Ding Xiurong, Yu Yanhua, Chen Ming, Kang Yanfang, Lou Jinli
Department of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Front Cell Infect Microbiol. 2025 Jun 6;15:1567105. doi: 10.3389/fcimb.2025.1567105. eCollection 2025.
Liver abscess is a severe complication that can occur following thermal ablation of liver cancer, with an incidence rate ranging from 0.2% to 2.4%. This study aimed to identify risk factors associated with the development of post-ablation liver abscesses and to characterize the microbiological features of the isolated pathogens.
A matched case-control study was conducted at Beijing Youan Hospital from January 2018 to December 2023. Cases were defined as patients who developed liver abscesses within three months following ablation therapy, while controls comprised patients who did not develop such abscesses. Clinical and microbiological data were collected and analyzed. The relevant independent risk factors for the occurrence of liver abscesses were identified and assessed using multivariate logistic regression analysis.
Post-ablation liver abscesses predominantly occurred in male patients aged 60 years or older, typically manifesting around six days after the procedure. Common symptoms included fever, chills, abdominal distension, and abdominal pain. Multivariate analysis identified diabetes mellitus (OR=3.215; 95% CI 1.330-7.771), history of abdominal surgery (OR=2.810; 95% CI 1.074-7.353), biliary disease (OR=18.832; 95% CI 2.291-154.795), and elevated ALP levels (OR=1.010; 95% CI 1.002-1.019) as independent risk factors for post-ablation liver abscesses. Among the 61 patients with liver abscesses, a total of 78 bacterial strains were isolated from the abscess fluid, with Gram-negative bacteria accounting for 75.6% of the isolates. (30.8%) and (20.5%) were the most frequently identified pathogens. Drug sensitivity testing revealed that both and exhibited high susceptibility to Amikacin, Cefoxitin, Ceftazidime, Imipenem, Meropenem, and Piperacillin-tazobactam.
Post-ablation liver abscesses are primarily caused by Gram-negative bacteria. A history of diabetes, prior abdominal surgery, biliary disease, and elevated ALP levels are significant risk factors influencing the development of post-ablation liver abscesses.
肝脓肿是肝癌热消融术后可能发生的严重并发症，发病率在0.2%至2.4%之间。本研究旨在确定与消融后肝脓肿发生相关的危险因素，并描述分离出的病原体的微生物学特征。
2018年1月至2023年12月在北京佑安医院进行了一项配对病例对照研究。病例定义为消融治疗后三个月内发生肝脓肿的患者，对照组包括未发生此类脓肿的患者。收集并分析临床和微生物学数据。采用多因素逻辑回归分析确定并评估肝脓肿发生的相关独立危险因素。
消融后肝脓肿主要发生在60岁及以上男性患者中，通常在术后约六天出现。常见症状包括发热、寒战、腹胀和腹痛。多因素分析确定糖尿病（OR=3.215；95%CI 1.330-7.771）、腹部手术史（OR=2.810；95%CI 1.074-7.353）、胆道疾病（OR=18.832；95%CI 2.291-154.795）和碱性磷酸酶（ALP）水平升高（OR=1.010；95%CI 1.002-1.019）为消融后肝脓肿的独立危险因素。在61例肝脓肿患者中，共从脓肿液中分离出78株细菌，革兰阴性菌占分离株的75.6%。大肠埃希菌（30.8%）和肺炎克雷伯菌（20.5%）是最常鉴定出的病原体。药敏试验显示，大肠埃希菌和肺炎克雷伯菌对阿米卡星、头孢西丁、头孢他啶、亚胺培南、美罗培南和哌拉西林-他唑巴坦均表现出高度敏感性。
消融后肝脓肿主要由革兰阴性菌引起。糖尿病史、既往腹部手术史、胆道疾病和ALP水平升高是影响消融后肝脓肿发生的重要危险因素。
