P-1 PREVALENCE AND EPIDEMOLOGY OF BACTERIAL INFECTIONS IN PATIENTS WITH ALCOHOLIC HEPATITIS: A RETROSPECTIVE STUDY OF PATIENTS ADMITTED AT THE SAN RAFAEL DE ALAHUELA HOSPITAL, COSTA RICA

2021 
Introduction Bacterial infections in patients with alcoholic hepatitis have a high incidence and can contribute to the developments of organ failure and death. Aims To determinate the prevalence and epidemiology of bacterial infections in patients with alcoholic hepatitis; to evaluate the epidemiological and clinical characteristics in patients with alcoholic hepatitis; to identify predictive factors associated with infections in patients with alcoholic hepatitis; to determinate the proportions of patients with positive microbiological cultures; and to investigate the mortality in patients with alcoholic hepatitis with and without infection. Methodology This is a retrospective and observational study that included patients admitted to the San Rafael de Alajuela Hospital-Costa Rica; between November 2019 and February 2020. The medical records of all the patients who met the selection criteria were reviewed. Results 41 patients (80% male, mean age: 50 years ± 10) were analyzed. A high prevalence of concurrent sepsis was observed (73%, 36% nosocomial), with a proportion of culture positivity of 45%. Only the presence of leukocytosis and neutrophilia was associated with an increased risk of infection. The AUROC of the presence of leucocytosis was 0.86 (95% CI: 0.73-0.98) and the cut-off was 9520/mm3 presented the best diagnostic accuracy (S: 90%, E: 72.7%). Acute on chronic liver failure and severe alcoholic hepatitis was associated with high mortality. Conclusion The results confirm the high prevalence of bacterial infections in patients with alcoholic hepatitis. Leucocytes value was a risk factor for the development of infection and acute on chronic liver failure was associated with higher mortality.
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