scholarly journals Genomic Heterogeneity inKlebsiella pneumoniaeStrains Is Associated with Primary Pyogenic Liver Abscess and Metastatic Infection

2005 ◽  
Vol 192 (1) ◽  
pp. 117-128 ◽  
Author(s):  
Li‐Chen Ma ◽  
Chi‐Tai Fang ◽  
Cha‐Ze Lee ◽  
Chia‐Tung Shun ◽  
Jin‐Town Wang
Keyword(s):  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Metastatic Infection

scholarly journals Cryptogenic and non-cryptogenic liver abscess: A retrospective analysis of 178 cases revealed distinct characteristics

2018 ◽  
Vol 46 (9) ◽  
pp. 3824-3836 ◽  
Author(s):  
Jing Chen ◽  
Minwei Zhang ◽  
Jinlong Chen ◽  
Yaogui Ning ◽  
Xiaoyang Cai ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Multivariate Logistic Regression Analysis ◽  
Pyogenic Liver Abscess ◽  
Tertiary Hospital ◽  
Microbial Infection ◽  
Theoretical Support ◽  
Metastatic Infection ◽  
Infectious Origin ◽  
Male Sex ◽  
Different Characteristics

Objective To enhance theoretical support of pyogenic liver abscess (PLA) treatment by comparing characteristics of patients with either PLA with an identified infectious origin (non-cryptogenic) or PLA with no obvious underlying cause (cryptogenic). Methods This retrospective study included all first episodes of PLA in adults admitted to a tertiary hospital between 2009 and 2016. Relevant clinical data were collected for patients with cryptogenic or non-cryptogenic PLA and compared across a number of characteristics. Results In all, 178 patients were included: 111 cases (62.4%) of cryptogenic PLA, and 67 cases (37.6%) of non-cryptogenic PLA. Diabetes mellitus was significantly more prevalent in patients with cryptogenic PLA than those with non-cryptogenic PLA. The proportion of multidrug resistance/poly-microbial infection was significantly lower and Klebsiella pneumoniae infection was significantly higher in the cryptogenic versus non-cryptogenic PLA group. Metastatic infection occurred in four patients with cryptogenic PLA only, and all had diabetes and K. pneumoniae infection. Multivariate logistic regression analysis revealed that male sex, diabetes and K. pneumoniae were independent predictors for cryptogenic PLA. Conclusions Cryptogenic and non-cryptogenic PLA have distinctly different characteristics, suggesting a potential need for different treatment approaches.

scholarly journals Independent prediction of aspartate aminotransferase to alanine aminotransferase ratio for adverse outcomes of patients with pyogenic liver abscess

2021 ◽  
Author(s):  
Huifang Dai ◽  
Youjin Pan ◽  
Jing Xu
Keyword(s):  
Liver Abscess ◽  
Roc Curve ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Univariate Analysis ◽  
Pyogenic Liver Abscess ◽  
Adverse Outcomes ◽  
Cutoff Value ◽  
Metastatic Infection ◽  
The Relationship

Abstract Background: In viral hepatitis, an increase in the ratio of aspartate aminotransferase to alanine aminotransferase (AAR) is associated with poor prognosis. However, the relationship between AAR and pyogenic liver abscess (PLA) remains to be unclear. In this study, the relationship between AAR and adverse outcomes in PLA patients were explored, and the predictive value of AAR were evaluated. Methods: In total, 240 PLA patients were consecutively enrolled in this study and followed up at 3 months. Univariate analysis, receiver-operating characteristic (ROC) curve analysis and multivariate logistic regression analyses were performed. Results: According to the ROC curve of AAR for adverse outcomes, the patients were divided into two groups using a cutoff of 0.97. Patients with high AAR had higher risk of mortality rate (16.5% vs 2.9%), empyema (23.7% vs 10.4%), metastatic infection (19.1% vs 9.7%), acute myocardial (7.3% vs 0.7%), acute hepatic failure (7.3% vs 2.2%) and septic shock (13.7% vs 4.4%) than patients with low AAR (all P<0.05). after adjusting for potential confounding factors in our logistic model, high AAR was independently associated with death (odds ratio (OR)=6.17, 95% of confidence interval (CI)=1.88-20.26) and all adverse outcomes (OR=4.03, 95% CI=2.12-7.66). AAR had the largest area under ROC curve (AUC) than ALT, AST in all adverse outcomes (AUC=0.690, cutoff value=0.97, P<0.01) and death prediction (AUC=0.821, cutoff value=1.31, P<0.01). Conclusion: In the clinical application of PLA, AAR may be a good method to predict the prognosis.

scholarly journals The AST/ALT (De Ritis) Ratio Independently Predicts Adverse Outcomes in Patients with Pyogenic Liver Abscess

2020 ◽  
Author(s):  
Huifang Dai ◽  
Jing Xu
Keyword(s):  
Liver Abscess ◽  
Roc Curve ◽  
Univariate Analysis ◽  
Acute Hepatic Failure ◽  
Pyogenic Liver Abscess ◽  
Adverse Outcomes ◽  
Receiver Operating Curve ◽  
Cutoff Value ◽  
Metastatic Infection ◽  
Receiver Operating

Abstract Background: An elevated aspartate aminotransaminase to alanine aminotransaminase ratio (AST/ALT) displays relationships to poor prognosis in viral hepatitis. However, the association between AST/ALT and pyogenic liver abscess (PLA) is unclear.Aim:This study delved into the relationships of AST/ALT and unfavorable results of PLA cases and ascertained AST/ALT predicting significance.Methods: In total, 240 PLA cases were consecutively recruited here and underwent a 3-month following-up. This study carried out receiver-operating characteristic (ROC) curve study, multiple-variate logistic regression analyses and univariate analysis.Results: In line with the receiver-operating curve of AST/ALT for unfavorable results, the cases fell to two subgroups with the use of a threshold of 0.97. Cases with high AST/ALT had higher risk of mortality (16.5% vs 2.9%), metastatic infection (19.1% vs 9.7%), acute hepatic failure (7.3% vs 2.2%), acute myocardial (7.3% vs 0.7%), empyema (23.7% vs 10.4%) and septic shock (13.7% vs 4.4%) than cases with low AST/ALT (all P < 0.05). after adjusting for potential confounders in our logistic model, high AST/ALT was independently associated with all unfavorable results (OR = 4.03, 95% CI = 2.12–7.66) and death (odds ratio (OR) = 6.17, 95% of confidence interval (CI) = 1.88–20.26). AST/ALT exhibited the widest area underneath ROC curve (AUC) as compared with AST, ALT in death prediction (AUC = 0.821, cutoff value = 1.31, P < 0.01) and overall unfavorable results (AUC = 0.690, cutoff value = 0.97, P < 0.01).Conclusion: AST/ALT may be a good candidate for predicting prognosis in future clinical practice of PLA.

scholarly journals Endogenous Endophthalmitis and Liver Abscess: A Metastatic Infection or a Coincidence?

2021 ◽  
pp. 1-6
Author(s):  
Catarina Correia ◽  
Sandra Lopes ◽  
Sofia Mendes ◽  
Nuno Almeida ◽  
Pedro Figueiredo
Keyword(s):  
Liver Abscess ◽  
Signs And Symptoms ◽  
Pyogenic Liver Abscess ◽  
Endogenous Endophthalmitis ◽  
Metastatic Infection ◽  
Percutaneous Transhepatic Drainage ◽  
Severe Infections ◽  
Transhepatic Drainage ◽  
Systemic Antibiotics ◽  
Ocular Signs

<i>Klebsiella pneumoniae</i> is a gram-negative pathogen that is a common cause of severe infections, including pyogenic liver abscess. Dissemination of <i>K. pneumoniae</i> to other organs, including the eye, is associated with significant morbidity and mortality. In the particular case of endogenous endophthalmitis (EE) by <i>K. pneumoniae</i> the prognosis is poor. We report the case of a middle-aged female with <i>K. pneumoniae</i> liver abscess. The patient developed metastatic endophthalmitis that was aggressively treated with systemic antibiotics. The liver abscess resolved with antimicrobials and percutaneous transhepatic drainage, but regarding the endophthalmitis she was discharged from our hospital without recovery of her eyesight. Metastatic spread to the eye should be considered in all patients with liver abscesses who experience ocular signs and symptoms in order to establish a timely diagnosis of EE.

scholarly journals Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
United Arab Emirates ◽  
Liver Abscess ◽  
Hospital Admissions ◽  
Indian Subcontinent ◽  
Pyogenic Liver Abscess ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Liver Abscesses ◽  
Potential Risk Factors

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.

scholarly journals Association of blood culture with carbapenem use in pyogenic liver abscess: a two-center retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuangjun He ◽  
Jie Yu ◽  
Hairong Wang ◽  
Lifeng Wang ◽  
Yi Chen ◽  
...  
Keyword(s):  
Blood Culture ◽  
Liver Abscess ◽  
Bacterial Culture ◽  
Multivariate Analyses ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Extended Spectrum Beta Lactamase ◽  
Tertiary Care Centers ◽  
High Positivity Rate ◽  
Positive Results

Abstract Background Highly empiric use of carbapenem in pyogenic liver abscess (PLA) is widespread problem. However, few studies have examined the association between blood culture and carbapenem use in patients with PLA in China. Thus, we conducted this observational study. Methods The data of patients diagnosed with PLA at two comprehensive tertiary care centers from 2014 to 2020 were retrospectively collected. Demographic and clinical data were analyzed, and univariate and multivariate analyses were performed to investigate the association between blood culture and carbapenem use. Subgroup analysis was conducted to explore whether the effect is different in sepsis. Results Blood culture was performed in 110 (46.0%) patients, of whom 44 (40.0%) patients had positive results for bacterial culture. Extended-spectrum beta-lactamase (ESBL)-positive blood culture isolates were detected in 8 (7.3%) patients. The positivity rate of blood culture in sepsis was higher than in non-sepsis (58.1% vs. 32.9%, P = 0.015). Fewer patients who had a blood culture received carbapenem treatment in comparison to patients without blood culture (19.1% vs. 31.8%, P = 0.026). Multivariate analysis showed that blood culture was independently associated with less carbapenem exposure (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.16–0.68, P = 0.003), and this effect remained significant in the sepsis subgroup (adjusted OR = 0.17, 95% CI: 0.05–0.53, P = 0.002). Conclusion Blood culture had a high positivity rate and was associated with less carbapenem use in PLA, especially those who developed sepsis. More attention should be paid to performing early blood culture and less carbapenem use in PLA.

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