Percutaneous Aspiration Versus Catheter Drainage of Liver Abscess: A Retrospective Review

et al. 2020

BMC Infect Dis

Background: The role of ultrasonography-guided percutaneous fine-needle aspiration (PNA) for pyogenic liver abscess (PLA) remains without consensus, especially in abscesses 3 to 6 cm in diameter. The objective of this study was to evaluate the comparative effectiveness and safety of PNA combined with antibiotics. Methods: This was a retrospective study of patients with PLA that were from 3 to 6 cm in diameter who treated at two medical centers in Shanghai, China, from January 2014 to March 2019. Patients were divided into groups treated by PNA plus antibiotics or antibiotics alone. Patients demographics and clinical data related diagnosis, antibiotic treatment, and patient outcomes were analyzed. Results: Out of a total of 94 PLA patients, 42 (44.7%) patients received PNA combined with antibiotics, and 52 (55.3%) received antibiotics alone. There were no complications related to PNA. In the PNA group, 13 (31.7%) patients with negative blood culture and 8 (19.5%) patients without blood culture were microbiologically confirmed via aspiration. The time for temperature normalization (P < 0.001) and the reduction rate of C-reactive protein within the first week (P = 0.031) were significantly lower in the PNA group. In the multivariate analysis, treatment with PNA was more likely to result in clinical improvement of PLA (odds ratio = 0.33, 95% confidence intervals (CI): 0.11-0.96, P = 0.043). Conclusions: PNA combined with antibiotics appears to be a safe, effective, and promising treatment for PLA of 3-6 cm in size. Furthermore, the technique allows for direct microbial sample, which can improve the selection of antibiotics.

Section: Introductionmentioning

confidence: 99%

Percutaneous fine-needle aspiration for pyogenic liver abscess (3-6 cm): a two-center retrospective study

et al. 2020

BMC Infect Dis

“…In past decades, PCD and antibiotics have been the standard treatments for patients with bacterial liver abscess . Moreover, PCD is a safe, effective, and simple option for those who develop pyogenic liver abscess.…”

Section: Discussionmentioning

confidence: 99%

“…In past decades, PCD and antibiotics have been the standard treatments for patients with bacterial liver abscess. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Moreover, PCD is a safe, effective, and simple option for those who develop pyogenic liver abscess. In particular, PCD is the preferred mode of treatment in patients diagnosed with large abscess (>10 cm).…”

Section: Discussionmentioning

confidence: 99%

Application of ultrasound‐guided percutaneous intrahepatic portal vein catheterization with antibiotic injection for treating unliquefied bacterial liver abscess

Chen

et al. 2016

Hepatology Research

Aim:To investigate whether ultrasound-guided percutaneous portal vein catheterization can be successfully carried out in the intrahepatic region of patients with unliquefied bacterial liver abscess (UBLA), who are subsequently treated with an injection of antibiotics.Methods: Thirty-two UBLA patients were enrolled in this study. Among them, 13 patients were included in the experimental group; an ultrasound-guided percutaneous portal vein catheterization was undertaken in the intrahepatic region of these patients, and they also received an injection of antibiotics. The remaining 19 patients were retrospectively included in the control group; these patients only received systemic antibiotic therapy. The efficacy of intervention was compared with that of systemic treatment. Results:The catheterization procedures were successful in all the patients of the experimental group. However, two cases (15.4%) developed complications postoperatively. Compared to the control group, the following parameters of the experimental group were significantly shorter/lower: (i) duration for regaining normal body temperature; (ii) time period for achieving normal white blood cell count; (iii) length of hospitalization; (iv) cases of liquefied liver abscess during follow-up; and (v) cost of hospitalization (P < 0.05).Conclusion: Ultrasound-guided percutaneous portal vein catheterization is a simple, minimally invasive, and effective treatment for UBLA. It must be carried out in the intrahepatic region and a subsequent injection of antibiotics must be given.

“…The liver is the most common extra-intestinal organ to be infected. With the development of interventional radiology technology in recent years, the combination of percutaneous puncture drainage and antibiotics has become the mainstay of therapy which, compared to antibiotics therapy alone and surgical treatment, causes little trauma and has significant efficacy [9,10].…”

Section: Introductionmentioning

confidence: 99%

The increased recurrence rate of liver abscess caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae

Eur J Clin Microbiol Infect Dis

Ren

Chang

et al. 2020

Background The pathogenic bacterium Klebsiella pneumoniae (KP) is the major causative agent of pyogenic liver abscess (PLA). But reports about the prognosis of KP-caused PLA (KPLA) are rare. This study aimed to ascertain the recurrence rate of KPLA after initial treatment, and its contributing factors. Methods The medical records data were retrospectively analyzed of KPLA patients who were admitted to Shengjing Hospital of China Medical University from January 2012 to January 2018. According to whether or not there was recurrence of KPLA during follow-up, the patients were divided into a 'recurrence' and a 'non-recurrence' group. The clinical and CT characteristics of patients were compared between the two groups, and those factors related to KPLA recurrence were further analyzed. Results A total of 110 patients who had first-time episodes of KPLA were included into the study. The average follow-up time was 3.65±2.18 years. Twenty (18.18%) KPLA patients experienced recurrence. Those in the recurrence group had a significantly greater incidence of extended-spectrum βlactamase (ESBL) production compared to the non-recurrence group (30.0% vs 8.89%, P=0.018). Diabetes, biliary tract disease, and history of malignancy was not associated with recurrence (all P>0.05). No difference in the CT characteristics of KPLA (including abscess size, location, whether multilocular, gas production of KPLA, and thrombophlebitis) was found between the two groups. Multivariate regression analysis showed that ESBL production (OR, 6.3; 95% CI, 1.02-38.59; P=0.04) was an independent risk factor for the recurrence of KPLA. Conclusions KPLA has a high recurrence rate, and ESBL production is a risk factor for recurrent KPLA.