The role of Enterococcus spp. and multidrug-resistant bacteria causing pyogenic liver abscesses

BMC Infectious Diseases

Research Article

Katharina Schwarzkopf¹  Christian M. Lange¹  Stefan Zeuzem¹  Marcus M. Mücke¹  Victoria T. Mücke¹  Johanna Kessel²  Christoph Stephan²  Michael Hogardt³  Volkhard A. J. Kempf³ 

[1] Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt am Main, Germany;University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany;University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany;Department of Internal Medicine 2, University Hospital Frankfurt, Frankfurt am Main, Germany;University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany;Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany;

关键词: Pyogenic liver abscess;    Bacterial pathogens;    Susceptibility profiles;    Multidrug-resistant organisms;    Vancomycin-resistant enterococci;   

DOI  :  10.1186/s12879-017-2543-1

 received in 2017-03-11, accepted in 2017-06-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPyogenic liver abscesses (PLA) remain a significant clinical problem. Unfortunately, little is known about current bacterial susceptibility profiles and the incidence of multidrug resistant organisms (MDROs) causing PLA in Western countries. Yet, this crucial information is pivotal to guide empirical antibiotic therapy. Aim of this study was to provide detailed characteristics of PLA with a special focus on underlying bacterial pathogens and their susceptibility to antibiotics.MethodsA retrospective study of patients diagnosed with PLA from 2009 to 2015 in a large tertiary reference center in Germany was performed in order to characterize PLA and antimicrobial susceptibility profiles of causative bacterial species.ResultsOverall, 86 patients were included. The most common causes of PLA were bile duct stenosis/obstruction (31.4%) and leakage of biliary anastomosis (15.1%). Frequent predisposing diseases were malignancies (34.9%), diabetes (24.4%) and the presence of liver cirrhosis (16.3%). Of note, Enterococcus spp. were the most frequently cultured bacterial isolates (28.9%), and in 1/3 of cases vancomycin resistance was observed. In addition, a relevant frequency of gram-negative MDROs was identified. In particular, an alarming 10% and 20% of gram-negative bacteria were resistant to carbapenems and tigecycline, respectively. Of note, MDRO status did not predict ICU stay or survival in multivariate regression analysis. The mortality rate in our series was 16.3%.ConclusionOur study demonstrates an as yet underreported role of Enterococcus spp., often associated with vancomycin resistance, as well as of gram-negative MDROs causing PLA.

【 授权许可】

CC BY   
© The Author(s). 2017