Work

Global Prevalence, Temporal Trends, and Associated Mortality of Bacterial Infections in Patients with Liver Cirrhosis: A Meta-analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background and Aims: Bacterial infections (BIs) are common and severe complications in patients with liver cirrhosis, but global data are limited. Here, we aimed to evaluate the global prevalence, temporal changes, and associated mortality risk of BIs in liver cirrhosis. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for eligible studies published without language restrictions until 11 August 2025. A random-effects model was used for meta-analyses, meta-regression by study year, and pooling adjusted hazard ratios. Results: spp. was 3.8% (95% CI: 2.5-5.2) and 1.5% (95% CI: 0.8-2.6), respectively. The pooled prevalence of multidrug-resistant bacteria was 6.8% (95% CI: 4.0-11.3). The most common BI sites were the gastrointestinal tract, ascites fluid, and urinary tract. The highest prevalence of BIs was reported in Europe (38.2%; 95% CI: 24.8-53.6), followed by South America (37.5%; 95% CI: 29.7-46.1) and Asia (22.8%; 95% CI: 16.3-30.9). Patients with acute-on-chronic liver failure showed the highest prevalence of BIs (44.2%; 95% CI: 29.7-59.8). A modest increasing trend in BIs prevalence was observed over time. BIs were associated with an increased risk of mortality in patients with cirrhosis (adjusted hazard ratios 2.22, 95% CI 1.33-3.71). Conclusions: BIs are prevalent in cirrhosis, especially in acute-on-chronic liver failure, with a modest upward trend and increased mortality risk.

Source: Journal of Clinical and Translational Hepatology

DOI: 10.14218/jcth.2025.00260