Secondary Spontaneous Bacterial Peritonitis Prophylaxis Is Associated With a Higher Rate of Infections other than Spontaneous Bacterial Peritonitis in 2 US-Based National Cirrhosis Cohorts.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2025-03-10 DOI:10.14309/ctg.0000000000000837

Scott Silvey, Nilang Patel, Jacqueline G O'Leary, Sofia S Jakab, Heather Patton, Shari Rogal, John D Markley, Ramsey Cheung, Arpan Patel, Timothy R Morgan, Jasmohan S Bajaj

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引用次数: 0

Abstract

Introduction: Antibiotic overuse and subsequent antibiotic resistance lead to worse infection outcomes in cirrhosis. Secondary spontaneous bacterial peritonitis prophylaxis (SecSBBPr) is associated with higher SBP recurrence, but impact on non-SBP infections is unclear.

Methods: We studied patients with cirrhosis and SBP who were given SecSBPPr or not between 2009 and 2019 in 2 complementary national cohorts (Veterans Affairs Corporate Data Warehouse [VA-CDW] and non-VA TriNetX). Development of total non-SBP infections and specifically urinary tract infections (UTIs), bacteremia, pneumonia, and C. difficile using validated codes over 2 years was compared between those on SecSBPPr vs not. Multivariable regression for non-SBP infections was performed.

Results: VA-CDW: Of 4,673 veterans with index SBP, 2,539 (54.3%) were started on SecSBPPr. In total, 1,406 (30.1%) developed non-SBP infections (13.5% UTI, 12.4% pneumonia, 8.5% bacteremia, and 6.8% C. difficile ). On multivariable regression, SecSBPPr was significantly associated with any non-SBP infection (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.10-1.44, P < 0.0001) and UTI (OR 1.21, 95% CI 1.01-1.45, P = 0.036). TriNetX: Of 6,708 patients with index SBP, 3,261 (48.6%) were started on SecSBPPr. In total, 1,932 (28.8%) patients developed non-SBP infections (13.4% UTI, 12.9% pneumonia, 8.6% bacteremia, and 5.9% C. difficile ). On multivariable regression, SecSBPPr was significantly associated with any non-SBP infection (OR 1.33, 95% CI 1.12-1.59, P < 0.0001), UTI (OR 1.35, 95% CI 1.07-1.71, P = 0.010), pneumonia (OR 1.35, 95% CI 1.06-1.72, P = 0.017), and bacteremia (OR 1.47, 95% CI 1.10-1.97, P = 0.009).

Discussion: In 2 diverse US-based national cohorts of patients with cirrhosis and SBP, use of SecSBPPr was associated with a higher risk of non-SBP infections, especially urinary tract infections.

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在两个美国国家肝硬化队列中，二级收缩压预防与较高的非收缩压感染率相关。

简介：抗生素过度使用和随后的抗生素耐药性导致肝硬化感染结果恶化。继发性自发性细菌性腹膜炎预防（SecSBBPr）与较高的收缩压复发率相关，但对非收缩压感染的影响尚不清楚。方法：我们在2009-2019年两个互补的国家队列[退伍军人事务公司数据仓库（VA-CDW）和非va TriNetX]中研究了是否接受SecSBPPr治疗的肝硬化和收缩期高血压患者。使用验证代码比较了2年内使用SecSBPPr和未使用SecSBPPr的患者的总非收口bp感染和特别是尿路感染（UTI）、菌血症、肺炎和艰难梭菌的发展情况。对非收缩压感染进行多变量回归。结果：VA-CDW: 4673例收缩压指数的退伍军人中，2539例（54.3%）开始使用SecSBPPr。1406例（30.1%）发生非收缩压感染（13.5% UTI， 12.4%肺炎，8.5%菌血症和6.8%艰难梭菌）。在多变量回归中，SecSBPPr与任何非收缩压感染显著相关（OR 1.26, 95% CI:1.10-1.44）。结论：在美国两个不同的肝硬化和收缩压患者国家队列中，使用继发性收缩压预防与非收缩压感染的高风险相关，尤其是尿路感染。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.