Sex Specific Differences in Nosocomial Infections in Patients with Decompensated Liver Cirrhosis

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Tergast, Nicolas Simon, Abdul-Rahman Kabbani, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1068542/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background and aims: There are considerable differences between males and females regarding the etiology, progression and outcome of liver diseases. Infections are a frequent and severe complication in these patients. This study aimed to examine sex specific differences in the incidence and clinical course of nosocomial infections in patients with decompensated liver cirrhosis. Methods: A number of 555 consecutive patients with decompensated liver cirrhosis and ascites were analyzed. The patients were followed up for the incidence of nosocomial infections, acute kidney injury (AKI), acute-on-chronic liver failure (ACLF) as well as liver transplantation and death (LTx-free survival). Results: A number of 285 patients (111 women and 174 men) developed a nosocomial infection. Incidence was numerically lower in men (p=0.076). While the frequency of a nosocomial spontaneous bacterial peritonitis was similar between males and females, the incidence of a nosocomial urinary tract infection was significantly higher in women (p<0.001). No sex specific differences were documented regarding the outcome of an infection as indicated by a similar incidence of, AKI, ACLF as well as LTx-free survival. Conclusion: There seem to be no major differences in the incidence and outcome of nosocomial infections between male and female patients. Gastroenterology & Hepatology Liver cirrhosis nosocomial bacterial sex gender E. coli Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Over the recent years sex specific differences gain an increasing attention in medical research. Relevant differences include pharmacokinetic and pharmacodynamics of drugs, prevalence as well as natural history of several diseases (1-4). This certainly also affects the field of hepatology. E.g. women are more likely to suffer from autoimmune hepatitis and primary biliary cholangitis (5, 6) whereas men develop more frequently primary sclerosing cholangitis (7). Further, the progression of liver disease to fibrosis and cirrhosis differs. The toxic effect of alcohol is greater in females than in males, which leads to faster development of fibrosis in women with alcohol-related liver disease (8-10). However, this progress is opposite in other etiologies of cirrhosis such as hepatitis B and C (11), hemochromatosis and primary biliary cholangitis (9, 12). These differences were partly explained by diverse levels of sex hormones. Of note, the advantage of female sex in patients with hepatitis C diminishes after the menopause (9, 13). Recently, several studies suggested sex specific differences in end stage liver disease. Female patients with decompensated liver cirrhosis on the waiting list for liver transplantation were more likely to die and less likely to be transplanted than male patients in some studies (14, 15). The impact of creatinine in MELD score has been suggested as a possible explanation (16, 17). However, this remains controversial. Of note, Mariante-Neto et al. did not observe any differences in survival and chance for transplant between sexes in a similar study design (18) and the study by Umemura et al. even documented a better survival for female patients (19). One of the most common and severe complication in end stage liver disease are infections, particularly if acquired during hospitalization. The natural history of liver cirrhosis is significantly altered by an infection (20). Mortality is four times increased (21). Even after resolution of infection the survival remains impaired (20, 22). Moreover, infections trigger further cirrhosis-associated complications such as hepatic encephalopathy (23), acute-on-chronic liver failure (ACLF) (24) and acute kidney injury (AKI) (25). Fast diagnosis and adequate treatment of infections as well as sufficient measures for prophylaxis are absolutely crucial, in particular in those with decompensated liver disease (26). Therefore, it is of particular importance to know about the most common sites of infection and specific risk factors. Of note, the influence of sex on the incidence and clinical outcome of as well as risk factors for nosocomial infections in patients with decompensated liver cirrhosis has rarely been investigated in detail, so far. This study aimed to study sex specific differences in incidence and the clinical course of as well as risk factors for nosocomial infections in a large real-world cohort of patients with decompensated liver cirrhosis and ascites. Patients And Methods Patient cohort A number of 1314 consecutive patients who underwent a paracentesis from January 2012 until April 2018 at Hannover Medical School were considered for the study. In a first step, patients were selected automatically by the Enterprise Clinical Research Data Warehouse to avoid selection bias. Afterwards, the medical records of the patients were checked manually for inclusion and exclusion criteria leaving 556 individuals for the final analysis. Exclusion criteria included insufficient evidence of cirrhosis, malignant tumor disease other than hepatocellular carcinoma within the MILAN criteria, secondary intraabdominal infection, no sufficient follow up of nosocomial infection, HIV infection, congenital immune dysfunction, history of organ transplantation and no sufficient informed consent (Suppl. Figure1). Data collection Clinical information like presence of infection, age, medication, AKI, ACLF and death was collected manually from the patients’ files. Laboratory values at time of admission and time of infection were extracted automatically by the Enterprise Clinical Research Data Warehouse. Diagnosis of liver cirrhosis was confirmed by ultrasound, elastography, liver histology, biochemical results and/or a combination of the above. Definition of infection was based on the judgement of the treating physician and/or clinical symptoms in combination with the following criteria: Spontaneous bacterial peritonitis (SBP): ≥ 500 nucleus containing cells/mm 3 ascites fluid Urinary tract infection (UTI): leukocyturia and/or positive urine cultures and/or significant germination number as well as respective clinical signs of infection Pneumonia: evidence of pulmonary infiltrates in X-ray and respective clinical signs of infection Blood stream infection: clinical signs of infection and positive blood cultures AKI and ACLF were defined according to the guidelines of “The European Association for the Study of the Liver” (EASL) (24, 27-30). Study design Sex specific differences in the incidence of nosocomial infections The patients were followed up 28 days from hospital admission for nosocomial infections. A competing risk analysis was performed handling death and LTx as competing events. As potential risk factors for any nosocomial infection sex, diabetes, age as well as MELD score, and platelets (both indicating the severity of liver disease) were included. In the univariate and multivariate competing risk analysis for incidence of nosocomial SBP the following parameters were considered for the model: presence of peritoneal catheter, antibiotic prophylaxis with norfloxacin and prior SBP. When analyzing potential risk factors for nosocomial UTI presence of a urinary catheter was added to the multivariate model. In a second step the cohort was divided into the two subgroups (female and male patients) to evaluate if specific risk factors for the development of a nosocomial infection are sex-specific. Sex specific differences in the outcome of nosocomial infection LTx-free survival Primary end point was liver transplantation or death (LTx-free survival) within 28 days after the onset of any nosocomial infection, SBP and UTI, respectively. Parameters considered for the univariate and multivariate Cox-Regression model were Patients characteristics: sex, age, diabetes and esophageal varices Medication: β-Blocker and PPI intake Laboratory values: MELD score, albumin, CRP, leukocytes, sodium and platelets. Protein in ascites and nucleus containing cells in ascites were additionally included in the analysis for LTx-free survival after SBP. Incidence of AKI A competing risk model with LTx and death as competing risk was chosen. Follow-up was 28-days after the onset of nosocomial infection was completed. All patients with dialysis or occurrence of AKI before the onset of nosocomial infection were excluded from this analysis. The multivariate competing risk model was adjusted to the parameters sex, MELD score, CRP and platelets. All laboratory values were assessed at the onset of the infection. Incidence of ACLF A competing risk analysis with death and LTx as competing risk was performed. Follow-up was 28-days before the onset of nosocomial infection. The multivariate competing risk model was adjusted to the parameters sex, MELD score, CRP and platelets. Statistics All analyses were performed with IBM SPSS Statistics 26. Continuous variables were expressed as means and categorical variables as percentages. T-test was used for continuous variables and chi-square-test for categorical variables. To asses LTx-free survival univariate and multivariate Cox-regression (backward conditional) were applied. All parameters with p ≤ 0.05 and the investigated factor sex were included in multivariate analysis. Incidence of nosocomial infection, incidence of AKI and incidence of ACLF were analyzed by competing risk analysis. Multivariate competing risk analyses were performed in R Studio 3.5.2 with ‘crrstep-package’ (31-33). Backward direction was chosen and AIC criterion selected. Transformation into p-values and Hazard Ratios was done by using the function crrstep.output (34). Cumulative incidences were executed with ‘cmprsk’ package (35). Ethics The study was approved by the local ethic committee of Hannover Medical School (Nr. 7935_BO_K_2018) and was performed according to the Declaration of Helsinki. All included patients provided sufficient written informed consent for the scientific use of their clinical data at hospital admission. Results Study cohort Overall, 203 (36.5 %) women and 353 (63.5 %) men were included in the study cohort. The mean age of the individuals was 57 years. There were some differences in the baseline characteristics between female and male patients: Alcohol-related liver disease was more common in men (p = 0.002) whereas cholestatic (p = 0.011) etiology was more frequent in women. Esophageal varices were more often present in male than in female patients (p = 0.003). Further, the MELD score (p = 0.016) and the Serum-Creatinine (p = 0.003) were higher in men. Moreover, men had a lower platelet count (p = 0.029). The detailed baseline characteristics are displayed in Table 1 . Table 1 Baseline characteristics Variable All patients Female (n=203, 36.5 %) Male (n=353, 63.5 %) P-value Age (years) 56.8 (11.1) 56.3 (11.4) 57.1 (11.0) 0.448 Etiology of liver cirrhosis • Alcohol-related • Cryptogenic • Viral • NASH • Cholestatic • Other • Mixed 52 % (n=291) 11 % (n=61) 18 % (n=102) 7 % (n=38) 8 % (n=42) 14 % (n=79) 10 % (n=55) 44 % (n=89) 13 % (n=27) 17.2 % (n=35) 7 % (n=15) 11 % (n=23) 16 % (n=33) 9 % (n=19) 57 % (n=202) 10 % (n=34) 19 % (n=67) 7 % (n=23) 5 % (n=19) 13 % (n=46) 10 % (n=36) 0.002 0.183 0.610 0.694 0.011 0.294 0.750 PPI (n, %) 81 % (n=445) 77 % (n=154) 83 % (n=291) 0.078 Β-blockers (n, %) 38 % (n=212) 34 % (n=69) 41 % (n=143) 0.136 Esophageal varices (n, %) 76 % (n=422) 69 % (n=140) 80 % (n=282) 0.003 Diabetes (n, %) 24 % (n=135) 23 % (n=47) 25 % (n=88) 0.638 MELD score 18 (7.0) 17 (6.6) 19 (7.2) 0.016 Albumin (g/l) 27.1 (5.9) 26.6 (5.4) 27.4 (6.2) 0.273 Bilirubin (µmol/l) 91.9 (135.4) 86.6 (130.6) 94.9 (138.2) 0.488 CRP (mg/l) 30.4 (34.7) 30.1 (38.3) 30.5 (32.5) 0.903 INR (Ratio) 1.53 (0.46) 1.49 (0.37) 1.55 (0.50) 0.209 Creatinine (µmol/l) 130.6 (89.2) 115.6 (70.5) 139.2 (97.3) 0.003 Leukocytes (10 3 /µl) 8.8 (6.1) 9.3 (5.9) 8.6 (6.2) 0.164 Platelets (10 3 /µl) 147.6 (102.7) 160 (119.7) 140 (90.8) 0.029 Sodium (mmol/l) 134 (5.4) 134 (5.5) 134 (5.3) 0.863 Antibiotic intake within 12 weeks before admission 33 % (n=180) 32 % (n=64) 33 % (n=116) 0.818 All continues variables are displayed as mean with standard deviation. Categorical variables are displayed as proportions. Laboratory values were assessed at time of admission. Abbreviations: MELD: Model of end stage liver disease; PPI: Proton pump inhibitors; CRP: C-reactive protein; INR: International normalized Ratio Incidence and clinical course of a nosocomial infection in male vs. female patients Overall, 258 patients (111 women and 174 men) developed a nosocomial infection. The cumulative incidence function indicated no major difference in the incidence of nosocomial infections between male and female patients (p = 0.283) (Figure 1 ). Of note, after adjusting for other risk factors in the multivariate competing risk model, male sex was linked to a numerical lower hazard (HR: 0.81; p = 0.076). However, a statistically significant link to the incidence of nosocomial infections was only found for the MELD score (HR: 1.05; p < 0.001) (Table 2 a). Noteworthy, this was also consistent in both subgroups (female and male patients) and no sex-specific risk factors were detected. Outcome measures of nosocomial infection were AKI, ACLF and LTx-free survival. There was no difference between male and female patients in terms of the incidence of AKI, ACLF (data not shown) and LTx-free survival in the multivariate analysis (Table 3 a). Table 3 a : Uni- and multivariate Cox-regression of LTx-free survival after the onset of nosocomial infection Variable Univariate Multivariate P-value Hazard Ratio (CI) P-value Hazard Ratio (CI) Sex (male) 0.724 0.906 (0.522; 1.570) 0.614 Age 0.420 0.991 (0.968; 1.014) Diabetes 0.763 0.908 (0.486; 1.698) Esophageal varices 0.705 0.891 (0.490; 1.620) β-Blocker 0.003 0.333 (0.163; 0.683) 0.056 0.445 (0.194; 1.022) PPI 0.548 0.809 (0.405; 1.615) MELD score <0.001 1.123 (1.081; 1.167) <0.001 1.109 (1.066; 1.152) Albumin 0.997 1.000 (0.938; 1.067) CRP 0.042 1.004 (1.000; 1.007) 0.073 Leukocytes 0.067 1.017 (0.999; 1.036) Sodium 0.688 0.991 (0.950; 1.034) Platelets 0.046 0.966 (0.992; 1.000) 0.254 Laboratory values were assessed at time of the onset of nosocomial infection. Abbreviations: MELD: Model of end stage liver disease; CRP: C-reactive protein; LTx: Liver transplantation; PPI: Proton pump inhibitors; CI: Confidence interval Table 3 b : Uni- and multivariate Cox-regression of LTx-free survival after the onset of nosocomial SBP Variable Univariate Multivariate P-value Hazard Ratio (CI) P-value Hazard Ratio (CI) Sex (male) 0.696 0.862 (0.410; 1.812) 0.659 Age 0.682 1.007 (0.975; 1.039) Diabetes 0.360 0.659 (0.269; 1.611) Esophageal varices 0.735 0.870 (0.387; 1.954) β-Blocker 0.010 0.247 (0.086; 0.711) 0.058 0.349 (0.117; 1.038) PPI 0.847 1.110 (0.385; 3.199) MELD score <0.001 1.131 (1.082; 1.183) 0.001 1.096 (1.041; 1.154) Albumin 0.309 0.953 (0.869; 1.046) CRP 0.001 1.006 (1.002; 1.009) <0.001 1.010 (1.005; 1.016) Leukocytes 0.077 1.018 (0.998; 1.038) Sodium 0.530 1.020 (0.960; 1.083) Platelets 0.013 0.992 (0.986; 0.998) 0.080 0.994 (0.988; 1.001) Protein ascites 0.502 0.736 (0.300; 1.802) Nucleus containing cells 0.839 0.993 (0.932; 1.059) Laboratory values were assessed at time of the onset of nosocomial SBP Abbreviations: LTx: liver transplantation; SBP: spontaneous bacterial peritonitis; MELD: Model of end stage liver disease; CRP: C-reactive protein; CI: Confidence interval Table 3 c : Uni- and multivariate Cox-regression of LTx-free survival after the onset of nosocomial UTI Variable Univariate Multivariate P-value Hazard Ratio (CI) P-value Hazard Ratio (CI) Sex (male) 0.533 1.313 (0.557; 3.092) 0.769 Age 0.851 1.004 (0.964; 1.045) Diabetes 0.560 1.349 (0.493; 3.693) Esophageal varices 0.166 2.372 (0.699; 8.056) β- Blocker 0.054 0.339 (0.133; 1.019) PPI 0.893 1.089 (0.315; 3.764) MELD score <0.001 1.146 (1.085; 1.211) <0.001 1.146 (1.085; 1.211) Albumin 0.259 0.958 (0.889; 1.032) CRP 0.605 1.002 (0.995; 1.009) Leukocytes 0.058 1.060 (0.998; 1.127) Sodium 0.519 0.978 (0.914; 1.046) Platelets 0.223 0.996 (0.989; 1.002) Laboratory values were assessed at time of the onset of nosocomial UTI Abbreviations: LTx: liver transplantation; UTI: urinary tract infection; MELD: Model of end stage liver disease; CRP: C-reactive protein; CI: Confidence interval Differences in the most common sites of nosocomial infections Overall, SBP (n = 136, 48 %) was the most frequent nosocomial infection followed by UTI (n = 62, 22 %). We documented only minor differences between male and female patients. SBP was the most frequent site of infection in men constituting to 53 % (n = 96) of the infections. On the contrary, in only 34 % (n = 40) of the infections in female patients a SBP was diagnosed (p=0.048). In contrast, UTI was more common in females. In females 31 % (n = 37) of the nosocomial infections could be attributed to the urinary tract whereas this was only the case in 14 % (n = 25) of the infections in males (p<0.001). Similar rates of pneumonia were detected among the infections in male and female patients (p=0.758), while blood stream infections were more frequent in men (8 % vs 3 %, p=0.154) (Figure 2 ). Incidence and clinical course of as well as risk factor for nosocomial SBP in male vs. female patients Although SBP was more frequent among the infection in males, the overall cumulative incidence of nosocomial SBP did not differ between male and female patients (p = 0.493) (Figure 3 ). In the final multivariate competing risk model only presence of a peritoneal catheter (HR: 2.19; p < 0.001) was significantly linked to the development of nosocomial SBP (Table 2 b) in both female (HR: 3.46; p < 0.001) and male (HR: 1.85; p = 0.002) patients. In female patients the platelet count (HR: 1.003; p = 0.009) was also linked to SBP development. In 19 female patients (32 %) with nosocomial SBP a pathogen was detected. In the majority of cases (84 %) gram-positive bacteria were identified. Similarly, in 30 male patients with nosocomial SBP (27 %) a pathogen was detected, which were also more frequently gram-positive bacteria (67 %) (Suppl. Table 1). The LTx-free survival after a nosocomial SBP did not differ between male and female patients (Table 3 b). Further, there was no difference between male and female patients in terms of the incidence of AKI and ACLF after nosocomial SBP (data not shown). Incidence and clinical course of nosocomial UTI in male vs. female patients Cumulative incidence of nosocomial UTI was significantly higher in female than in male patients (p < 0.001) (Figure 4 ). Moreover, female sex was identified as an independent risk factor for the incidence of UTI in the multivariate competing risk analysis (HR: 2.16; p < 0.001). Other independent risk factors for UTI included use of a urinary catheter (HR: 3.94, p < 0.001) and a higher MELD score (HR: 1.39; p = 0.008) (Table 2 c). Of note, considering only male patients urinary catheter was detected as the only risk factor (HR: 5.4, p<0.001). Overall, in 24 female patients with nosocomial UTI a pathogen was detected (48 %). Gram-positive bacteria and gram-negative bacteria were detected in 62% and 54 %, respectively. In 11 female patients more than one pathogen was present. However, this was mostly due to the presence of Candida species. Further, in 24 of the male patients a pathogen was detected (59 %). Gram-positive bacteria were identified in 16 male patients (67 %) while gram-negative bacteria were present in 10 men (41 %) and in 6 male patients more than one pathogen was detected (Suppl. Table 1). Of note, among those with nosocomial UTI, sex was not documented as relevant risk factor for mortality/LTx (Table 3 c). Discussion There are significant differences in the etiology and the progression of liver disease between men and women (5-7). Moreover, in those with end stage liver disease sex has been documented as a relevant factor with respect to the likelihood for transplantation and survival in some studies (14, 15). Nosocomial infections are a common and particularly severe complication at this stage that significantly alter the natural course of the disease (36). Men and women differ in various parts including the distribution of immune cells (10). Thus, we hypothesized that differences in the incidence and outcome of infections need to be considered that would partly explain the differences in the outcome of advanced liver cirrhosis that was documented between sexes in some studies. However, in our large well-defined cohort no major differences between male and female patients were identified. There was a slightly, numerically lower incidence of nosocomial infections in male patients. However, this was not statistically significant after adjusting for the severity of liver disease and other relevant confounders. Moreover, the difference between males and females was mostly related to the higher incidence of UTI that was documented in female patients. The higher incidence of UTI is not surprising and well in line to other studies (37-40). Of note, nosocomial UTI was not linked to a higher mortality compared to other infections. Thus, it seems unlikely that this results in a higher waiting list mortality that was described in prior studies (14, 16, 17, 41). Of note, there was a trend towards a higher incidence of SBP in male patients. In line with our data O´Leary et al reported a numerical higher incidence of SBP in men compared to women. However, this was not further investigated (16). The main route of SBP is bacterial translocation from the intestinum (42). Recent studies pointed out that the gut microbiome differs between men and women (43, 44), which may alter the likelihood for SBP as well as detectable bacteria. Indeed, there were some minor differences in the detected pathogens between male and female patients with SBP. However, the numbers were too small to draw any meaningful conclusion. Infections are without a doubt one of the major hazards when managing female as well as male patients with end-stage liver disease. Early diagnosis, immediate treatment and in particular the development of prophylactic measures are key challenges to improve patients’ outcome. Therefore, it is important to define risk factors for infections in general as well as specific sites of infection in this cohort. We identified the presence of a peritoneal and urinary catheter as risk factor for the and development of nosocomial SBP and UTI, respectively. This was not different between male and female patients. Of note, in male patient urinary catheter was even the only independent risk factor for UTI. The high prevalence of UTIs in patients with urinary catheter is well in line with studies investigating the incidence of UTI in non-cirrhotic cohorts (45). Temporary urinary catheter might be useful to document urinary output if required for patient management. The placement of a peritoneal catheter in hospitalized patients with ascites is not so common, so far. Nevertheless, repetitive paracentesis can be avoided (46). However, our data emphasize that the indication for urinary catheter as well as peritoneal catheters should be critically evaluated and be removed as soon as possible (47). This of particular importance in patients with decompensated cirrhosis who are particularly vulnerable for infections (48, 49). The main limitation of our study is the retrospective single-center design. Therefore, some aspects of the management of patients might be center specific and the clinical diagnosis of infection may vary between the treating physicians. However, a large number of patients was included in our study and our data provides some valuable information for future research questions. Moreover, it is to our best knowledge the first study that specifically addressed the impact of sex on the incidence and outcome of nosocomial infections among patients with decompensated liver cirrhosis. To conclude, women developed only a numerical higher incidence of nosocomial infections, which are mostly due to a higher risk for UTI. Similar risk factors need to be considered for both sexes, which includes the use of temporary catheters. However, male and female do not differ with respect to the outcome of infections with respect to AKI, ACLF and LTx-free survival. Thus, a similar management seems appropriate. Abbreviations LTx-free survival: Liver transplant free survival; AKI: Acute kidney injury; ACLF: Acute on chronic liver failure; UTI: Urinary tract infection; SBP: Spontaneous bacterial peritonitis; HIV: Human Immunodeficiency Virus; GFR: glomerular filtration rate; EASL: The European Association for the Study of the Liver; LTx: liver transplantation; PPI: Proton pump inhibitors; CRP: C-reactive protein; AIC: Akaike’s information criterion; HR: Hazard Ratio; CI: Confidence interval Declarations Conflict of interest: No conflict of interest was present in the current study. 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Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology. 2013 Jun;144(7):1426-9. 25. Maiwall R, Sarin SK, Kumar S, Jain P, Kumar G, Bhadoria AS, et al. Development of predisposition, injury, response, organ failure model for predicting acute kidney injury in acute on chronic liver failure. Liver Int. 2017 10;37(10):1497-507. 26. Kim JJ, Tsukamoto MM, Mathur AK, Ghomri YM, Hou LA, Sheibani S, et al. Delayed paracentesis is associated with increased in-hospital mortality in patients with spontaneous bacterial peritonitis. Am J Gastroenterol. 2014 Sep;109(9):1436-42. 27. Arroyo V, Jalan R. Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics. Semin Liver Dis. 2016 05;36(2):109-16. 28. Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, et al. Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis. Hepatology. 2015 Jul;62(1):243-52. 29. European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 Aug;69(2):406-60. 30. Angeli P, Gines P, Wong F, Bernardi M, Boyer TD, Gerbes A, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. Gut. 2015 Apr;64(4):531-7. 31. Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. Journal of the American statistical association. 1999;94(446):496-509. 32. Stepwise Covariate Selection for the Fine & Gray Competing Risks Regression Model [Internet].; 2015 [updated Feb 23,; cited 19.03.2019]. Available from: https://cran.r-project.org/web/packages/crrstep/crrstep.pdf. 33. Kuk D, Varadhan R. Model selection in competing risks regression. Stat Med. 2013;32(18):3077-88. 34. crrstep.output: Transform the result of ccrstep [Internet].; 2017 [updated Sep 23,; cited 19.03.2019]. Available from: https://rdrr.io/github/SophiaJia/Jsurvformat/man/crrstep.output.html#heading-1. 35. Package 'cmprsk' [Internet]. [cited 02.09.2019]. Available from: https://cran.r-project.org/web/packages/cmprsk/cmprsk.pdf. 36. Villanueva C, Albillos A, Genescà J, Garcia-Pagan JC, Brujats A, Calleja JL, et al. Bacterial infections adversely influence the risk of decompensation and survival in compensated cirrhosis. J Hepatol. 2021. 37. Reuken PA, Stallmach A, Bruns T. Mortality after urinary tract infections in patients with advanced cirrhosis - Relevance of acute kidney injury and comorbidities. Liver Int. 2013 Feb;33(2):220-30. 38. Fasolato S, Angeli P, Dallagnese L, Maresio G, Zola E, Mazza E, et al. Renal failure and bacterial infections in patients with cirrhosis: epidemiology and clinical features. Hepatology. 2007 Jan;45(1):223-9. 39. Rabinovitz M, Prieto M, Gavaler JS, Van Thiel DH. Bacteriuria in patients with cirrhosis. J Hepatol. 1992 Sep;16(1-2):73-6. 40. Cadranel JF, Denis J, Pauwels A, Barbare JC, Eugène C, di Martino V, et al. Prevalence and risk factors of bacteriuria in cirrhotic patients: a prospective case-control multicenter study in 244 patients. J Hepatol. 1999 Sep;31(3):464-8. 41. Lai JC, Terrault NA, Vittinghoff E, Biggins SW. Height contributes to the gender difference in wait-list mortality under the MELD-based liver allocation system. Am J Transplant. 2010 Dec;10(12):2658-64. 42. Ramachandran A, Balasubramanian KA. Intestinal dysfunction in liver cirrhosis: Its role in spontaneous bacterial peritonitis. J Gastroenterol Hepatol. 2001 Jun;16(6):607-12. 43. Min Y, Ma X, Sankaran K, Ru Y, Chen L, Baiocchi M, et al. Sex-specific association between gut microbiome and fat distribution. Nature communications. 2019;10(1):1-9. 44. Takagi T, Naito Y, Inoue R, Kashiwagi S, Uchiyama K, Mizushima K, et al. Differences in gut microbiota associated with age, sex, and stool consistency in healthy Japanese subjects. J Gastroenterol. 2019;54(1):53-63. 45. Geerlings SE. Clinical presentations and epidemiology of urinary tract infections. Urinary Tract Infections: Molecular Pathogenesis and Clinical Management. 2017:27-40. 46. Stratmann K, Fitting D, Zeuzem S, Bojunga J, Trebicka J, Friedrich-Rust M, et al. Establishing an indwelling peritoneal catheter as a standard procedure for hospitalized patients with ascites: Retrospective data on feasibility, effectiveness and safety. United European gastroenterology journal. 2019;7(5):673-81. 47. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clinical infectious diseases. 2010;50(5):625-63. 48. Schultalbers M, Tergast TL, Simon N, Kabbani A, Kimmann M, Zu Siederdissen CH, et al. Frequency, characteristics and impact of multiple consecutive nosocomial infections in patients with decompensated liver cirrhosis and ascites. United European gastroenterology journal. 2020;8(5):567-76. 49. Fernández J, Navasa M, Gómez J, Colmenero J, Vila J, Arroyo V, et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis. Hepatology. 2002 Jan;35(1):140-8. Additional Declarations No competing interests reported. Supplementary Files SuppFig1.png Supplementary Figure 1: Flowchart of patient recruitment Abbreviations: HCC: hepatocellular carcinoma; HIV: Human Immunodeficiency Virus SupplementaryTable1.docx Supplementary Table 1 Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revision 13 Dec, 2021 Reviews received at journal 30 Nov, 2021 Reviewers agreed at journal 22 Nov, 2021 Reviewers invited by journal 22 Nov, 2021 Editor assigned by journal 22 Nov, 2021 Editor invited by journal 18 Nov, 2021 Submission checks completed at journal 18 Nov, 2021 First submitted to journal 10 Nov, 2021 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1068542","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":64437307,"identity":"0fae0d46-1784-4d4a-9cfd-079ae894021a","order_by":0,"name":"Marie Griemsmann","email":"","orcid":"","institution":"Hannover Medical School","correspondingAuthor":false,"prefix":"","firstName":"Marie","middleName":"","lastName":"Griemsmann","suffix":""},{"id":64437308,"identity":"ded28718-f74f-4992-83f7-58b5b22f736c","order_by":1,"name":"Tammo L. Tergast","email":"","orcid":"","institution":"Hannover Medical School","correspondingAuthor":false,"prefix":"","firstName":"Tammo","middleName":"L.","lastName":"Tergast","suffix":""},{"id":64437309,"identity":"5f098bc6-fea6-4976-a45f-130b302eaab1","order_by":2,"name":"Nicolas Simon","email":"","orcid":"","institution":"Hannover Medical School","correspondingAuthor":false,"prefix":"","firstName":"Nicolas","middleName":"","lastName":"Simon","suffix":""},{"id":64437310,"identity":"8de830c7-afc8-4e52-a337-a0086b65b7c4","order_by":3,"name":"Abdul-Rahman Kabbani","email":"","orcid":"","institution":"Hannover Medical School","correspondingAuthor":false,"prefix":"","firstName":"Abdul-Rahman","middleName":"","lastName":"Kabbani","suffix":""},{"id":64437311,"identity":"c2097282-f1d9-4c30-a760-9cdce7518acc","order_by":4,"name":"Michael P. 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Abbreviations: LTx: liver transplantation\n","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/e61c23ad3fbc971954ebb622.png"},{"id":15785491,"identity":"83559ff4-55dd-4c5f-8c2c-3f9528f85203","added_by":"auto","created_at":"2021-11-22 15:51:44","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":53680,"visible":true,"origin":"","legend":"Distribution of site of nosocomial infection\nIn some patients more than one nosocomial infection was present. Abbreviations: SBP: spontaneous bacterial peritonitis; UTI: urinary tract infection","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/344a21f1b7e464f6e0b5efac.png"},{"id":15786158,"identity":"fca585bd-3985-4afc-bee1-c5d1d0be7011","added_by":"auto","created_at":"2021-11-22 15:54:43","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":46634,"visible":true,"origin":"","legend":"Incidence of nosocomial SBP\nDeath and LTx were treated as competing risk. Abbreviations: LTx: liver transplantation; SBP: spontaneous bacterial peritonitis","description":"","filename":"Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/5fbdc5526e8b6ba5f57f2576.png"},{"id":15786159,"identity":"de6170a0-7c2b-4873-8e1a-a26ecfdfaeab","added_by":"auto","created_at":"2021-11-22 15:54:44","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":40969,"visible":true,"origin":"","legend":"Incidence of nosocomial UTI\nDeath and LTx were treated as competing risk. Abbreviations: LTx: liver transplantation; UTI: urinary tract infection","description":"","filename":"Fig4.png","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/16fe9d541bd661ec09b0064a.png"},{"id":15786170,"identity":"9c7aebc5-32a6-4353-aeea-5f56cfb2ad5d","added_by":"auto","created_at":"2021-11-22 15:54:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":663578,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/f74091f1-6130-475f-afdf-2f1ec286a8f8.pdf"},{"id":15785486,"identity":"0eda6552-582b-42a3-9a1d-2bc7c813e123","added_by":"auto","created_at":"2021-11-22 15:51:43","extension":"png","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":45017,"visible":true,"origin":"","legend":"Supplementary Figure 1: Flowchart of patient recruitment\nAbbreviations: HCC: hepatocellular carcinoma; HIV: Human Immunodeficiency Virus","description":"","filename":"SuppFig1.png","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/542f8a2d76cdb01758f8b768.png"},{"id":15785489,"identity":"89ef57f9-e1cd-438e-babf-1b95f2a10349","added_by":"auto","created_at":"2021-11-22 15:51:44","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":13941,"visible":true,"origin":"","legend":"Supplementary Table 1","description":"","filename":"SupplementaryTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-1068542/v1/8c65ee1a4cae717d04be54f6.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eSex Specific Differences in Nosocomial Infections in Patients with Decompensated Liver Cirrhosis\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOver the recent years sex specific differences gain an increasing attention in medical research. Relevant differences include pharmacokinetic and pharmacodynamics of drugs, prevalence as well as natural history of several diseases (1-4). This certainly also affects the field of hepatology. E.g. women are more likely to suffer from autoimmune hepatitis and primary biliary cholangitis (5, 6) whereas men develop more frequently primary sclerosing cholangitis (7). Further, the progression of liver disease to fibrosis and cirrhosis differs. The toxic effect of alcohol is greater in females than in males, which leads to faster development of fibrosis in women with alcohol-related liver disease (8-10). However, this progress is opposite in other etiologies of cirrhosis such as hepatitis B and C (11), hemochromatosis and primary biliary cholangitis (9, 12). These differences were partly explained by diverse levels of sex hormones. Of note, the advantage of female sex in patients with hepatitis C diminishes after the menopause (9, 13).\u003c/p\u003e \u003cp\u003eRecently, several studies suggested sex specific differences in end stage liver disease. Female patients with decompensated liver cirrhosis on the waiting list for liver transplantation were more likely to die and less likely to be transplanted than male patients in some studies (14, 15). The impact of creatinine in MELD score has been suggested as a possible explanation (16, 17). However, this remains controversial. Of note, Mariante-Neto et al. did not observe any differences in survival and chance for transplant between sexes in a similar study design (18) and the study by Umemura et al. even documented a better survival for female patients (19).\u003c/p\u003e \u003cp\u003eOne of the most common and severe complication in end stage liver disease are infections, particularly if acquired during hospitalization. The natural history of liver cirrhosis is significantly altered by an infection (20). Mortality is four times increased (21). Even after resolution of infection the survival remains impaired (20, 22). Moreover, infections trigger further cirrhosis-associated complications such as hepatic encephalopathy (23), acute-on-chronic liver failure (ACLF) (24) and acute kidney injury (AKI) (25). Fast diagnosis and adequate treatment of infections as well as sufficient measures for prophylaxis are absolutely crucial, in particular in those with decompensated liver disease (26). Therefore, it is of particular importance to know about the most common sites of infection and specific risk factors. Of note, the influence of sex on the incidence and clinical outcome of as well as risk factors for nosocomial infections in patients with decompensated liver cirrhosis has rarely been investigated in detail, so far.\u003c/p\u003e \u003cp\u003eThis study aimed to study sex specific differences in incidence and the clinical course of as well as risk factors for nosocomial infections in a large real-world cohort of patients with decompensated liver cirrhosis and ascites.\u003c/p\u003e"},{"header":"Patients And Methods","content":"\u003cdiv\u003e\n \u003ch2\u003ePatient cohort\u003c/h2\u003e\n \u003cp\u003eA number of 1314 consecutive patients who underwent a paracentesis from January 2012 until April 2018 at Hannover Medical School were considered for the study. In a first step, patients were selected automatically by the Enterprise Clinical Research Data Warehouse to avoid selection bias. Afterwards, the medical records of the patients were checked manually for inclusion and exclusion criteria leaving 556 individuals for the final analysis. Exclusion criteria included insufficient evidence of cirrhosis, malignant tumor disease other than hepatocellular carcinoma within the MILAN criteria, secondary intraabdominal infection, no sufficient follow up of nosocomial infection, HIV infection, congenital immune dysfunction, history of organ transplantation and no sufficient informed consent (Suppl. Figure1).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eData collection\u003c/h2\u003e\n \u003cp\u003eClinical information like presence of infection, age, medication, AKI, ACLF and death was collected manually from the patients\u0026rsquo; files. Laboratory values at time of admission and time of infection were extracted automatically by the Enterprise Clinical Research Data Warehouse. Diagnosis of liver cirrhosis was confirmed by ultrasound, elastography, liver histology, biochemical results and/or a combination of the above. Definition of infection was based on the judgement of the treating physician and/or clinical symptoms in combination with the following criteria:\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eSpontaneous bacterial peritonitis (SBP): \u0026ge; 500 nucleus containing cells/mm\u003csup\u003e3\u003c/sup\u003e ascites fluid\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eUrinary tract infection (UTI): leukocyturia and/or positive urine cultures and/or significant germination number as well as respective clinical signs of infection\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003ePneumonia: evidence of pulmonary infiltrates in X-ray and respective clinical signs of infection\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eBlood stream infection: clinical signs of infection and positive blood cultures\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n \u003cp\u003eAKI and ACLF were defined according to the guidelines of \u0026ldquo;The European Association for the Study of the Liver\u0026rdquo; (EASL) (24, 27-30).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ch2\u003eStudy design\u003c/h2\u003e\n \u003cdiv\u003e\n \u003ch2\u003eSex specific differences in the incidence of nosocomial infections\u003c/h2\u003e\n \u003cp\u003eThe patients were followed up 28 days from hospital admission for nosocomial infections. A competing risk analysis was performed handling death and LTx as competing events. As potential risk factors for any nosocomial infection sex, diabetes, age as well as MELD score, and platelets (both indicating the severity of liver disease) were included. In the univariate and multivariate competing risk analysis for incidence of nosocomial SBP the following parameters were considered for the model: presence of peritoneal catheter, antibiotic prophylaxis with norfloxacin and prior SBP. When analyzing potential risk factors for nosocomial UTI presence of a urinary catheter was added to the multivariate model. In a second step the cohort was divided into the two subgroups (female and male patients) to evaluate if specific risk factors for the development of a nosocomial infection are sex-specific.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv\u003e\n \u003ch2\u003eSex specific differences in the outcome of nosocomial infection\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eLTx-free survival\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePrimary end point was liver transplantation or death (LTx-free survival) within 28 days after the onset of any nosocomial infection, SBP and UTI, respectively. Parameters considered for the univariate and multivariate Cox-Regression model were\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003ePatients characteristics: sex, age, diabetes and esophageal varices\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eMedication: \u0026beta;-Blocker and PPI intake\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eLaboratory values: MELD score, albumin, CRP, leukocytes, sodium and platelets. Protein in ascites and nucleus containing cells in ascites were additionally included in the analysis for LTx-free survival after SBP.\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n \u003cp\u003e\u003cstrong\u003eIncidence of AKI\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA competing risk model with LTx and death as competing risk was chosen. Follow-up was 28-days after the onset of nosocomial infection was completed. All patients with dialysis or occurrence of AKI before the onset of nosocomial infection were excluded from this analysis. The multivariate competing risk model was adjusted to the parameters sex, MELD score, CRP and platelets. All laboratory values were assessed at the onset of the infection.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eIncidence of ACLF\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA competing risk analysis with death and LTx as competing risk was performed. Follow-up was 28-days before the onset of nosocomial infection. The multivariate competing risk model was adjusted to the parameters sex, MELD score, CRP and platelets.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ch2\u003eStatistics\u003c/h2\u003e\n \u003cp\u003eAll analyses were performed with IBM SPSS Statistics 26. Continuous variables were expressed as means and categorical variables as percentages. T-test was used for continuous variables and chi-square-test for categorical variables.\u003c/p\u003e\n \u003cp\u003eTo asses LTx-free survival univariate and multivariate Cox-regression (backward conditional) were applied. All parameters with p \u0026le; 0.05 and the investigated factor sex were included in multivariate analysis.\u003c/p\u003e\n \u003cp\u003eIncidence of nosocomial infection, incidence of AKI and incidence of ACLF were analyzed by competing risk analysis. Multivariate competing risk analyses were performed in R Studio 3.5.2 with \u0026lsquo;crrstep-package\u0026rsquo; (31-33). Backward direction was chosen and AIC criterion selected. Transformation into p-values and Hazard Ratios was done by using the function crrstep.output (34). Cumulative incidences were executed with \u0026lsquo;cmprsk\u0026rsquo; package (35).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv\u003e\n \u003ch2\u003eEthics\u003c/h2\u003e\n \u003cp\u003eThe study was approved by the local ethic committee of Hannover Medical School (Nr. 7935_BO_K_2018) and was performed according to the Declaration of Helsinki. All included patients provided sufficient written informed consent for the scientific use of their clinical data at hospital admission.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eStudy cohort\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOverall, 203 (36.5 %) women and 353 (63.5 %) men were included in the study cohort. The mean age of the individuals was 57 years. There were some differences in the baseline characteristics between female and male patients: Alcohol-related liver disease was more common in men (p = 0.002) whereas cholestatic (p = 0.011) etiology was more frequent in women. Esophageal varices were more often present in male than in female patients (p = 0.003). Further, the MELD score (p = 0.016) and the Serum-Creatinine (p = 0.003) were higher in men. Moreover, men had a lower platelet count (p = 0.029). The detailed baseline characteristics are displayed in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBaseline characteristics\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAll patients\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003e(n=203, 36.5\u0026nbsp;%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003e(n=353, 63.5\u0026nbsp;%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.8 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.3 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.1 (11.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.448\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEtiology of liver cirrhosis\u003c/p\u003e\n \u003cp\u003e\u0026bull; Alcohol-related\u003c/p\u003e\n \u003cp\u003e\u0026bull; Cryptogenic\u003c/p\u003e\n \u003cp\u003e\u0026bull; Viral\u003c/p\u003e\n \u003cp\u003e\u0026bull; NASH\u003c/p\u003e\n \u003cp\u003e\u0026bull; Cholestatic\u003c/p\u003e\n \u003cp\u003e\u0026bull; Other\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mixed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52\u0026nbsp;% (n=291)\u003c/p\u003e\n \u003cp\u003e11\u0026nbsp;% (n=61)\u003c/p\u003e\n \u003cp\u003e18\u0026nbsp;% (n=102)\u003c/p\u003e\n \u003cp\u003e7\u0026nbsp;% (n=38)\u003c/p\u003e\n \u003cp\u003e8\u0026nbsp;% (n=42)\u003c/p\u003e\n \u003cp\u003e14\u0026nbsp;% (n=79)\u003c/p\u003e\n \u003cp\u003e10\u0026nbsp;% (n=55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u0026nbsp;% (n=89)\u003c/p\u003e\n \u003cp\u003e13\u0026nbsp;% (n=27)\u003c/p\u003e\n \u003cp\u003e17.2\u0026nbsp;% (n=35)\u003c/p\u003e\n \u003cp\u003e7\u0026nbsp;% (n=15)\u003c/p\u003e\n \u003cp\u003e11\u0026nbsp;% (n=23)\u003c/p\u003e\n \u003cp\u003e16\u0026nbsp;% (n=33)\u003c/p\u003e\n \u003cp\u003e9\u0026nbsp;% (n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57\u0026nbsp;% (n=202)\u003c/p\u003e\n \u003cp\u003e10 % (n=34)\u003c/p\u003e\n \u003cp\u003e19\u0026nbsp;% (n=67)\u003c/p\u003e\n \u003cp\u003e7\u0026nbsp;% (n=23)\u003c/p\u003e\n \u003cp\u003e5\u0026nbsp;% (n=19)\u003c/p\u003e\n \u003cp\u003e13\u0026nbsp;% (n=46)\u003c/p\u003e\n \u003cp\u003e10\u0026nbsp;% (n=36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.183\u003c/p\u003e\n \u003cp\u003e0.610\u003c/p\u003e\n \u003cp\u003e0.694\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.294\u003c/p\u003e\n \u003cp\u003e0.750\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePPI (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81\u0026nbsp;% (n=445)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77\u0026nbsp;% (n=154)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83\u0026nbsp;% (n=291)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026Beta;-blockers (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u0026nbsp;% (n=212)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34\u0026nbsp;% (n=69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41\u0026nbsp;% (n=143)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEsophageal varices (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76\u0026nbsp;% (n=422)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69\u0026nbsp;% (n=140)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80\u0026nbsp;% (n=282)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiabetes (n, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u0026nbsp;% (n=135)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u0026nbsp;% (n=47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026nbsp;% (n=88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.638\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMELD score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17 (6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19 (7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.016\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlbumin (g/l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.1 (5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.6 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.4 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.273\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBilirubin (\u0026micro;mol/l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.9 (135.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86.6 (130.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.9 (138.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.488\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCRP (mg/l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.4 (34.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.1 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.5 (32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.903\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eINR (Ratio)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.53 (0.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.49 (0.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.55 (0.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCreatinine (\u0026micro;mol/l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e130.6 (89.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e115.6 (70.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e139.2 (97.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeukocytes (10\u003csup\u003e3\u003c/sup\u003e/\u0026micro;l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.8 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.3 (5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePlatelets (10\u003csup\u003e3\u003c/sup\u003e/\u0026micro;l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e147.6 (102.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e160 (119.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e140 (90.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.029\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSodium (mmol/l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e134 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e134 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e134 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAntibiotic intake within 12 weeks before admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u0026nbsp;% (n=180)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32\u0026nbsp;% (n=64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u0026nbsp;% (n=116)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.818\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eAll continues variables are displayed as mean with standard deviation. Categorical variables are displayed as proportions.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eLaboratory values were assessed at time of admission.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eAbbreviations: MELD: Model of end stage liver disease; PPI: Proton pump inhibitors; CRP: C-reactive protein; INR: International normalized Ratio\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cem\u003eIncidence and clinical course of a nosocomial infection in male vs. female patients\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOverall, 258 patients (111 women and 174 men) developed a nosocomial infection. The cumulative incidence function indicated no major difference in the incidence of nosocomial infections between male and female patients (p = 0.283) (Figure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Of note, after adjusting for other risk factors in the multivariate competing risk model, male sex was linked to a numerical lower hazard (HR: 0.81; p = 0.076). However, a statistically significant link to the incidence of nosocomial infections was only found for the MELD score (HR: 1.05; p \u0026lt; 0.001) (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003ea). Noteworthy, this was also consistent in both subgroups (female and male patients) and no sex-specific risk factors were detected.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u003cimg 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\"\u003e\u003c/div\u003e\n\u003cp\u003eOutcome measures of nosocomial infection were AKI, ACLF and LTx-free survival. There was no difference between male and female patients in terms of the incidence of AKI, ACLF (data not shown) and LTx-free survival in the multivariate analysis (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003ea).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab5\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cstrong\u003ea\u003c/strong\u003e: Uni- and multivariate Cox-regression of LTx-free survival after the onset of nosocomial infection\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eUnivariate\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMultivariate\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHazard Ratio (CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHazard Ratio (CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSex (male)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.724\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.906 (0.522; 1.570)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.420\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.991 (0.968; 1.014)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.763\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.908 (0.486; 1.698)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEsophageal varices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.705\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.891 (0.490; 1.620)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;-Blocker\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.333 (0.163; 0.683)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.056\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.445 (0.194; 1.022)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePPI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.548\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.809 (0.405; 1.615)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMELD score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.123 (1.081; 1.167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.109 (1.066; 1.152)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlbumin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.000 (0.938; 1.067)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCRP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.004 (1.000; 1.007)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeukocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.017 (0.999; 1.036)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSodium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.991 (0.950; 1.034)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePlatelets\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.966 (0.992; 1.000)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003eLaboratory values were assessed at time of the onset of nosocomial infection.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003eAbbreviations: MELD: Model of end stage liver disease; CRP: C-reactive protein; LTx: Liver transplantation; PPI: Proton pump inhibitors; CI: Confidence interval\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab6\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cstrong\u003eb\u003c/strong\u003e: Uni- and multivariate Cox-regression of LTx-free survival after the onset of nosocomial SBP\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eUnivariate\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMultivariate\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHazard Ratio (CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHazard Ratio (CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSex (male)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.696\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.862 (0.410; 1.812)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.659\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.682\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.007 (0.975; 1.039)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.659 (0.269; 1.611)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEsophageal varices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.735\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.870 (0.387; 1.954)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026beta;-Blocker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.247 (0.086; 0.711)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.349 (0.117; 1.038)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePPI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.110 (0.385; 3.199)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMELD score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.131 (1.082; 1.183)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.096 (1.041; 1.154)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlbumin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.953 (0.869; 1.046)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.006 (1.002; 1.009)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.010 (1.005; 1.016)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeukocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.018 (0.998; 1.038)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSodium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.530\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.020 (0.960; 1.083)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePlatelets\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.992 (0.986; 0.998)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.994 (0.988; 1.001)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtein ascites\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.502\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.736 (0.300; 1.802)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNucleus containing cells\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.993 (0.932; 1.059)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eLaboratory values were assessed at time of the onset of nosocomial SBP\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eAbbreviations: LTx: liver transplantation; SBP: spontaneous bacterial peritonitis; MELD: Model of end stage liver disease; CRP: C-reactive protein; CI: Confidence interval\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:200%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:200%;font-family:\"Arial\",sans-serif;'\u003eTable 3 c\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-size:16px;line-height:200%;font-family:\"Arial\",sans-serif;'\u003e: Uni- and multivariate Cox-regression of LTx-free survival after the onset of nosocomial UTI\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width:520.4pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 148.9pt;border-right: none;border-bottom: none;border-left: none;border-image: initial;border-top: 1pt solid black;padding: 0in 5.4pt;height: 28.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eVariable\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 188pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 28.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eUnivariate\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 183.5pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 28.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eMultivariate\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 60.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 17.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eP-value\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.1pt;border: none;background: silver;padding: 0in 5.4pt;height: 17.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eHazard Ratio (CI)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 17.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eP-value\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122.6pt;border: none;background: silver;padding: 0in 5.4pt;height: 17.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eHazard Ratio (CI)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 148.9pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eSex (male)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.533\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.1pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e1.313 (0.557; 3.092)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.769\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122.6pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 148.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 8.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eAge\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 8.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.851\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.1pt;border: none;background: silver;padding: 0in 5.4pt;height: 8.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e1.004 (0.964; 1.045)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 8.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122.6pt;border: none;background: silver;padding: 0in 5.4pt;height: 8.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 148.9pt;border: none;padding: 0in 5.4pt;height: 14.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eDiabetes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;padding: 0in 5.4pt;height: 14.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.560\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.1pt;border: none;padding: 0in 5.4pt;height: 14.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e1.349 (0.493; 3.693)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;padding: 0in 5.4pt;height: 14.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122.6pt;border: none;padding: 0in 5.4pt;height: 14.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 148.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 12.35pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003eEsophageal varices\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border: none;background: silver;padding: 0in 5.4pt;height: 12.35pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.166\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.1pt;border: none;background: silver;padding: 0in 5.4pt;height: 12.35pt;vertical-align: top;\"\u003e\n \u003cp 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normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.223\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.1pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;background: silver;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e0.996 (0.989; 1.002)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60.9pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;background: silver;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122.6pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;background: silver;padding: 0in 5.4pt;height: 15.6pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:200%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size:16px;line-height:200%;font-family:\"Arial\",sans-serif;'\u003eLaboratory values were assessed at time of the onset of nosocomial UTI\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Arial\",sans-serif;'\u003eAbbreviations: LTx: liver transplantation; UTI: urinary tract infection; MELD: Model of end stage liver disease; CRP: C-reactive protein; CI: Confidence interval\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDifferences in the most common sites of nosocomial infections\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOverall, SBP (n = 136, 48 %) was the most frequent nosocomial infection followed by UTI (n = 62, 22 %). We documented only minor differences between male and female patients. SBP was the most frequent site of infection in men constituting to 53 % (n = 96) of the infections. On the contrary, in only 34 % (n = 40) of the infections in female patients a SBP was diagnosed (p=0.048). In contrast, UTI was more common in females. In females 31 % (n = 37) of the nosocomial infections could be attributed to the urinary tract whereas this was only the case in 14 % (n = 25) of the infections in males (p\u0026lt;0.001). Similar rates of pneumonia were detected among the infections in male and female patients (p=0.758), while blood stream infections were more frequent in men (8 % vs 3 %, p=0.154) (Figure \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIncidence and clinical course of as well as risk factor for nosocomial SBP in male vs. female patients\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAlthough SBP was more frequent among the infection in males, the overall cumulative incidence of nosocomial SBP did not differ between male and female patients (p = 0.493) (Figure \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). In the final multivariate competing risk model only presence of a peritoneal catheter (HR: 2.19; p \u0026lt; 0.001) was significantly linked to the development of nosocomial SBP (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003eb) in both female (HR: 3.46; p \u0026lt; 0.001) and male (HR: 1.85; p = 0.002) patients. In female patients the platelet count (HR: 1.003; p = 0.009) was also linked to SBP development.\u003c/p\u003e\n\u003cp\u003eIn 19 female patients (32 %) with nosocomial SBP a pathogen was detected. In the majority of cases (84 %) gram-positive bacteria were identified. Similarly, in 30 male patients with nosocomial SBP (27 %) a pathogen was detected, which were also more frequently gram-positive bacteria (67 %) (Suppl. Table 1).\u003c/p\u003e\n\u003cp\u003eThe LTx-free survival after a nosocomial SBP did not differ between male and female patients (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003eb). Further, there was no difference between male and female patients in terms of the incidence of AKI and ACLF after nosocomial SBP (data not shown).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIncidence and clinical course of nosocomial UTI in male vs. female patients\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eCumulative incidence of nosocomial UTI was significantly higher in female than in male patients (p \u0026lt; 0.001) (Figure \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Moreover, female sex was identified as an independent risk factor for the incidence of UTI in the multivariate competing risk analysis (HR: 2.16; p \u0026lt; 0.001). Other independent risk factors for UTI included use of a urinary catheter (HR: 3.94, p \u0026lt; 0.001) and a higher MELD score (HR: 1.39; p = 0.008) (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003ec). Of note, considering only male patients urinary catheter was detected as the only risk factor (HR: 5.4, p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003eOverall, in 24 female patients with nosocomial UTI a pathogen was detected (48 %). Gram-positive bacteria and gram-negative bacteria were detected in 62% and 54 %, respectively. In 11 female patients more than one pathogen was present. However, this was mostly due to the presence of Candida species. Further, in 24 of the male patients a pathogen was detected (59 %). Gram-positive bacteria were identified in 16 male patients (67 %) while gram-negative bacteria were present in 10 men (41 %) and in 6 male patients more than one pathogen was detected (Suppl. Table 1).\u003c/p\u003e\n\u003cp\u003eOf note, among those with nosocomial UTI, sex was not documented as relevant risk factor for mortality/LTx (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003ec).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThere are significant differences in the etiology and the progression of liver disease between men and women (5-7). Moreover, in those with end stage liver disease sex has been documented as a relevant factor with respect to the likelihood for transplantation and survival in some studies (14, 15). Nosocomial infections are a common and particularly severe complication at this stage that significantly alter the natural course of the disease (36). Men and women differ in various parts including the distribution of immune cells (10). Thus, we hypothesized that differences in the incidence and outcome of infections need to be considered that would partly explain the differences in the outcome of advanced liver cirrhosis that was documented between sexes in some studies. However, in our large well-defined cohort no major differences between male and female patients were identified.\u003c/p\u003e \u003cp\u003eThere was a slightly, numerically lower incidence of nosocomial infections in male patients. However, this was not statistically significant after adjusting for the severity of liver disease and other relevant confounders. Moreover, the difference between males and females was mostly related to the higher incidence of UTI that was documented in female patients. The higher incidence of UTI is not surprising and well in line to other studies (37-40). Of note, nosocomial UTI was not linked to a higher mortality compared to other infections. Thus, it seems unlikely that this results in a higher waiting list mortality that was described in prior studies (14, 16, 17, 41).\u003c/p\u003e \u003cp\u003eOf note, there was a trend towards a higher incidence of SBP in male patients. In line with our data O\u0026acute;Leary et al reported a numerical higher incidence of SBP in men compared to women. However, this was not further investigated (16). The main route of SBP is bacterial translocation from the intestinum (42). Recent studies pointed out that the gut microbiome differs between men and women (43, 44), which may alter the likelihood for SBP as well as detectable bacteria. Indeed, there were some minor differences in the detected pathogens between male and female patients with SBP. However, the numbers were too small to draw any meaningful conclusion.\u003c/p\u003e \u003cp\u003eInfections are without a doubt one of the major hazards when managing female as well as male patients with end-stage liver disease. Early diagnosis, immediate treatment and in particular the development of prophylactic measures are key challenges to improve patients\u0026rsquo; outcome. Therefore, it is important to define risk factors for infections in general as well as specific sites of infection in this cohort. We identified the presence of a peritoneal and urinary catheter as risk factor for the and development of nosocomial SBP and UTI, respectively. This was not different between male and female patients. Of note, in male patient urinary catheter was even the only independent risk factor for UTI. The high prevalence of UTIs in patients with urinary catheter is well in line with studies investigating the incidence of UTI in non-cirrhotic cohorts (45). Temporary urinary catheter might be useful to document urinary output if required for patient management. The placement of a peritoneal catheter in hospitalized patients with ascites is not so common, so far. Nevertheless, repetitive paracentesis can be avoided (46). However, our data emphasize that the indication for urinary catheter as well as peritoneal catheters should be critically evaluated and be removed as soon as possible (47). This of particular importance in patients with decompensated cirrhosis who are particularly vulnerable for infections (48, 49).\u003c/p\u003e \u003cp\u003eThe main limitation of our study is the retrospective single-center design. Therefore, some aspects of the management of patients might be center specific and the clinical diagnosis of infection may vary between the treating physicians. However, a large number of patients was included in our study and our data provides some valuable information for future research questions. Moreover, it is to our best knowledge the first study that specifically addressed the impact of sex on the incidence and outcome of nosocomial infections among patients with decompensated liver cirrhosis.\u003c/p\u003e \u003cp\u003eTo conclude, women developed only a numerical higher incidence of nosocomial infections, which are mostly due to a higher risk for UTI. Similar risk factors need to be considered for both sexes, which includes the use of temporary catheters. However, male and female do not differ with respect to the outcome of infections with respect to AKI, ACLF and LTx-free survival. Thus, a similar management seems appropriate.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eLTx-free survival: Liver transplant free survival; AKI: Acute kidney injury; ACLF: Acute on chronic liver failure; UTI: Urinary tract infection; SBP: Spontaneous bacterial peritonitis; HIV: Human Immunodeficiency Virus; GFR: glomerular filtration rate; EASL: The European Association for the Study of the Liver; LTx: liver transplantation; PPI: Proton pump inhibitors; CRP: C-reactive protein; AIC: Akaike\u0026rsquo;s information criterion; HR: Hazard Ratio; CI: Confidence interval\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003eNo conflict of interest was present in the current study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial support:\u0026nbsp;\u003c/strong\u003eMS and this study were supported by the \u0026lsquo;KlinStrucMed Programm \u0026ndash; Promotionskolleg\u0026rsquo; funded by the Else Kr\u0026ouml;ner-Fresenius-Stiftung. BM was supported by the clinician scientist program of Hannover Medical School.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003e1. Soldin OP, Mattison DR. Sex differences in pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 2009;48(3):143-57.\u003c/p\u003e\n\u003cp\u003e2. Ayyar VS, DuBois DC, Nakamura T, Almon RR, Jusko WJ. Modeling corticosteroid pharmacokinetics and pharmacodynamics, part II: sex differences in methylprednisolone pharmacokinetics and corticosterone suppression. J Pharmacol Exp Ther. 2019;370(2):327-36.\u003c/p\u003e\n\u003cp\u003e3. Regitz-Zagrosek V, Kararigas G. Mechanistic pathways of sex differences in cardiovascular disease. Physiol Rev. 2017;97(1):1-37.\u003c/p\u003e\n\u003cp\u003e4. Pike CJ. Sex and the development of Alzheimer's disease.\u0026nbsp;J Neurosci Res. 2017;95(1-2):671-80.\u003c/p\u003e\n\u003cp\u003e5. Kaplan MM.\u0026nbsp;Primary biliary cirrhosis. N Engl J Med. 1996;335(21):1570-80.\u003c/p\u003e\n\u003cp\u003e6. 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Hepatology. 2002 Jan;35(1):140-8.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Liver cirrhosis, nosocomial, bacterial, sex, gender, E. coli","lastPublishedDoi":"10.21203/rs.3.rs-1068542/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1068542/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cu\u003eBackground and aims:\u003c/u\u003e There are considerable differences between males and females regarding the etiology, progression and outcome of liver diseases. Infections are a frequent and severe complication in these patients. This study aimed to examine sex specific differences in the incidence and clinical course of nosocomial infections in patients with decompensated liver cirrhosis.\u003c/p\u003e\u003cp\u003e\u003cu\u003eMethods:\u003c/u\u003e A number of 555 consecutive patients with decompensated liver cirrhosis and ascites were analyzed. The patients were followed up for the incidence of nosocomial infections, acute kidney injury (AKI), acute-on-chronic liver failure (ACLF) as well as liver transplantation and death (LTx-free survival). \u003c/p\u003e\u003cp\u003e\u003cu\u003eResults:\u003c/u\u003e A number of 285 patients (111 women and 174 men) developed a nosocomial infection. Incidence was numerically lower in men (p=0.076). While the frequency of a nosocomial spontaneous bacterial peritonitis was similar between males and females, the incidence of a nosocomial urinary tract infection was significantly higher in women (p\u0026lt;0.001). No sex specific differences were documented regarding the outcome of an infection as indicated by a similar incidence of, AKI, ACLF as well as LTx-free survival.\u003c/p\u003e\u003cp\u003e\u003cu\u003eConclusion:\u003c/u\u003e There seem to be no major differences in the incidence and outcome of nosocomial infections between male and female patients.\u003c/p\u003e","manuscriptTitle":"Sex Specific Differences in Nosocomial Infections in Patients with Decompensated Liver Cirrhosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-11-22 15:51:42","doi":"10.21203/rs.3.rs-1068542/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2021-12-14T04:18:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-11-30T22:08:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"4c36a5ca-ec46-45b3-9921-6e380eb22121","date":"2021-11-22T08:00:48+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2021-11-22T07:48:27+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2021-11-22T07:46:28+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2021-11-18T20:17:21+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2021-11-18T20:09:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2021-11-10T16:59:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"153d4f52-3604-4a63-8fc5-5f0a58e9d042","owner":[],"postedDate":"November 22nd, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":8671907,"name":"Gastroenterology \u0026 Hepatology"}],"tags":[],"updatedAt":"2022-01-27T07:44:09+00:00","versionOfRecord":[],"versionCreatedAt":"2021-11-22 15:51:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1068542","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1068542","identity":"rs-1068542","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}