Table 2.
Comparison of the clinical characteristics, treatment, and clinical outcomes of patients with pyogenic liver abscess caused by multidrug-resistant organisms and non-multidrug-resistant organisms.
| MDRO (n = 44) |
Non-MDRO (n = 131) |
P | |
|---|---|---|---|
| Age (years), mean ± SD | 60.8 ± 12.9 | 56.7 ± 14.1 | .088 |
| Male sex, n (%) | 34 (77.3) | 88 (67.2) | .207 |
| Body mass index, mean ± SD | 21.4 ± 3.3 | 24.2 ± 3.9 | <.001 |
| Diabetes, n (%) | 13 (29.5) | 54 (41.2) | .168 |
| Hypertension, n (%) | 14 (31.8) | 41 (31.3) | .949 |
| Fatty liver, n (%) | 1 (2.3) | 23 (17.6) | .011 |
| Cirrhosis/hepatic failure, n (%) | 12 (27.3) | 5 (3.8) | <.001 |
| Malignant tumour, n (%) | 30 (68.2) | 8 (6.1) | <.001 |
| Charlson Comorbidity Index, mean ± SD | 7.0 ± 3.4 | 2.8 ± 2.1 | <.001 |
| Immunosuppressant use | 23 (52.3) | 3 (2.3) | <.001 |
| Hospitalization within the past 6 months | 36 (81.8) | 14 (10.7) | <.001 |
| Invasive procedures within the past 6 months | 32 (72.7) | 4 (3.1) | <.001 |
| Antibiotic use within the past 6 months | 26 (59.1) | 10 (7.6) | <.001 |
| Suspected origin of the liver abscess, n (%) | <.001 | ||
| Cryptogenic | 3 (6.8) | 85 (64.9) | |
| Direct spread | 7 (15.9) | 31 (23.7) | |
| Biliary tract | 33 (75) | 14 (10.7) | |
| Hematogenous | 1 (2.3) | 1 (0.8) | |
| Clinical manifestations | |||
| Fever | 42 (95.5) | 128 (97.7) | .601 |
| Disturbance | 2 (4.5) | 16 (12.2) | .249 |
| Vomiting | 2 (4.5) | 23 (17.6) | .033 |
| Diarrhea | 0 (0.0) | 11 (8.4) | .068 |
| Headache | 0 (0.0) | 16 (12.2) | .013 |
| Laboratory examination | |||
| White blood cell count (×10 [9]/L) | 10.4 ± 5.0 | 12.4 ± 5.0 | .019 |
| Absolute lymphocyte count (×10 [9]/L) | 1.0 ± 0.5 | 1.2 ± 0.5 | .01 |
| Neutral-lymphocyte ratio | 8.4 ± 7.1 | 11.2 ± 8.3 | .044 |
| Hemoglobin (g/L) | 95.7 ± 23.2 | 114.6 ± 18.7 | <.001 |
| Platelet count (×10 [9]/L) | 182.5 ± 126.7 | 237.2 ± 144.7 | .026 |
| CRP (mg/L) | 108.1 ± 52.0 | 120.8 ± 59.5 | .209 |
| ALT (U/L) | 52.7 ± 59.4 | 78.6 ± 94.0 | .088 |
| AST (U/L) | 60.6 ± 66.8 | 60.6 ± 90.0 | .999 |
| ALP (U/L) | 265.8 ± 196.7 | 190.8 ± 106.2 | .019 |
| ALB (g/L) | 29.6 ± 5.1 | 31.8 ± 4.7 | .010 |
| FIB (g/L) | 4.9 ± 1.4 | 5.9 ± 2.9 | .022 |
| APTT(s) | 34.6 ± 7.9 | 31.2 ± 6.9 | .007 |
| Imaging Results | |||
| Abscess size (mm), mean ± SD | 63.8 ± 29.1 | 68.5 ± 26.8 | .326 |
| Abscess location, n (%) | .176 | ||
| Right lobe | 29 (65.9) | 91 (69.5) | |
| Left lobe | 5 (11.4) | 24 (18.3) | |
| Bilateral | 10 (22.7) | 16 (12.2) | |
| Treatment and clinical outcomes | |||
| Bacteremia, n (%) | 24 (54.5) | 46 (35.1) | .023 |
| Metastatic abscess, n (%) | 5 (11.4) | 51 (38.9) | .001 |
| Pulmonary Abscess, n (%) Endophthalmitis, n (%) |
2 (4.5) | 26 (19.8) | .017 |
| 0 (0.0) | 30 (22.9) | <.001 | |
| Multiple abscesses, n (%) | 18 (40.9) | 37 (28.2) | .117 |
| Separated shadow, n (%) | 10 (22.7) | 46 (35.1) | .128 |
| Gas liver, n (%) | 12 (27.3) | 2 (1.5) | <.001 |
| Portal vein thrombus, n (%) | 2 (4.5) | 2 (1.5) | .263 |
| Treatment methods | .018 | ||
| Antimicrobial agents alone | 7 (15.9) | 48 (36.6) | |
| Antimicrobial agents and drainage | 34 (77.3) | 70 (53.4) | |
| Antimicrobial agents and surgery | 3 (6.8) | 13 (9.9) |
ALB, albumin; ALP, alkaline phosphatase; ALT, alanine aminotransferase; APTT, activated partial thromboplastin time; AST, aspartate aminotransferase; CRP, C-reactive protein; FIB, fibrinogen/fibrin degradation products, MDRO, multidrug-resistant organism(s).