Clinical characteristics and outcome of patients with enterococcal liver abscess.

Große, K; Ohm, D; Würstle, S; Brozat, J F; Schmid, R M; Trautwein, C; Stallmach, A; Bruns, T; Reuken, Philipp A

doi:10.1038/s41598-021-01620-9

Klinik und Poliklinik für Innere Medizin II, Gastroenterologie (Prof. Schmid)

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Document type:: Article; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Author(s):: Große, K; Ohm, D; Würstle, S; Brozat, J F; Schmid, R M; Trautwein, C; Stallmach, A; Bruns, T; Reuken, Philipp A
Title:: Clinical characteristics and outcome of patients with enterococcal liver abscess.
Abstract:: Epidemiology of bacteria isolated from pyogenic liver abscesses change, and an increase in enterococci has been reported in European hospitals. The aim of this study was to investigate the clinical characteristics and outcome of enterococcal PLA. We performed a retrospective analysis of patients with microbiologically confirmed PLA at three German university centers. Indicators of enterococcal PLA were determined using binary logistic regression, and survival analysis was performed using Kaplan-Meier statistics and Cox regression analysis. Enterococci were isolated in 51/133 (38%) patients with PLA. Patients with enterococcal PLA had smaller abscess diameter (4.8 vs. 6.7 cm, p = 0.03) than patients with non-enterococcal PLA, but had more frequent polymicrobial culture results. In univariate logistic regression analysis, alcohol abuse (OR 3.94, 95% CI 1.24-12.49, p = 0.02), hepatobiliary malignancies (OR 3.90, 95% CI 1.86-8.18, p < 0.001) and cirrhosis (OR 6.36, 95% CI 1.27-31.96, p = 0.02) were associated with enterococcal PLA. Patients with enterococcal PLA had a higher mortality than patients with non-enterococcal PLA (hazard ratio 2.92; 95% confidence interval 1.09-7.80; p = 0.03), which remained elevated even after excluding patients with hepatobiliary malignancies, cirrhosis, and transplant recipients in a sensitivity analysis. The increased mortality was associated with non-fecal enterococci but not in patients with Enterococcus faecalis. In this retrospective, multicenter study, enterococcal PLA was common and indicated an increased risk of mortality, underscoring the need for close clinical monitoring and appropriate treatment protocols in these patients.
Journal title abbreviation:: Sci Rep
Year:: 2021
Journal volume:: 11
Journal issue:: 1
Fulltext / DOI:: doi:10.1038/s41598-021-01620-9
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34782684
Print-ISSN:: 2045-2322
TUM Institution:: II. Medizinische Klinik und Poliklinik (Gastroenterologie)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin II, Gastroenterologie (Prof. Schmid)2021