamp":1467363399000},"page":"71-79","source":"Crossref","is-referenced-by-count":64,"title":["The impact of infection by multidrug\u2010resistant agents in patients with cirrhosis. 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