Death and length of stay are increased among hospitalized inflammatory bowel disease (IBD) patients who develop healthcare-acquired infections (HAIs), according to a study in Clinical Gastroenterology and Hepatology, the journal of the American Gastroenterological Association (AGA) Institute. Also, HAIs are most frequent in patients with severe liver disease, according to an additional study published in the journal.
Â
"Our data demonstrate that inflammatory bowel disease patients with hospital-acquired infections are at increased risk of inpatient mortality and experience a significantly longer length of stay in the hospital," says Raffi Karagozian, MD, of Brigham and Women's Hospital and lead author of this study. "Though hospital-acquired infections are low-frequency events, increased vigilance to avoid these infections among patients could improve outcomes."
Â
Among the 2,324 patients with IBD examined in this study, there were 20 deaths and 22 reported cases of hospital-acquired infections (these types of infections occur in approximately 1 percent of hospitalized cases with IBD). The mortality from these infections among IBD patients was 13.6 percent, compared with 0.9 percent among controls.
Â
The median length of stay for patients with IBD and hospital-acquired infections was 22 days, versus six days for controls. Of these 22 cases, 15 were urinary tract infections, five were blood stream infections and two were from multiple sources.
Â
Hospital-acquired infections affect approximately 2 million patients each year in the U.S., resulting in 90,000 deaths with an estimated $4.5 billion to $5.7 billion per year toward patient-care costs. Between 5 percent and 10 percent of patients admitted to acute-care hospitals acquire one or more infections, and the risks have steadily increased during recent decades.
Â
In a second study, researchers found that the large majority of total bacterial infections (54) in hospitalized cirrhotic patients were health-care associated (22) or hospital acquired (20). Bacterial resistance was also more frequent among patients with either of these infections. These infectious episodes worsened liver function in 62 percent of patients. In addition to the severity of the liver disease, protein malnutrition was an important risk factor for the development of infections in liver cirrhosis.
Â
Cirrhosis occurs when the liver is permanently scarred or injured by chronic conditions and diseases. The scar tissue that forms in cirrhosis harms the structure of the liver, blocking the flow of blood through the organ.
Â
"It is worth noting that in-hospital death was higher in cirrhotic patients with health-care-associated infections compared with those not infected. In addition, infected cirrhotic patients showed worse long-term survival (compared to those without infections) even if they were discharged from the hospital," says Manuela Merli, MD, of Sapienza University of Rome and lead author of this study. "Bacterial infections are in fact a frequent and serious burden among patients with cirrhosis because they can further deteriorate liver function."
Â
Cases of infection are reported in 40 percent of hospitalized cirrhotic patients. As infections worsen, liver function deteriorates and mortality increases. Therefore, cirrhotic patients should be closely monitored for infections.
Â
Â
Â
Â
Â
Â
Â
Health at Risk: The Impact of Antimicrobial Resistance From a Global to Local Health Perspective
March 6th 2024Discover the critical role infection preventionists play in combating multidrug-resistant organisms, from the impact on patient care to the challenges of treatment, and the evolving landscape of antimicrobial resistance with Katharine J Hoffman, MPH, CIC.
Rare Disease Day 2024: Spotlight on Rare Infectious Diseases
February 29th 2024Rare Disease Day on February 29, 2024, shines a global light on the impact of rare diseases, including rare infectious diseases. With a focus on early diagnosis and treatment access, this day highlights the struggles of those with rare conditions.
FDA Approves Enmetazobactam for Complicated UTIs: A Breakthrough in Antimicrobial Therapy
February 26th 2024Enmetazobactam (Exblifep; Orchid Pharma) has received FDA approval for treating complicated urinary tract infections (cUTIs), offering a promising solution in the battle against antimicrobial resistance.