Liver Cyst Infection Outcomes in Patients With ADPKD.

Area of Science:

• Nephrology
• Infectious Diseases
• Hepatology

Background:

• Liver cyst infection is a rare but severe complication in autosomal dominant polycystic kidney disease (ADPKD).
• Optimal management strategies for ADPKD-associated liver cyst infections are not well-established.
• This study investigates treatment outcomes for liver cyst infections in ADPKD patients.

Purpose of the Study:

• To analyze treatment strategies and outcomes for liver cyst infections in patients with ADPKD.
• To identify factors influencing treatment failure, relapse, and recurrence of liver cyst infections.
• To provide evidence-based recommendations for managing liver cyst infections in ADPKD.

Main Methods:

• A multicentric retrospective study including 62 patients and 112 episodes of liver cyst infection.
• Infection defined by clinical, laboratory (CRP ≥ 50 mg/l), and imaging (CT, 18FDG-PET/CT, MRI) criteria, or confirmed by cyst puncture.
• Analysis of determinants for treatment failure, relapse (<2 months), and recurrence (>2 months).

Main Results:

• Escherichia coli was the most common pathogen (51%), with significant antimicrobial resistance.
• Treatment failure or relapse occurred in 27% of episodes; longer antibiotic duration (≥14 days) was protective.
• Recurrence affected 38% of patients; antibiotic duration (≥28 days) and history of renal cyst infection were key factors.

Conclusions:

• Liver cyst infection management requires careful consideration of antibiotic duration.
• Antibiotic therapy for ≥28 days is associated with reduced treatment failure, relapse, and recurrence.
• History of renal cyst infection increases recurrence risk, necessitating vigilant follow-up.