Multidrug-resistant colonization in decompensated cirrhosis outside the ICU predicts infection and poor outcomes
This study demonstrates that rectal colonization with multidrug-resistant organisms is both common and clinically significant in patients with decompensated cirrhosis outside the intensive care unit. These findings are highly relevant for hepatologists, infectious disease clinicians, and epidemiologists, as colonized ward patients faced a substantially increased risk of developing infections from their colonizing strain and experienced worse outcomes, particularly those with recent acute-on-chronic liver failure. Practically, incorporating colonization status into empirical antibiotic decision-making and evaluating targeted multidrug-resistant organism surveillance strategies beyond the intensive care unit could enhance early management and improve risk stratification. While further work is needed to assess feasibility and cost-effectiveness, our results provide a strong evidence base to inform the development of surveillance-driven approaches in routine cirrhosis care.
Authors
- Cristina Pitart (ORCID: https://orcid.org/0000-0002-3083-7915)
- M. Torrance
- Berta López‐Sáez (ORCID: https://orcid.org/0000-0002-3005-3897)
- Javier Fernández (ORCID: https://orcid.org/0000-0002-5622-0489)
- Àlex Soriano (ORCID: https://orcid.org/0000-0002-9374-0811)
- María Hernández‐Tejero (ORCID: https://orcid.org/0000-0002-6782-9150)
- Francesc Marco (ORCID: https://orcid.org/0000-0002-1863-6379)
- Jordi Vilà (ORCID: https://orcid.org/0000-0002-8025-3926)
- Santiago Andres Ortiz Galindo (ORCID: https://orcid.org/0000-0003-3009-1022)
- Marco Pavesi (ORCID: https://orcid.org/0000-0002-0143-8093)
- Ester López
- Nicolás Bustos (ORCID: https://orcid.org/0000-0001-6390-9316)
- José Antonio Martínez (ORCID: https://orcid.org/0000-0002-7012-9817)
- José-Luis Dı́az (ORCID: https://orcid.org/0009-0002-6655-5351)
- Fátima Aziz
- Foix Valles (ORCID: https://orcid.org/0009-0009-5488-209X)
Institutions
- Departament de Salut (ES)
- European Foundation for the Study of Chronic Liver Failure (ES)
- Vivantes Klinikum (DE)
- Centro de Investigación Biomédica en Red (ES)
- Hospital Clínic de Barcelona (ES)
- Hospital de Sabadell (ES)
- Mayo Clinic in Arizona (US)
- Barcelona Institute for Global Health (ES)
- Fundació Clínic per a la Recerca Biomèdica (ES)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Forbes Hospital (US)
- Universitat de Barcelona (ES)
Publication Details
- Journal
- JHEP Reports
- Published
- 2025-12-08
- DOI
- https://doi.org/10.1016/j.jhepr.2025.101707
- Citations
- 1
- Primary Topic
- Liver Disease and Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 1.32
Funders
- Pfizer
- Gilead Sciences
- Shionogi
- Universitat de Barcelona
- Grifols
- Instituto de Salud Carlos III