Clinical features and risk factors for pyogenic liver abscess caused by multidrug-resistant organisms: A retrospective study

ABSTRACT

The incidence rate of pyogenic liver abscess caused by multidrug-resistant bacteria has increased in recent years. This study aimed to identify the clinical characteristics and risk factors for pyogenic liver abscess caused by multidrug-resistant bacteria. We conducted a retrospective analysis of the clinical features, laboratory test results, and causes of pyogenic liver abscesses in 239 patients admitted to a tertiary hospital. Multivariable logistic regression was used to identify risk factors for multidrug resistance. Among patients with pyogenic liver abscesses, the rate of infection caused by multidrug-resistant organisms was observed to be 23.0% (55/239), with a polymicrobial infection rate of 14.6% (35/239). Additionally, 71 cases (29.7%) were associated with biliary tract disease. Patients with pyogenic liver abscesses caused by multidrug-resistant organisms had a significantly higher likelihood of polymicrobial infection and increased mortality (7/44 [15.9%] vs. 3/131 [2.3%]; p = .003). The Charlson Comorbidity Index (adjusted odds ratio [aOR]: 1.32, 95% confidence interval [CI]: 1.06–1.68), hospitalization (aOR: 10.34, 95% CI: 1.86–60.3) or an invasive procedure (aOR: 9.62; 95% CI: 1.66–71.7) within the past 6 months, and gas in the liver on imaging (aOR: 26.0; 95% CI: 3.29–261.3) were independent risk factors for pyogenic liver abscess caused by multidrug-resistant bacteria. A nomogram was constructed based on the risk factors identified. The nomogram showed high diagnostic accuracy (specificity, 0.878; sensitivity 0.940). Multidrug-resistant organisms causing pyogenic liver abscesses have specific characteristics. Early identification of patients at high risk of infection with multidrug-resistant organisms could help improve their management and enable personalized treatment.

KEYWORDS:

• Pyogenic liver abscess
• multidrug-resistant organisms
• Klebsiella pneumoniae
• Escherichia coli; risk factors
• intrahepatic gas

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Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions statement

XQ designed the study. QL, CC, and XZ collected and analysed the data. QL and MH wrote the paper. XQ and MH revised the intellectual content. All authors agree to be accountable for all aspects of the work.

Data availability statement

All the data supporting the findings of this study are provided in the article and online at https://doi.org/10.7910/DVN/V1EYGB.

Correction Statement

This article was originally published with errors, which have now been corrected in the online version. Please see Correction (https://doi.org/10.1080/21505594.2024.2363658)

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (82372262, 82102404) and the China International Medical Foundation (Z-2018-35-2003).