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 pat...

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Autores principales:	K. Große, D. Ohm, S. Würstle, J. F. Brozat, R. M. Schmid, C. Trautwein, A. Stallmach, T. Bruns, Philipp A. Reuken
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6f1baaf5a07248bdade2fa7108fd2b1e
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spelling	oai:doaj.org-article:6f1baaf5a07248bdade2fa7108fd2b1e2021-11-21T12:17:21ZClinical characteristics and outcome of patients with enterococcal liver abscess10.1038/s41598-021-01620-92045-2322https://doaj.org/article/6f1baaf5a07248bdade2fa7108fd2b1e2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01620-9https://doaj.org/toc/2045-2322Abstract 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.K. GroßeD. OhmS. WürstleJ. F. BrozatR. M. SchmidC. TrautweinA. StallmachT. BrunsPhilipp A. ReukenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q K. Große D. Ohm S. Würstle J. F. Brozat R. M. Schmid C. Trautwein A. Stallmach T. Bruns Philipp A. Reuken Clinical characteristics and outcome of patients with enterococcal liver abscess
description	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.
format	article
author	K. Große D. Ohm S. Würstle J. F. Brozat R. M. Schmid C. Trautwein A. Stallmach T. Bruns Philipp A. Reuken
author_facet	K. Große D. Ohm S. Würstle J. F. Brozat R. M. Schmid C. Trautwein A. Stallmach T. Bruns Philipp A. Reuken
author_sort	K. Große
title	Clinical characteristics and outcome of patients with enterococcal liver abscess
title_short	Clinical characteristics and outcome of patients with enterococcal liver abscess
title_full	Clinical characteristics and outcome of patients with enterococcal liver abscess
title_fullStr	Clinical characteristics and outcome of patients with enterococcal liver abscess
title_full_unstemmed	Clinical characteristics and outcome of patients with enterococcal liver abscess
title_sort	clinical characteristics and outcome of patients with enterococcal liver abscess
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6f1baaf5a07248bdade2fa7108fd2b1e
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Clinical characteristics and outcome of patients with enterococcal liver abscess

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