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Invasive Fungal Infections in Acute Decompensation of Cirrhosis: Epidemiology, Predictors of 28-Day Mortality, and Outcomes

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Abstract

Acute-on-chronic liver failure (ACLF) is a severe syndrome characterized by acute decompensation (AD), organ failures, and high short-term mortality. Once patients with AD or ACLF have complications with invasive fungal infection (IFI), the mortality rate further increases. In this study, a total of 1636 patients with AD of cirrhosis diagnosed between January 2008 and December 2017 were enrolled in the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. Of the 1636 patients with AD of cirrhosis, 191 were complicated by IFI and their epidemiological characteristics were investigated. Cox proportional hazards regression was performed to analyze the factors impacting a 28-day survival in AD or ACLF with IFI. The findings indicated that the incidence of IFI in patients with AD of cirrhosis was 13.5%; the most common source of infection is pneumonia; the most common strain of fungi was Candida albicans, followed by Aspergillus fumigatus. Further, IFI is associated with poor 28-day survival in patients hospitalized for AD of cirrhosis with or without ACLF. Regarding patients with AD or ACLF with IFI, HE, AKI, INR, PLT, and ACLF grading are independent risk factors affecting 28-day outcomes.

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Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

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Funding

This work was supported by National Clinical Research Center for Infectious Diseases (NCRC-ID202106); National Key Research and Development Plan (2022YFC2304803); Capital’s Funds for Health Improvement and Research, China (NO.20201-5031); Education and Teaching Research Project of Peking University Health Science Center (2022YB49).

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Author notes

  1. Yu Wang and Chen Li contributed equally to this work. Author order was determined by contributions to the study.

Authors and Affiliations

  1. Senior Department of Hepatology, the Fifth Medical Center of Chinese, PLA General Hospital, 100# West Fourth Ring Road, Beijing, 100030, China

    Yu Wang, Chen Li, Haibin Su & Jinhua Hu

  2. Chinese PLA Medical School, Beijing, 100039, China

    Yu Wang & Jinhua Hu

  3. Peking University 302 Clinical Medical School, Beijing, 100039, China

    Chen Li, Haibin Su & Jinhua Hu

Authors
  1. Yu Wang
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  2. Chen Li
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  3. Haibin Su
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  4. Jinhua Hu
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Contributions

YW, CL, JH and HS participated in the treatment of these patients and designed the study. YW, CL, HS, and JH collected and analyzed the data. YW and CL wrote the first draft with assistance from JH and HS. JH edited the final manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jinhua Hu.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical Statement

This study was in accordance with the Helsinki Declaration and approved by the Ethics Committee of the Fifth Medical Center of Chinese PLA General Hospital. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

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Wang, Y., Li, C., Su, H. et al. Invasive Fungal Infections in Acute Decompensation of Cirrhosis: Epidemiology, Predictors of 28-Day Mortality, and Outcomes. Indian J Microbiol (2024). https://doi.org/10.1007/s12088-024-01243-4

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  • DOI: https://doi.org/10.1007/s12088-024-01243-4

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