Pathogenic characteristics and treatments of bacterial liver abscess
FENG Likui, ZHOU Lin, DU Guosheng
Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital,Hepatobiliary Surgery Department of the 8th Medical Center of PLA General Hospital,Beijing 100091,China
Abstract：Objective To identify the clinical and pathogenic characteristics of patients with bacterial liver abscess (BLA) so as to provide reference for clinical treatment. Methods The clinical data on 112 patients with BLA treated in the 8th Medical Center of PLA General Hospital between January 2015 and December 2020 was retrospectively analyzed. The demographic data, clinical presentation,laboratory examinations,imaging features,microbiological tests and treatments were compared between the group with underlying hepatobiliary diseases and the one without these diseases. Results The age of the patients averaged (58.82±12.36) years. There were 64 cases (57.1%) combined with underlying hepatobiliary diseases. The dominating clinical manifestation of these patients was fever (92.9%),followed by abdominal pain (58%) and chills (41.1%). Chills and elevated Fib were more common in patients without underlying hepatobiliary diseases (χ2=4.21,5.35,P<0.05). However,elevated TBil was more common in patients with underlying hepatobiliary diseases. The majority of cases of BLA were solitary (65.2%) and localized in the right hepatic lobe (65.2%). There was no statistically significant difference in size,number,location or gas-formation of abscesses between the two groups. Bacteria culture was available in 85 patients and 53 cases (62.4%) were positive. The results of bacteria culture showed Klebsiella pneumoniae (54.7%) was the leading pathogen that was sensitive to most antimicrobial agents. Escherichia coli was commonly seen in patients with underlying hepatobiliary diseases (P<0.05). Conclusions The dominant pathogen is Klebsiella pneumoniae that is sensitive to antimicrobials. Escherichia coli infection is commonly seen in patients with underlying hepatobiliary diseases and antibiotic resistance is also more complex so that antibiotics should be used with caution according to results of drug sensitivity test.
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2021, Vol. 32 
