Asymptomatic Bacteriuria in Non–Hospitalized Patients With Liver Cirrhosis : is C–Reactive Protein Helpful?

Yahia Z. Gad; Amany M. Hassan

Volume : V, Issue : IV, April - 2015

Asymptomatic Bacteriuria in Non–Hospitalized Patients With Liver Cirrhosis : is C–Reactive Protein Helpful?

Yahia Z. Gad, Amany M. Hassan

Abstract :

Background/aim: Bacteriuria has been implicated as a source of infection with a substantial risk of morbidity and mortality in cirrhotic patients. In this work, we aimed to screen for asymptomatic bacteriuria in

non–hospitalized Egyptian patients with cirrhotic liver disease.

Patients and methods: A total of eligible 397 consecutive follow–up cirrhotic patients attending our outpatient clinic,

during 2013, were enrolled. All patients were subjected to history taking, clinical examination, traditional laboratory

investigations, urine culture, and C–reactive protein (CRP) measurement. Ultrasonography assessed the prostate volume

(PV) and post–void residual volume (PVRV) in males.

Results: Cirrhotic females (P < 0.001 with Diabetes Mellitus (D.M.)( P < 0.05) and a positive past history of hepatic

encephalopathy (HE) (P < 0.001) and gut bleeding(P < 0.001), are significantly associated with asymptomatic bacteriuria On multivariate logistic regression analysis, female gender (P = 0.013), D.M. (P = 0.007), Child–Pugh class C (P =

0.014) are independent predictors for development of asymptomatic bacteriuria. CRP levels are significantly elevated (P

< 0.001) in patients with asymptomatic bacteriuria when compared with the corresponding group without bacteriuria.

Conclusions: Our data revealed a significant prevalence of asymptomatic bacteriuria in non–hospitalized cirrhotic patients. Considering its potential hazards and resources availability, asymptomatic bacteriuria should be systematically

screened on regular outpatient basis and not to miss moderate CRP rises in cirrhotic patients to initiate norfloxacin

therapy.