Open AccessClinical and microbiological characteristics of pyogenic liver abscess in a tertiary hospital in East China
Author(s) -
Haishen Kong,
Fei Yu,
Weili Zhang,
Xuefen Li
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000008050
Subject(s) - medicine , pyogenic liver abscess , klebsiella pneumoniae , pneumonia , concomitant , incidence (geometry) , antibiotics , retrospective cohort study , carbapenem , liver abscess , gastroenterology , medical record , diabetes mellitus , klebsiella pneumonia , pathogen , surgery , abscess , microbiology and biotechnology , pseudomonas aeruginosa , immunology , bacteria , escherichia coli , endocrinology , chemistry , optics , genetics , biology , biochemistry , physics , gene
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.