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Introduction and Objectives: Infections in cirrhotic patients are frequent. Early diagnosis and treatment are essential to minimize the risk of serious complications. Currently, an epidemiological change in the causal bacterial agents is being evidenced. This study aimed to identify the involved bacterial infections in cirrhotic patients to determine the prevalence of multi and extremely-resistant and quinolone bacterial-resistant infections and to evaluate the mortality rate of these patients. Materials and Methods: Retrospective, descriptive and observational study including hospitalized patients older than 18 years with liver cirrhosis from September 2018 to October 2020. All of them were studied in a third-level of complexity hospital in Rosario, Argentina and admitted to suffering bacterial infections. Results: 70 patients were analyzed. The mean age was 47 years, male sex was 59%. The most frequent cause of cirrhosis was alcoholic (47%). Healthcare-associated infections predominated (44%). The most frequent infection was spontaneous bacterial peritonitis (21%). The most frequently isolated germs were Gram-negative (65%), with a predominance of E. Coli (45%). Gram-positive germs were recovered in 43%. Bacteria with high antibiotic resistance were isolated in 59.5% (E. coli, K. pneumoniae, enterococci) and 23% were associated with extremely resistant germs. No significant results were obtained when we compared the prophylactic use of quinolones, rifaximin, proton pump inhibitors, and previous use of antibiotics with the finding of resistant bacteria. The isolation of resistant germs was associated with a greater need for hemodialysis (p 0.034) and the presence of encephalopathy (p 0.044). Deaths (21%) were higher in those patients linked to systemic inflammatory response syndrome (SIRS) (p 0.036), in-hospital infections (p 0.017) and associated with resistant bacteria (p 0.02). Conclusions: A high percentage of both resistant and extremely resistant bacteria to treatment were found in our study. A high number of them were associated with gram-positive germs. These data indicate a change in the epidemiological behavior of cirrhotic infections.

Hepatitis E virus (HEV) is a public health concern due to its zoonotic transmission to human, being pigs a highly recognized reservoir. We previously demonstrated HEV genotype 3 infections in pig herds from the highest commercial active region from Argentina. Here, we present a case of acute symptomatic hepatitis E in an elderly man with occupational exposure to pigs who referred regular consumption of pork and sausages. HEV infection in this patient was demonstrated by serological methods, as well as by HEV RNA detection in serum and stool samples using the HEV/MS2 duplex RT‐qPCR, formerly optimized in our laboratory. We further detected HEV RNA in pig faeces from the patient´s farm. To confirm the potential role of swine in the transmission, we performed a phylogenetic analysis of all HEV RNA derived from both, the patient and the pig samples. A 303 nt region within the HEV 5 'ORF2 was amplified by nested RT‐PCR and subsequently sequenced. Phylogenetic analysis showed that the strains isolated from the farmer and from his pigs presented a nucleotide identity of 100%. These results support the zoonotic transmission of circulating HEV strains and confirm this epidemiological association for the first time in Argentina. [ABSTRACT FROM AUTHOR]

Unlabelled: BACKGROUND & AIMS. Studies about the natural history of hepatitis C virus (HCV) infection report variable progression to cirrhosis depending on study design. Retrospective cross-sectional liver clinic studies overestimate the rate of fibrosis progression due to inclusion of patients with more severe disease leaving mild and asymptomatic patients underrepresented. We evaluated fibrosis progression in a group of "healthy" asymptomatic subjects, attending to a voluntary campaign for the detection of HCV infection., Material and Methods: A detection campaign was launched on subjects transfused before 1993. Of 1699 volunteers, 61(3.6%) had HCV infection. A liver biopsy was performed in 40 (65%). Assessed risk factors for liver fibrosis were: sex, body mass index, alcohol consumption (> 20 g/d - > 40g/d ), genotype, HLA-DRB1 alleles, present age, age at infection and duration of infection., Results: 25 (62.5%) were women with a median age of 52.5 years. The median duration of infection was 21.5 years with a median age at infection of 27 years. As regards fibrosis, 25 (62.5%) had a Low Stage (F0-F1), 8 patients, 20%, had severe fibrosis, one patient (2.5%) had cirrhosis. Alcohol consumption was the only risk factor associated with fibrosis progression., Conclusions: The low progression to cirrhosis may be explained by the clinical characteristics of our population: asymptomatic middle-aged "healthy" subjects infected at young age. The progression to severe fibrosis was noticeable; hence a longer follow-up might demonstrate changes in this outcome. Significant alcohol consumption clearly worsens the natural history of HCV infection; this is no so evident for occasional or mild alcohol consumers.