Epidemiological, Clinical, Microbiological, and Risk Factors of Pyogenic Liver Abscess: An 18-years Retrospective Single-Center Analysis

Abstract

Background: A pyogenic liver abscess (PLA) is the most frequently observed subtype of liver abscess in the western world. The disease has been subjected to a remarkable change. We aimed to investigate the recent trend in pyogenic liver abscess's epidemiology, clinical, microbiological, and risk factors features. Methods: A retrospective analysis of medical records was done for the patients diagnosed with PLA from January 2000 to June 2018. The institutional review board approved the study. Results: We identified 113 patients with PLA, 60% were males, with a mean age of 54 ± 20 years, and 58 ± 19 years old for males and females, respectively (p = 0.298), with an increasing annual incidence in 2012-2013, and 2016-2017 (Figure 1). Fever and right upper quadrant abdominal pain were the most common symptoms (65%, 55%, respectively). Forty percent of the patients had Biliary tract diseases like cholecystitis or biliary intervention as cholecystectomy or ERCP, and 20% had diabetes mellitus (Table 1). The abscess culture was obtained in 96 cases, 37 cases were negative (39%), 27 cases showed polymicrobial growth (28%) and 15 cases showed Escherichia coli (16%) (Figure 2). The abscess cultures were mostly negative in the first 5 years, then changed to Streptococcus anginosus, and polymicrobial growth in the last four years. Conclusions: PLA is more common in males with a recent increase in incidence. Culture negative PLA was observed in patients who were empirically treated with antibiotics. Polymicrobial was the most common identifiable organism with a change in the microbiological trend every 5 years.

Pyogenic Liver Abscess Caused by Staphylococcus hominis: A Case Report

“…Apart from K. pneumoniae , Escherichia coli is also a frequently identified pathogen in pyogenic liver abscess. Other common pathogenic bacteria includes Enterococcus species and Streptococcus anginosus 13 . Here we report a rarely identified pathogenic bacterium, S. hominis as the causative agent of the multiple liver abscesses.…”

“…Other common pathogenic bacteria includes Enterococcus species and Streptococcus anginosus. 13 Here we report a rarely identified pathogenic bacterium, S. hominis as the causative agent of the multiple liver abscesses.…”

Multiple Hepatic Abscesses Secondary to Streptococcus anginosus Infection: A Case Report and Review of the Literature

“…Hepatic abscesses are rare disease entities, with an approximate annual incidence of 2.3 per 100,000 people [ 3 ], and the etiologic agent is usually polymicrobial [ 4 ]. Common agents include enteric gram-negative bacilli (Escherichia coli, Klebsiella pneumonia), Streptococcus milleri group (SMG), and anaerobes.…”

Clinical efficacy of ulinastatin in the treatment of unliquefied pyogenic liver abscess complicated by septic shock: A randomized controlled trial

“…The incidence of PLA is higher in Asia compared to Europe and the United States, with an annual incidence of 1.1−5.4/100,000 in China 3 , 4 and up to 17.6/100,000 in Taiwan, and 1.0−4.1/100,000 in European countries and America. 5 , 6 , 7 Due to the rapid advances in medical technology, the diagnosis and treatment of PLA have greatly improved, resulting in a decrease in mortality rates from >80% at the beginning of the previous century to <10%. 8 , 9 In the most recent decade, the changing diet and aging of the global population, coupled with the emergence of diabetes, malignant tumors, and multidrug resistant highly virulent pathogens, account, at least in part, for the annual increase in incidence and mortality rate of PLAs.…”

“…Pyogenic LA (PLAs) account for >80% of LA morbidity. The incidence of PLA is higher in Asia compared to Europe and the United States, with an annual incidence of 1.1−5.4/100,000 in China 3,4 and up to 17.6/100,000 in Taiwan, and 1.0−4.1/100,000 in European countries and America 5–7 . Due to the rapid advances in medical technology, the diagnosis and treatment of PLA have greatly improved, resulting in a decrease in mortality rates from >80% at the beginning of the previous century to <10% 8,9 .…”