Bacterial infection remains a leading cause of mortality and morbidity for patients with cirrhosis, with hospitalization, alterations in the intestinal microbiota, and therapeutic drugs all implicated in its development. Bacterial infections also remain the most common precipitant of acute-on-chronic liver failure, with infection occurring as a direct consequence of the progression of this syndrome. Furthermore, recent epidemiological analyses have demonstrated that infections due to multidrug-resistant bacteria are occurring with increasing frequency in patients with cirrhosis. Despite significant advances in the understanding of the pathophysiological processes triggered by an infection in patients with cirrhosis, a demonstrable survival benefit for the sickest patients who require ICU admission has not yet occurred. Early diagnosis of infection and appropriate antimicrobial treatment is essential to ensuring optimal outcomes for these patients. This review provides an evidence-based analysis of both the current strategies for prevention and the recommended management of common bacterial infections in patients with cirrhosis.

中文翻译：

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肝硬化患者的细菌感染：不要被毒死。

细菌感染仍然是肝硬化患者死亡和发病的主要原因，住院，肠道菌群的改变以及治疗药物都与细菌的发展有关。细菌感染仍然是慢性肝功能衰竭最常见的诱因，感染是这种综合征发展的直接结果。此外，最近的流行病学分析表明，在肝硬化患者中，由多药耐药细菌引起的感染的发生频率越来越高。尽管在了解肝硬化患者感染引发的病理生理过程方面取得了重大进展，但尚未出现对于需要ICU入院的最病患者的明显生存益处。感染的早期诊断和适当的抗菌治疗对于确保这些患者的最佳结局至关重要。这篇综述对肝硬化患者目前的预防策略和推荐的常见细菌感染管理方法进行了循证分析。