123. Impact of Enterococcal Bacteremia on Clinical Outcomes in Patients with Liver Cirrhosis

BACKGROUND: Patients with liver cirrhosis are at an increased risk for bacterial infections due to bacteria overgrowth and dysregulation of the intestinal barrier function. These infectious complications are associated with significant morbidity and mortality. Currently, there is a paucity of literature evaluating the clinical outcomes of patients with enterococcal bacteremia and cirrhosis. We hypothesized that patients with cirrhosis and subsequent enterococcal bacteremia would have a higher odds of mortality. METHODS: This was a retrospective, case–control study including adult patients (>18 years) with liver cirrhosis and >1 positive blood culture with Enterococcus species (ENT) admitted from June 2013 through August 2018. These cases were then matched with cirrhotic patients without enterococcal bacteremia (NO ENT) in a 1:1 ratio based on the Model for End-Stage Liver Disease (MELD) score. The primary endpoint was all-cause inpatient mortality. Multivariable logistic regression was used to control for other patient covariates. RESULTS: A total of 136 patients were identified during the study period (68 ENT and 68 NO ENT). The median length of stay was significantly longer in ENT patients (24.5 vs. 9 days, P < 0.001), while NO ENT patients were more likely to have renal dysfunction (55.9% vs. 83.8%, P < 0.001). All other baseline characteristics between the two groups were similar. Inpatient mortality was found to be significantly higher in ENT patients than NO ENT patients (51.5% vs. 29.4%, P = 0.009). In the multivariable analysis, risk factors found to be independently associated with mortality included enterococcal bacteremia (OR 3.96, 95% CI 1.61–9.73), MELD score (OR 1.11, 95% CI 1.05–1.19), and APACHE II score (OR 1.14, 95% CI 1.06–1.23). CONCLUSION: Enterococcal bacteremia, MELD score, and APACHE II score were found to be independent risk factors for all-cause inpatient mortality in patients with liver cirrhosis. Future studies are needed to elucidate how treatment choice and bacterial characteristics might also influence patient outcomes. DISCLOSURES: All authors: No reported disclosures.