Comparative Analysis Of Risk Factors And Bacterial Spectrum Changes Of Different Clinical Types Of Bacterial Liver Abscess

Objective:To explore the risk factors and bacterial spectrum changes of different clinical types of bacterial liver abscess,so as to provide some medical evidence for the scientific prevention and treatment of bacterial liver abscess.Methods:Patients with bacterial liver abscess diagnosed in the Department of General surgery of Baotou Central Hospital from January 2017 to February 2021 were divided into recurrent group(A1)and primary group(A2)according to whether they were hospitalized repeatedly or not,and divided into single group(B1)and multiple group(B2)according to the number of abscesses reported by imaging.According to the results of bacterial culture,the patients were divided into culture positive group(C1)and culture negative group(C2).The results of clinical manifestations,laboratory and imaging examination,underlying diseases,microbial culture and drug sensitivity test were collected and compared.Results:(1)After screening the inclusion criteria,there were 47 females with an average age of 60.1 years,and 80 males with an average age of 59.9 years.There were118 cases in initial group,9 cases in recurrent group,109 cases in single group and 18 cases in multiple group,114 cases were positive in culture and 13 cases were negative in culture.(2)Comparison of the indexes between the two groups with or without recurrent attacks: there was significant difference between the two groups with or without diabetes and biliary diseases(P < 0.05),and the incidence of biliary diseases and diabetes in the recurrent group was significantly higher than that in the first group.There was no significant difference in bilirubin,inflammatory index,tumor history and imaging findings between the two groups(P > 0.05).(3)There were significant differences in the indexes of multiple abscess between the two groups with or without hypertension,diabetes,fever and involvement of right lobe(P < 0.05),and the prevalence rate of hypertension was lower in multiple abscess group.the proportion of diabetes and fever was higher.There was no significant difference in biliary tract disease,tumor history,inflammatory index and bilirubin between the two groups(P >0.05).(4)Comparison of different culture results between the two groups: there were significant differences in concomitant biliary diseases,total bilirubin(totalbilirubin,TBIL),direct bilirubin(directbilirubin,DBIL)and indirect bilirubin(indirectbilirubin,IBIL)between the two groups.The incidences of biliary diseases,TBIL,DBIL and IBIL in the positive culture group were significantly higher than those in the negative culture group.There was no significant difference in diabetes,tumor history,inflammatory index,imaging and other indexes between the two groups(P >0.05).(5)Results of microbial culture: 103 cases of Klebsiella pneumoniae were cultured in 127 subjects,the detection rate was 81.1%,13 cases(10.23%)were not detected,and the other strains were detected in less than 2 cases(1.57%).(6)20 cases of drug resistance were detected in 103 cases of Klebsiella pneumoniae: amikacin(2cases),piperacillin / tazobactam(2 cases),compound sulfamethoxazole(4 cases),ciprofloxacin(3 cases),levofloxacin(1 case),cefoxitin(1 case),ampicillin / sulbactam(2 cases),chloramphenicol(5 cases).The strains were 100% sensitive to imipenem,gentamicin,ceftazidime,aztreonam,cefoperazone / sulbactam,cefepime,meropenem,amoxicillin / potassium clavulanate,etc.Conclusion:1.The culture positive rate of bacterial liver abscess with biliary diseases was higher.2.There was a significant positive correlation between diabetic patients and recurrent and multiple abscesses of bacterial liver abscess.3.At present,Klebsiella pneumoniae has become a common microorganism of bacterial liver abscess in this area,and the strain has high sensitivity to cephalosporins and carbapenem antibiotics.