关键词: 细菌性肝脓肿, 临床特征, 病原菌, 脓肿穿刺抽脓, 治疗, 预后

Abstract: Objective This study was conducted to summarize the clinical feature and pathogen distribution in patients with bacterial liver abscess (BLA). Methods 60 consecutive patients with BLA were encountered in our hospital between January 2020 and April 2023, and all were treated with abscess puncture and aspiration or catheterization under ultrasound guidance at base of antibacterial therapy. Bacterial culture, separation and characterization was routinely carried out. Results The underlying diseases in our 60 patients with BLA were diabetes and hypertension, and the common symptoms and sign included anorexia, jaundice, peritonitis, high fever, chills, abdominal pain, nausea and vomiting and tapping pain in the liver area; the white blood cell counts, neutrophil cell counts, serum ALT and AST levels increased, while hemoglobin and albumin levels decreased; the abscess localized at left lobe, right lobe, double lobes and at junction of left and right lobes accounted for 26.7%, 58.3%, 8.3% and 6.7%, with the mean diameter of abscess of (3.6±0.9)cm; out of 89 strains of pathogens separated, the Lebsiella pneumonia, Escherichia coli and Staphylococcus aureus accounted for 46.1% (n=41), 20.2% (n=18) and 14.6% (n=13); the resistance of Lebsiella pneumonia to ampicillin was 100.0%, to seven antibiotics was greater than 30.0%, while to other nine antibiotics was less than 30%; the most Escherichia coliwas resistant to ampicillin, and the resistance to 13 antibiotics was over 30.0%, while to other three antibiotics was less 30%; at the end of 13-28 (15.2±3.6)day treatment, the recovery rate as showed by total disappearance of the abscess in our series was 88.3%, left 7 patients (11.7%)had their intrahepatic abscess uncurable, which disappeared after a little longer observation and management. Conclusion The BLA mostly often occurs in persons with diabetes and hypertension, and the common pathogens are Klebsiella pneumoniae and Escherichia coli. The percutaneous transhepatic drainage at base of antimicrobial treatment might obtain a promising outcomes.

Key words: Bacterial liver abscess, Clinical feature, Pathogen, Percutaneous transhepatic drainage, Therapy, Prognosis