Secondary SBP Prophylaxis is associated with a higher rate of non-SBP infections in Two 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 2009-2019 in two 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 (UTI), bacteremia, pneumonia, and C.difficile using validated codes over 2 years was compared between those on SecSBPPr versus not. Multi-variable regression for non-SBP infections was performed.

Results: VA-CDW: Of 4673 Veterans with index SBP, 2539 (54.3%) were started on SecSBPPr. 1406 (30.1%) developed non-SBP infections (13.5% UTI, 12.4% pneumonia, 8.5% bacteremia and 6.8% C.difficile). On multi-variable regression, SecSBPPr was significantly associated with any non-SBP infection (OR 1.26, 95% CI:1.10-1.44, p<0.0001) and UTI (OR 1.21, 95% CI:1.01-1.45, p=0.036). TriNetX: Of 6708 patients with index SBP, 3261 (48.6%) were started on SecSBPPr. 1932 (28.8%) patients developed non-SBP infections (13.4% UTI, 12.9% pneumonia, 8.6% bacteremia and 5.9% C.difficile). On multi-variable 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).

Conclusions: In two diverse US-based national cohorts of patients with cirrhosis and SBP, use of secondary SBP prophylaxis was associated with a higher risk of non-SBP infections, especially urinary tract infections.

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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.