Pyogenic Liver Abscess: Recent Trends in Etiology and Mortality

Abstract

The data suggest that K. pneumoniae has become the predominant etiology of pyogenic liver abscess and that mortality from this disease has decreased substantially.

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

“…This is consistent with the fact that every recurrence was ipsilateral to the first event. Mortality in our series was 7.8%, similar to that reported in the 16,17,22,27,28 studies have analyzed risk factors for mortality, including the presence of active oncologic 17,22,26,29,30 renal failure, 17,18,22,26,29 hiperbilirrubinemia, 17,29,30 hypoalbuminemia, 17,29 MDRB isolation 17,29 and multiple abscesses 17,22,26,29,30 with inconsistent results. In our series, factors associated with mortality in univariate analysis included biliary disease, multiple abscesses, the bilateral liver involvement, and bilirrubinemia >5 mg/dL.…”

“…The results contrast with numerous series that reported progressive increase of K. pneumoniae over E. coli as primary pathogen causing PLA, especially in patients with diabetes mellitus. 1,5,[12][13][14][15][16][17] The isolation of MDRB was slightly higher as compared to other reports 17 and could be explained by the notable presence of patients with chronic disease and history of prolonged hospitalizations. A 75% of MDRB were isolated in transplant recipients or patients with NBIPLA with active oncologic disease.…”

Liver abscess caused by Klebsiella pneumoniae: two case reports

“…First reported from Taiwan as a solitary organism in PLA [4], in recent studies Klebsiella pneumoniae was recognized as the leading pathogen of PLA in Asia and Western countries [2,3]. Furthermore, it was found to be associated with Asian ethnicity, diabetes mellitus and cryptogenic liver abscesses [2,3,5].…”

“…The most common bacteria isolated from liver abscess patients are gram-negative rods. Until the end of the last century, Escherichia coli was recognized as the predominant cause of bacterial liver abscesses [1], but more recently Klebsiella pneumoniae was found to be the leading pathogen in Asia and Western countries [2,3].…”

Hepatobiliary and pancreatic disorders

“…So the trend seems to be a shift from a high incidence in the young to average ages in the fifth to sixth decades of life. 6 With improved methods of tackling parasitic infestations like ascariasis and hydatid cysts, morbidity is considerably low in recent times and there is a noticeable fall in the overall incidence. 7 The inevitable consequences of untreated calculi or intervention on the biliary tree, both therapeutically and for injuries, have led to problems like biliary strictures that demand early surgical management.…”