Related Experiment Video
Updated: Aug 9, 2025
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
Demographics and Clinical Outcomes of Culture-Positive versus Culture-Negative Pyogenic Liver Abscess in an Asian
Yao Liu1,2,3, Jinqing Liu1,2,3, Lei Fu1,2,3
1Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Objective:
Despite its high case-fatality risk, pyogenic liver abscess (PLA) lacks clear management guidelines in patients with negative microbial cultures. Our aim was to evaluate differences in clinical characteristics between patients with culture-negative liver abscess (CNLA) and those with culture-positive liver abscess (CPLA), and identify differences in the main causative pathogen.
Methods:
In this study, we retrospectively collected medical records of PLA patients admitted to a teaching hospital from January 2010 to December 2019.
Results:
In total, 324 PLA patients were enrolled in this study. Of these, 202 (62.3%) cases were confirmed cultural positive, including 109 patients (54%) and 20 (9.9%) patients infected with Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E.coli), respectively. Patients in the CPLA group were older (p=0.029) and had higher prevalence of abscesses larger than 5 cm in diameter (p = 0.003), gas-forming rate (p = 0.016), and percutaneous drainage (p < 0.001) compared with CNLA group. Patients with CPLA had significantly longer hospitalizations than those with CNLA (p = 0.010). Nevertheless, there was no significant difference in in-hospital mortality between the two groups (p = 0.415). Compared with patients with E. coli, those with K. pneumoniae had higher incidence of diabetes mellitus (p = 0.041), solitary abscess (p < 0.001), localization in the right hepatic lobe (p = 0.033), abscess size larger than 5 cm (p < 0.001) and percutaneous drainage (p = 0.002), but mortality was not significantly different (p = 1.000).
Conclusion:
No significant difference in in-hospital mortality was found between patients with CNLA and those with CPLA group. However, clinical characteristics and management were different between the main causative pathogens, including K. pneumoniae and E. coli.
Insights
Pyogenic liver abscess (PLA) management differs based on microbial culture results. While mortality rates are similar between culture-negative and culture-positive cases, clinical features vary significantly between pathogens like Klebsiella pneumoniae and Escherichia coli.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Pyogenic liver abscess (PLA) presents a high case-fatality risk but lacks standardized management guidelines, particularly for culture-negative cases.
- Understanding clinical differences between culture-negative liver abscess (CNLA) and culture-positive liver abscess (CPLA) is crucial for optimizing patient care.
Purpose of the Study:
- To compare clinical characteristics of CNLA and CPLA patients.
- To identify differences in main causative pathogens and their associated clinical presentations.
Main Methods:
- Retrospective collection of medical records from PLA patients admitted between January 2010 and December 2019.
- Analysis of clinical data, including abscess characteristics, causative pathogens, and treatment outcomes.
Main Results:
- Of 324 PLA patients, 202 (62.3%) were culture-positive. Klebsiella pneumoniae and Escherichia coli were the most common pathogens.
- CPLA patients were older and exhibited larger abscesses, gas formation, and required more percutaneous drainage compared to CNLA patients.
- Klebsiella pneumoniae infections were associated with higher rates of diabetes, solitary abscesses, right lobe localization, larger abscess size, and percutaneous drainage compared to E. coli infections.
Conclusions:
- In-hospital mortality did not significantly differ between CNLA and CPLA groups.
- Significant variations in clinical characteristics and management exist based on the primary causative pathogen, such as K. pneumoniae versus E. coli.
More Related Videos
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
01:27Acute Pyelonephritis I: Introduction
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:26Sputum Studies I: Gram Stain, cytology, and Acid-fast smear and culture
Gram Stain
The Gram Stain is an integral part of sputum studies. It involves the staining of sputum, which permits...