Health Condition 1: K769- Liver disease, unspecified
Conditions
Interventions
Intervention1: Nil: Nil
Control Intervention1: Nil: Nil
Sponsors
Institute of Liver and Biliary Sciences
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients with Acute on Chronic Liver Failure admitted to the ward/High Dependency Unit/Intensive Care Unit.
Exclusion criteria
Exclusion criteria: 1.Patients on immunosuppressant medications or on daily steroids (excluding inhaled steroids) or >2 weeks. 2.Patients with additional primary or acquired immunosuppressive states like hypogammaglobinemia, post-splenectomy, human immunodeficiency virus (HIV) infection etc. 3.Neutropenia defined as absolute neutrophil count or total white blood cell count (WBC) 4.Patients with extra-hepatic malignancy or on cytotoxic chemotherapy. 5.Patients with ileus, bowel hypomotility, severe constipation requiring laxatives/purgatives or enemas to evacuate. 6.Patients with fresh or altered blood in stools. 7.Patients with anatomical predisposition to infection/ bacterial seeing like prosthesis or foreign body. Patients with exfoliative skin conditions, significant mucosal ulcerations, or skin ulcers. Patients who have received > 2 weeks of antibiotics before current admission. 8.Pregnant patients.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Fecal isolation rates of carbapenem resistant gram negative bacterial species (CR-GNB) among hospitalized ACLF patientsTimepoint: Day 28 | — |
Secondary
| Measure | Time frame |
|---|---|
| Concordance of bowel colonizing resistant bacterial species, with concurrent or subsequent infecting bacterial isolates from extra-intestinal sitesTimepoint: Day 28;Correlation of fecal carriage of resistant bacterial species with antibiotic exposure antibiotic type and durationTimepoint: Day 28;Correlation of fecal carriage resistant bacterial species with patient outcomes (admission duration or survival duration, short-term survival to discharge, readmission rates, and 30-day survivalTimepoint: Day 28;Correlation of the fecal carriage rates of resistant bacterial species with etiology and severity of ACLF, including onset and resolution of organ failure (OF).Timepoint: Day 28;Factors predisposing patients colonized with resistant bacterial species to develop extra-intestinal infectious events due to the same speciesTimepoint: Day 28;Fecal carriage rates of C. difficile among hospitalized ACLF patients.Timepoint: Day 28;Fecal isolation rates of ESBL producing gram negative bacterial species among hospitalized ACLF patientsTimepoint: Day 28;Fecal isolation rates of Vancomycin-resistant enterococci (VRE) species among hospitalized ACLF patientsTimepoint: Day 28;Timeline of bowel colonization with resistant bacterial species among hospitalized ACLF patientsTimepoint: Day 28 | — |
Countries
India
Contacts
Public ContactDr Vikram Bhatia
Institute of Liver and Biliary Sciences
Outcome results
None listed