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A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms

The emergence of multidrug-resistant organisms (MDROs) is a growing problem worldwide. However, little is known about the incidence, clinical features and outcomes of pyogenic liver abscesses (PLAs) caused by MDROs. A retrospective study of 833 patients with PLA admitted from 2008 to 2017 was perfor...

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Autores principales: Park, Ji-Won, Kim, Jung-Hee, Jung, Jang-Han, Kim, Sung-Eun, Kim, Hyoung-Su, Jeong, Haemin, Suk, Ki Tae, Jang, Myoung-Kuk, Kim, Dong-Joon, Lee, Myung-Seok, Park, Sang-Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874681/
https://www.ncbi.nlm.nih.gov/pubmed/35207386
http://dx.doi.org/10.3390/jcm11041114
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author Park, Ji-Won
Kim, Jung-Hee
Jung, Jang-Han
Kim, Sung-Eun
Kim, Hyoung-Su
Jeong, Haemin
Suk, Ki Tae
Jang, Myoung-Kuk
Kim, Dong-Joon
Lee, Myung-Seok
Park, Sang-Hoon
author_facet Park, Ji-Won
Kim, Jung-Hee
Jung, Jang-Han
Kim, Sung-Eun
Kim, Hyoung-Su
Jeong, Haemin
Suk, Ki Tae
Jang, Myoung-Kuk
Kim, Dong-Joon
Lee, Myung-Seok
Park, Sang-Hoon
author_sort Park, Ji-Won
collection PubMed
description The emergence of multidrug-resistant organisms (MDROs) is a growing problem worldwide. However, little is known about the incidence, clinical features and outcomes of pyogenic liver abscesses (PLAs) caused by MDROs. A retrospective study of 833 patients with PLA admitted from 2008 to 2017 was performed. MDROs were found in 55 (6.6%) patients, and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae was the most common causative microorganism. To evaluate the clinical features of and risk factors for MDRO-induced PLAs, propensity score matching (PSM) was performed in a 1:3 ratio (55 patients with MDROs and 165 patients without MDROs). After PSM, previous hepatobiliary procedure, preadmission exposure to antibiotics and elevated alkaline phosphatase levels were independent risk factors for MDRO-induced PLA. Sixteen patients (7.3%) died during hospitalization. Admission to intensive care unit (ICU), inadequate initial antibiotic treatment and use of inotropic agents were factors predictive of mortality. Although the presence of MDROs was not associated with in-hospital mortality, inadequate initial antibiotic treatment was prescribed to a large portion of the patients with MDRO-induced PLAs. We conclude that initial empirical antibiotic therapy for PLA should be based on the possibility of infection with MDROs, and close monitoring is necessary for patients with risk factors for in-hospital mortality.
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spelling pubmed-88746812022-02-26 A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms Park, Ji-Won Kim, Jung-Hee Jung, Jang-Han Kim, Sung-Eun Kim, Hyoung-Su Jeong, Haemin Suk, Ki Tae Jang, Myoung-Kuk Kim, Dong-Joon Lee, Myung-Seok Park, Sang-Hoon J Clin Med Article The emergence of multidrug-resistant organisms (MDROs) is a growing problem worldwide. However, little is known about the incidence, clinical features and outcomes of pyogenic liver abscesses (PLAs) caused by MDROs. A retrospective study of 833 patients with PLA admitted from 2008 to 2017 was performed. MDROs were found in 55 (6.6%) patients, and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae was the most common causative microorganism. To evaluate the clinical features of and risk factors for MDRO-induced PLAs, propensity score matching (PSM) was performed in a 1:3 ratio (55 patients with MDROs and 165 patients without MDROs). After PSM, previous hepatobiliary procedure, preadmission exposure to antibiotics and elevated alkaline phosphatase levels were independent risk factors for MDRO-induced PLA. Sixteen patients (7.3%) died during hospitalization. Admission to intensive care unit (ICU), inadequate initial antibiotic treatment and use of inotropic agents were factors predictive of mortality. Although the presence of MDROs was not associated with in-hospital mortality, inadequate initial antibiotic treatment was prescribed to a large portion of the patients with MDRO-induced PLAs. We conclude that initial empirical antibiotic therapy for PLA should be based on the possibility of infection with MDROs, and close monitoring is necessary for patients with risk factors for in-hospital mortality. MDPI 2022-02-19 /pmc/articles/PMC8874681/ /pubmed/35207386 http://dx.doi.org/10.3390/jcm11041114 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Ji-Won
Kim, Jung-Hee
Jung, Jang-Han
Kim, Sung-Eun
Kim, Hyoung-Su
Jeong, Haemin
Suk, Ki Tae
Jang, Myoung-Kuk
Kim, Dong-Joon
Lee, Myung-Seok
Park, Sang-Hoon
A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms
title A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms
title_full A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms
title_fullStr A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms
title_full_unstemmed A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms
title_short A Multicenter Retrospective Study on Clinical Characteristics and Outcome of Pyogenic Liver Abscess Focusing Multidrug-Resistant Organisms
title_sort multicenter retrospective study on clinical characteristics and outcome of pyogenic liver abscess focusing multidrug-resistant organisms
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874681/
https://www.ncbi.nlm.nih.gov/pubmed/35207386
http://dx.doi.org/10.3390/jcm11041114
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