Clinical Characteristics of 606 Patients with Community-Acquired Pyogenic Liver Abscess: A Six-Year Research in Yantai

Hong-Xia Yu,1,* Guo-Shuai Lin,1,* Ji-Fan Zhang,2 Cong-Cong Wang,1 Xiang-Jun Long,1 Mao-Mao Zhao1 1Department of Infection, Yuhuangding Hospital, Yantai, People’s Republic of China; 2Department of Critical Care Medicine, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mao-Mao Zhao, Department of Infection, Yuhuangding Hospital, No. 20 of Yuhuangding East Road, Zhifu District, Yantai, People’s Republic of China, Tel +86 13863872227, Fax +86 6240341, Email zhaomm295@126.comObjective: This study was designed to analyze the clinical characteristics, etiological characteristics, drug resistance, and empirical use of antibiotics for community-acquired pyogenic liver abscess (PLA) to provide a basis for rational and effective empirical treatment of PLA in the local area.Methods: The clinical data, etiological characteristics, drug resistance, and empirical anti-infective therapy schemes of 606 patients with PLA were collected and analyzed retrospectively.Results: The included patients were mainly males, with a male-to-female ratio of 1.3:1. The average age of the patients was 60.3 ± 14.1 years. The underlying diseases were diabetes and biliary tract disease, accounting for 38.7% and 22.3%, respectively. The main clinical manifestations were fever (92.9%), abdominal pain (44.7%), and nausea (33.3%). Imaging findings: the proportion of patients with a single lesion was 74.7%, and 67% of the patients had involvement in the right lobe of the liver. The main pathogen was Klebsiella pneumoniae accounted for 74.9% in blood culture and 84.1% in pus culture, mainly extended-spectrum β-lactamase. In 272 strains negative for extended-spectrum β-lactamase (ESBLs), 100% were resistant to ampicillin and less than 50% were sensitive to nitrofurantoin. Only 36 ESBL-positive strains had higher than 80% sensitivity to carbapenems, β-lactamase inhibitor compound, and amikacin.