Clinical and microbiological characteristics of pyogenic liver abscess in a tertiary hospital in East China

Pyogenic liver abscess (PLA) is a potentially life-threatening disease affecting many parts of the world, especially Asia. In this study, we explored the clinical and microbiological characteristics of PLA in Chinese patients. A 5-year (2010-2014) retrospective review of medical records on all PLA patients who were admitted to a tertiary teaching hospital was performed. Among 217 PLA cases who were confirmed cultural positive, Klebsiella pneumonia (K pneumonia) was the most common pathogen (n= 165, 76.0%), followed by Escherichia coli (n= 21, 9.7%). Notably, there is a higher incidence of diabetes mellitus in patients with K pneumoniae-induced PLA (KP-PLA) than that with non-K pneumoniae-induced PLA (non-KP-PLA)(43.0% vs 21.2%, P=. 005). However, it was less prevalent for concomitant hepatobiliary disease (20.0% vs 34.6%, P=. 039) and history of intraabdominal trauma or surgery (13.3% vs 38.5%, P<. 001) in patients with KP-PLA. Although K pneumoniae are sensitive to most common antibiotics (antibiotic resistance rates below 10%), some strains (1.2%) developed resistant to carbapenem. These results confirmed K pneumoniae as the predominant pathogen of PLA in the area in which the study was conducted. More attention should be directed toward monitoring the emergence of carbapenem-resistant K pneumoniae. KP-PLA is frequently diagnosed in patients with metabolic diseases accompanied by serious consequences, and it is therefore prudent to see that they receive sensitivity-directed antibiotic therapy.