Clinical features and etiological analysis of 195 patients with pyogenic liver abscess

JIN Chao; DONG Guo-zhen; LI Xiao-ting; LIU Hong-yu; SU Man; LI Ji-jiao; WEI Yan-chun; WANG Ke-shan; CAI Cai-lian; JIANG Jian-ning; SU Ming-hua

doi:10.19538/j.nk2025110110

Abstract：Objective To explore the clinical and etiological characteristics of patients with pyogenic liver abscess(PLA).Methods The clinical data of 195 patients with PLA whose liver pus culture results were positive in the First Affiliated Hospital of Guangxi Medical University from January 2013 to August 2022 were retrospectively analyzed.According to the etiology of liver abscess,the patients were divided into a group of Klebsiella pneumoniae liver abscess(KPLA)and a group of non-Klebsiella pneumoniae liver abscess(NKPLA),and the clinical differences between the two groups were compared.Results Among the 195 patients with PLA,146 were male and 49 were female;the male to female ratio was 1.0∶0.3.The age ranged from 2 to 89 years,with a mean age of(53.6±13.5)years.The most common underlying disease of PLA was diabetes mellitus,accounting for 55.9％(109/195),followed by liver and biliary system diseases,accounting for 30.8％(60/195).The main pathogenic bacteria of liver pus culture in 195 PLA patients were Kleptococcus pneumoniae(KP),accounting for 78.5％(153/195),followed by Escherichia coli,accounting for 12.8％(25/195).Of the 195 PLA patients,97.4％(190/195)were discharged after treatment,2.1％(4/195)gave up treatment due to deteriorated condition and were discharged,and 0.5％(1/195)died in hospital.The rate of combination with diabetes mellitus and the infection rate of extrahepatic metastasis in KPLA group were higher than those in NKPLA group(both P＜0.05),and patients in NKPLA group had higher rate of combination with liver and biliary tract diseases,bile duct calculus,history of hepatobiliary surgery and malignant tumors than the patients in NKPLA group(all P＜0.05).A total of 153 strains of Kleysiella pneumoniae were detected in 195 patients,of which 145 strains underwent complete drug susceptibility test and 8 strains did not.The results showed that Klebsiella pneumoniae was sensitive to most antimicrobials,but with poor sensitivity to piperacillin,and was 100％resistant to ampicillin.Twenty-five strains of Escherichia coli were detected,of which 21 completed drug susceptibility test and 4 did not.The results showed that Escherichia coli was highly sensitive to cephalosporins and carbapenems,and highly resistant to quinolones and penicillins.Conclusion In the past decade,Klebsiella pneumoniae is the main pathogenic bacteria of PLA in the First Affiliated Hospital of Guangxi Medical University,followed by Escherichia coli.No carbapenem-resistant strains of Klebsiella pneumoniae and Escherichia coli have been found.