Liu Yao, Liu Jinqing, Fu Lei, Jiang Chuan, Peng Shifang
Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Key Laboratory of Viral Hepatitis of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Infect Drug Resist. 2023 Feb 16;16:903-911. doi: 10.2147/IDR.S395428. eCollection 2023.
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.
In this study, we retrospectively collected medical records of PLA patients admitted to a teaching hospital from January 2010 to December 2019.
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 () and (), respectively. Patients in the CPLA group were older (=0.029) and had higher prevalence of abscesses larger than 5 cm in diameter ( = 0.003), gas-forming rate ( = 0.016), and percutaneous drainage ( < 0.001) compared with CNLA group. Patients with CPLA had significantly longer hospitalizations than those with CNLA ( = 0.010). Nevertheless, there was no significant difference in in-hospital mortality between the two groups ( = 0.415). Compared with patients with , those with had higher incidence of diabetes mellitus ( = 0.041), solitary abscess ( < 0.001), localization in the right hepatic lobe ( = 0.033), abscess size larger than 5 cm ( < 0.001) and percutaneous drainage ( = 0.002), but mortality was not significantly different ( = 1.000).
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 and .
尽管化脓性肝脓肿（PLA）致死风险高，但对于微生物培养结果为阴性的患者，尚无明确的管理指南。我们的目的是评估培养阴性肝脓肿（CNLA）患者与培养阳性肝脓肿（CPLA）患者临床特征的差异，并确定主要致病病原体的差异。
在本研究中，我们回顾性收集了2010年1月至2019年12月在一家教学医院住院的PLA患者的病历。
本研究共纳入324例PLA患者。其中，202例（62.3%）培养结果为阳性，分别有109例（54%）和20例（9.9%）患者感染了（）和（）。与CNLA组相比，CPLA组患者年龄更大（=0.029），直径大于5 cm的脓肿患病率更高（=0.003），产气率更高（=0.016），经皮引流率更高（<0.001）。CPLA患者的住院时间显著长于CNLA患者（=0.010）。然而，两组患者的院内死亡率无显著差异（=0.415）。与（）患者相比，（）患者糖尿病发病率更高（=0.041），单发脓肿发生率更高（<0.001），右肝叶定位更多（=0.033），脓肿直径大于5 cm的比例更高（<0.001），经皮引流率更高（=0.002），但死亡率无显著差异（=1.000）。
CNLA患者与CPLA组患者的院内死亡率无显著差异。然而，主要致病病原体（包括（）和（））之间的临床特征和管理存在差异。
