CLEARED Consortium: How infections affect cirrhosis patients hospitalized worldwide

By A.J. Hostetler, Communications Director
Stravitz-Sanyal Institute for Liver Disease and Metabolic Health

A new global study reveals a concerning trend: health care providers are often skipping crucial infection tests and prescribing antibiotics to patients with cirrhosis, which is leading to higher mortality rates.

The findings, published Sept. 4 by The Lancet Gastroenterology & Hepatology, shine a light on how infections affect cirrhosis patients in hospitals across the world.

Led by Dr. Jasmohan Bajaj, a gastroenterologist at the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health and the Richmond VA Medical Center, the study spanned continents, collecting data from 4,238 patients in 98 hospitals across 26 countries who participate in the CLEARED Consortium. The team examined patient demographics, infection types and treatment approaches.

The results are sobering. About a third of the patients were already infected when they arrived at the hospital, with poorer countries seeing more cases. The most common infections were spontaneous bacterial peritonitis, pneumonia, and urinary tract infections, often caused by bacteria like E. coli and Klebsiella pneumoniae. Alarmingly, 40% of these bacteria were resistant to antibiotics.

Patients with infections experienced more severe health issues and faced a higher risk of death, particularly in less affluent regions where proper testing is a challenge. The study highlights the dangers of overprescribing antibiotics without first identifying the specific infection, a practice that’s all too common in many hospitals.

Infections in cirrhosis patients are a serious threat, especially in regions lacking the resources for accurate testing. This study underscores the urgent need for better infection management to save lives.