This systematic review and meta-analysis examined bacterial infections in adult patients with cirrhosis across the globe. The researchers analyzed data from 35,180 infected patients to understand how often bacteria were resistant to standard medicines and how this affected survival rates.
The study found that 32.9% of positive bacterial cultures involved Gram-positive bacteria, a proportion that has been increasing over time. This trend was more common in high-income countries and Europe. Meanwhile, multidrug-resistant bacteria made up 33.3% of cases overall. These resistant infections were most frequent in low or lower-middle-income countries and South-East Asia, while rates were lowest in high-income countries and the Americas.
Despite the growing threat of drug resistance, the data showed a declining trend in in-hospital, 30-day, and 90-day mortality rates. However, the reduction in long-term mortality was less pronounced. The authors noted that comprehensive global data on these infections remain limited, which affects how certain these findings are. This research highlights the urgent need for international collaboration and specific national strategies to manage bacterial infections in people with cirrhosis.
