Clinical and microbiological characteristics of pyogenic liver abscess in a tertiary hospital in East China. Issue 37 (September 2017)

• Record Type: Journal Article
• Authors: Kong, Haishen; Yu, Fei; Zhang, Weili; Li, Xuefen
• Other Names: Kantarçeken. Bülent section editor.
• Is Part Of: Medicine. Volume 96:Issue 37(2017)
• Publication Date: 2017-09
• Subjects: antibiotic resistance -- Klebsiella pneumonia -- pyogenic liver abscess; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008050
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Pyogenic liver abscess (PLA) is a potentially life-threatening disease affecting many parts of the world, especially Asia. In this study, we explored the clinical and microbiological characteristics of PLA in Chinese patients. A 5-year (2010–2014) retrospective review of medical records on all PLA patients who were admitted to a tertiary teaching hospital was performed. Among 217 PLA cases who were confirmed cultural positive, Klebsiella pneumonia ( K pneumonia) was the most common pathogen (n = 165, 76.0%), followed by Escherichia coli (n = 21, 9.7%). Notably, there is a higher incidence of diabetes mellitus in patients with K pneumoniae -induced PLA (KP-PLA) than that with non- K pneumoniae -induced PLA (non-KP-PLA)(43.0% vs 21.2%, P = .005). However, it was less prevalent for concomitant hepatobiliary disease (20.0% vs 34.6%, P = .039) and history of intraabdominal trauma or surgery (13.3% vs 38.5%, P < .001) in patients with KP-PLA. Although K pneumoniae are sensitive to most common antibiotics (antibiotic resistance rates below 10%), some strains (1.2%) developed resistant to carbapenem. These results confirmed K pneumoniae as the predominant pathogen of PLA in the area in which the study was conducted. More attention should be directed toward monitoring the emergence of carbapenem-resistant K pneumoniae . KP-PLA is frequently diagnosed in patients with metabolic diseases accompanied by serious consequences, and it is therefore prudent to see that they receive sensitivity-directed antibiotic therapy.