Prevalence and risk factors of bacteriuria in cirrhotic patients: a prospective case-control multicenter study in 244 patients

Background/Aims: The prevalence and risks factors of bacteriuria in cirrhot ics have not been assessed by case-control study, and there are conflicting data concerning the role of liver failure and of ascites, The aims of this study were: i) to evaluate the prevalence of bacteriuria in cirrhotics, ii ) to search for associated factors, iii) to evaluate the role of bladder po st-void residual volume? and iv) to test the sensitivity of isolated bacter ia to norfloxacin. Methods: The prevalence and risk factors of bacteriuria on admission were d etermined by a multicenter prospective case-control study. Results: Two hundred and forty-four cirrhotic patients and 240 controls wer e studied. Bacteriuria was present in 38 patients (15.6%; IC 5%: 11%-20%) a nd 18 controls (7.5%; IC 5%: 4.2%-11%; p<0.001). By univariate analysis, fe male ses and ongoing diuretic treatment were associated with bacteriuria (p <0.0001 and p<0.04, respectively). Pugh's grade, ascites and bladder residu al volume were not associated with bacteriuria, By multivariate analysis, f emale sex (p<0.0001) and Child-Pugh score (p<0.03) mere predictors of bacte riuria, Sensitivity of bacteria to norfloxacin was observed in 94.7%; steri le urine cultures were noted in 95.2% of patients treated with this antibio tic. Conclusion: Bacteriuria is twice as frequent in cirrhotic patients as in ma tched controls, and there is a trend to association with female ses and liv er insufficiency.