Clinical characteristics, pathogenic bacteria, and risk factors for different locations of pyogenic liver abscesses:...

This study aims to investigate the epidemiology, etiology, and clinical characteristics of patients with a pyogenic liver abscess treated at this institution over 10 years to offer insights into its clinical management.

Patients diagnosed with a pyogenic liver abscess and hospitalized in the Affiliated Hospital of Chengde Medical College from June 2013 to June 2023 were retrospectively analyzed. The liver was categorized into left and right lobes using the middle hepatic vein as the boundary. Patients with abscesses encompassing both lobes were excluded. The patients were divided into left- and right-liver groups based on the abscess location. Epidemiological information, results of puncture drainage fluid or blood cultures, and drug sensitivity patterns were compared and analyzed between the groups. Furthermore, the clinical characteristics and treatment strategies for liver abscesses in different locations were summarized.

A total of 415 patients with pyogenic liver abscesses were included. Most cases (74.2%) encompassed abscesses in the right lobe. Gas was significantly more common within right-lobe abscesses than within left-lobe abscesses(p<0.05). Concerning pathogenic bacteria, the proportion of Klebsiella pneumoniae was significantly higher in right-lobe abscesses (44.5%,p<0.05) than in left-lobe abscesses. The proportion of Escherichia coli was significantly higher in left-lobe abscesses (10.3%,p<0.05). Previous abdominal surgery was considered a high-risk factor for E. coli infection in patients with left-lobe abscesses.

E. coli accounted for a high proportion of left-lobe abscesses. Antimicrobial treatment with cefoperazone/sulbactam or piperacillin/tazobactam is recommended until pathogen culture findings are available, particularly for patients with liver abscesses with a history of abdominal surgery.