Suárez M, Martínez R, Gómez-Molina R, Mateo J. Infection risk and management in patients with cirrhosis: A critical overview. World J Hepatol 2025; 17(5): 104468 [DOI: 10.4254/wjh.v17.i5.104468]
Corresponding Author of This Article
Miguel Suárez, MD, PhD, Associate Chief Physician, Department of Gastroenterology, Virgen de la Luz Hospital, 1 Hermandad Donantes De Sangre, Cuenca 16002, Castille-La Mancha, Spain. msuarezmatias@sescam.jccm.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. May 27, 2025; 17(5): 104468 Published online May 27, 2025. doi: 10.4254/wjh.v17.i5.104468
Infection risk and management in patients with cirrhosis: A critical overview
Miguel Suárez, Raquel Martínez, Raquel Gómez-Molina, Jorge Mateo
Miguel Suárez, Raquel Martínez, Department of Gastroenterology, Virgen de la Luz Hospital, Cuenca 16002, Castille-La Mancha, Spain
Miguel Suárez, Raquel Martínez, Jorge Mateo, Medical Analysis Expert Group, Institute of Technology, Universidad de Castilla-La Mancha, Cuenca 16071, Castille-La Mancha, Spain
Miguel Suárez, Raquel Martínez, Jorge Mateo, Medical Analysis Expert Group, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo 45071, Castille-La Mancha, Spain
Raquel Gómez-Molina, Department of Laboratory Medicine, Virgen de la Luz Hospital, Cuenca 16002, Castille-La Mancha, Spain
Co-first authors: Miguel Suárez and Raquel Martínez.
Author contributions: Suárez M, Martínez R, and Mateo J participated in the design and structure of the manuscript; Suárez M, Martínez R, and Gómez-Molina contributed to the review of the literature, writing and the elaboration of the table; All authors have reviewed the paper. Suárez M and Martínez R contributed equally as co-first authors.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Miguel Suárez, MD, PhD, Associate Chief Physician, Department of Gastroenterology, Virgen de la Luz Hospital, 1 Hermandad Donantes De Sangre, Cuenca 16002, Castille-La Mancha, Spain. msuarezmatias@sescam.jccm.es
Received: December 23, 2024 Revised: February 27, 2025 Accepted: March 13, 2025 Published online: May 27, 2025 Processing time: 156 Days and 13.2 Hours
Abstract
In this paper, we analyze the article published by El Labban et al, which explores the impact of cirrhosis on patients with necrotizing fasciitis. The authors conclude that cirrhosis is a significant risk factor for increased in-hospital morbidity and mortality in this patient population. Building upon their final observation regarding the importance of understanding this association, we will delve into the topic of infections in patients with liver cirrhosis. These patients exhibit intrinsic characteristics that make them particularly susceptible to infections, both bacterial and fungal. This heightened risk not only increases the likelihood of severe infections but also makes them a common trigger for acute decompensations, including the development of acute-on-chronic liver failure, which markedly worsens prognosis and mortality. Infections in patients with cirrhosis often require a more aggressive and rapid diagnostic and therapeutic approach due to the higher risk of nosocomial infections, multidrug-resistant organisms, and atypical clinical presentations. Delayed or inadequate management can lead to unfavorable outcomes, further complicating the course of their underlying liver disease. The aim of this article is to emphasize the importance of early and appropriate management in patients with cirrhosis with infections. Evidence supports that timely and tailored interventions not only improve clinical outcomes but also reduce mortality. By raising awareness among clinicians about the complexity of these cases, we hope to contribute to optimizing the care of this high-risk population.
Core Tip: Patients with cirrhosis face a significantly higher risk of infections, which often trigger acute decompensations and worsen their prognosis. The study by El Labban et al emphasizes the need for early detection and understanding of the complex pathophysiology of patients with cirrhosis, including immune dysfunction, intestinal permeability, and the risk of multidrug-resistant organisms. Recognizing these factors and adopting multidisciplinary, patient-tailored approaches are critical to mitigating the heightened morbidity and mortality observed in this population.
