Epidemiological investigation of non-fermentative bacterial infection in cirrhotic patients

<b>Background</b>: This study aimed to describe the clinical characteristics of NFGNB in patients with cirrhosis as well as the risk factors for short-term mortality. <b>Methods</b>: A retrospective analysis was performed in patients with cirrhosis and NFGNB infections from 2011 to 2016 . <b>Results</b>: 144 episodes in 134 patients with liver cirrhosis and NFGNB infections were found in total. Of these, 81.2% were hospital-acquired or healthcare- associated infections, while only 18.8% of NFGNB infections originated from the community. <i>A. baumannii</i> were the most frequently isolated bacteria (39 episodes), followed by <i>S. maltophilia (38 episodes)</i> and <i>P. aeruginosa</i> (31 episodes). MDR- and non-MDR-NFGNB comprised 62.5% and 37.5% of infections respectively. The Kaplan-Meier survival curve showed no significant difference between MDR and non-MDR NFGNB patients (74.1% vs 75.5%, P = 0.811). Neither MDR or the subgroup of common NFGNB (<i>P. aeruginosa, A. baumannii, S. maltophilia</i>) was associated with the 28-day mortality (all P &gt;0.05). Low albumin levels and high Tbil levels were both independent risk factors for 28-day mortality (HR = 0.930, 95%CI (0.869, 0.995), P = 0.035; HR = 1.003, 95%CI (1.002, 1.005), P <b>Conclusions</b>: Diabetes increased 28-day mortality significantly, however, MDR status, site of infection and bacteria type did not.

**背景**：本研究旨在描述肝硬化患者合并非发酵革兰阴性杆菌（NFGNB）感染的临床特征，以及短期死亡率的危险因素。
**方法**：本研究对2011年至2016年确诊为肝硬化合并NFGNB感染的患者开展回顾性分析。
**结果**：本研究共纳入134例肝硬化合并NFGNB感染患者，共计144次感染发作。其中81.2%的感染为医院获得性感染或医疗相关感染，仅18.8%的NFGNB感染为社区获得性感染。鲍曼不动杆菌（A. baumannii）是最常见的分离菌株（39次发作），其次为嗜麦芽窄食单胞菌（S. maltophilia，38次发作）与铜绿假单胞菌（P. aeruginosa，31次发作）。多重耐药非发酵革兰阴性杆菌（MDR-NFGNB）与非多重耐药非发酵革兰阴性杆菌（non-MDR-NFGNB）分别占感染病例的62.5%与37.5%。Kaplan-Meier生存曲线分析显示，MDR-NFGNB患者与non-MDR-NFGNB患者的生存率无显著差异（74.1% vs 75.5%，P=0.811）。多重耐药状态以及常见非发酵革兰阴性杆菌（铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌）亚组均与28天死亡率无显著关联（所有P值均>0.05）。低白蛋白血症与高总胆红素（Tbil）水平均为28天死亡率的独立危险因素（风险比HR=0.930，95%置信区间CI：0.869~0.995，P=0.035；HR=1.003，95%CI：1.002~1.005，P）。
**结论**：糖尿病可显著升高患者28天死亡率，但多重耐药状态、感染部位及病原菌类型均无此关联。