Study On The Change Of Pathogenic Bacteria Of Pyogenic Liver Abscess In Recent 5 Years

Objective:With the improvement in living conditions and the widespread use of antibiotics,the infection,etiology of pyogenic liver abscess may change a lot.This study was to analysis the relationship between the pathogenic bacteria and the concomitant diseases of pyogenic liver abscess in recent 5 years,and compared these situation to that patients of pyogenic liver abscess in 10 years ago.So as to find the changes of the pathogenic bacteria and the concomitant diseases of pyogenic liver abscess,which can provide reffering evidence available for the prevention and treatment of pyogenic liver abscess.Methods:We retrospectively reviewed the clinical features of pyogenic liver abscess patients,admitted in our hospital from january 1994 to december 1998(as the first group),and compared to patients of pyogenic liver abscess admitted in our hospital from january 2004 to june 2008(as the second group).We investigated the outcome of blood cultures and abscess cultures of these patients,and as well as the concomitant diseases of patients in both groups.And then,we made statistical analysis of the outcome that from patients in the two groups and compared the differences in this outcome.Results:In the first group,separately patients with concomitant disease of biliary disease and diabetes mellitus take proportion of 32.35%(22/68 ),16.18%(11/68).On the other group,the proportion was 17.46%(22/126) and 30.95%(39/126).The proportion of the concomitant disease of biliary disease and diabetes mellitus had significant difference in both groups.In the first group,patients of whom blood cultures were obtained,positive rate of bacterial blood cultures were 17.65% (3/17patients).And patients of whom abscess cultures were obtained,positive rate of bacterial abscess cultures were 35%(7/20patients ).The differences in positive rate of bacterial blood cultures and abscess cultures had no statistical significance (p=0.2876>0.05).There were 11 trees of bacteria obtained in the Patients of whom cultures were obtained in the fist group.And E.coli was the most important bacteria (45.45%) and the second was Klebsiella pneumoniae(27.27%).In the second group,patients of whom blood cultures were obtained,positive rate of bacterial blood cultures were 27.91%(12/43patients).And patients of whom abscess cultures were obtained,positive rate of bacterial abscess cultures were 47.06%(24/51 patients).The differences in positive rate of bacterial blood cultures and abscess cultures had statistical significance(χ~2=13.31,p<0.05).That was the positive rate of bacterial blood cultures higher than the positive rate of bacterial abscess cultures.There were 39 trees of bacteria obtained in the Patients of whom cultures were obtained in the fist group,firstly was Klebsiella pneumoniae(56.41%) and secondly was E.coli(20.51%). In the first group,the positive rate of bacterial blood cultures of patients that with concomitant disease of diabetes mellitus was 50%(2/4patients),while the positive rate of patients that with concomitant disease of biliary disease was 66.67% (4/6patients).In the second group,the positive rate of bacterial cultures of patients that with concomitant disease of diabetes mellitus was 40%(8/20patients),while the positive rate of bacterial cultures of patients that with concomitant disease of biliary disease was 61.54%(8/13patients).The differences in positive rate of bacterial cultures between patients that with concomitant disease of diabetes mellitus and biliary disease had no statistical significance in both groups(p>0.05).Klebsiella pneumoniae were the most frequently isolated in the patients that with concomitant disease of diabetes mellitus in both groups.And E.coli were the most frequently isolated in the patients that with concomitant disease of biliary disease in both groups.Conclusions:in the recent 5 years,the construction of concomitant diseases of pyogenic liver abscess changed:the biliary disease have declined and diabetes mellitus have ascended obviously.And the major pathogenic bacteria of E.coliwas had been taken placed by Klebsiella pneumoniae.