ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ CĂN NGUYÊN VI SINH GÂY NHIỄM KHUẨN HUYẾT TRÊN BỆNH NHÂN XƠ GAN ĐIỀU TRỊ TẠI BỆNH VIỆN QUÂN Y 103

Abstract

Research on the clinical, subclinical and microbiological characteristics of sepsis in cirrhotic patients hospitalized in the Military Hospital 103

Research objective: Describe some clinical, subclinical and microbiological characteristics of sepsis in cirrhotic patients hospitalized at the Department of Infectious Diseases in Military Hospital 103. Subjects and research methods : A cross-sectional descriptive study, on 42 septic cirrhosis patients with positive blood culture results, treated at the Department of Infectious Diseases 103 Military Hospital from December 2020 to December 2022. Results: The age group 40 - 59 years old accounted for the majority of 66.7%, the ratio of males to females was 9.5/1. Alcoholic cirrhosis accounted for the highest rate of 46.6%, followed by HBV with 21.4%. The most common symptoms on admission were high fever and chills 81.0%; chest tightness and shortness of breath 38.1%, ascites and abdominal pain 33.3%. Laboratory tests: leukopenia (< 4 G/l) accounted for 28.6%; increases in CRP ≥ 100 mg/l and PCT ≥ 10 ng/ml accounted for the majority of 81% and 57.1% respectively. Rates of acute kidney injury and electrolyte disturbances were 61.9% and 78.6%, respectively, and increases in lactate ≥ 5 mmol/l was recorded at 33.3%. Entry of bacteria, 33.3% was from the gastrointestinal tract, respiratory tract was 28.6%, unknown origin was 19.0%. Gram-negative bacteria accounted for the majority with 76.2%. Microbial causes: E.coli (42.9%), K. pneumoniae (16.7%), Streptococcus spp (14.2%), S.aureus (7.1%) and Pseudomonas aeruginosa (7.1) %). Conclusion: Sepis in cirrhotic patients had diverse clinical manifestations, usually due to gram-negative and E. coli was the most common cause; laboratory tests were often accompanied by leukopenia, elevated inflammatory markers, acute kidney injury, and electrolyte disturbances.