Pathogen distribution and drug resistance in liver cancer patients with liver abscess after transarterial chemoembolization or ablation

Objective To investigate the pathogen distribution characteristics and drug resistance in patients with liver abscess after transarterial chemoembolization(TACE) or ablation for liver cancer,and to provide a basis for rational use of antibacterial agents in clinical practice. Methods A retrospective analysis was performed for the results of the strains isolated from liver pus and blood culture and drug sensitivity test of the liver cancer patients who were admitted to Beijing YouAn Hospital from January 2011 to December 2018 and developed liver abscess after TACE/ablation. The Chi-square test was used for comparison of categorical data between groups. Results A total of 49 patients were enrolled,with 15 in TACE group and 34 in ablation group. A total of 35 strains of pathogenic organisms were detected in the TACE group,and Gram-negative bacteria,Gram-positive bacteria,and fungi accounted for 54. 3%,40%,and 5. 7%,respectively; Klebsiella pneumoniae,Enterococcus faecium,and Pseudomonas aeruginosa were the main pathogenic bacteria isolated from liver pus culture,and Enterococcus faecalis,Escherichia coli,and Citrobacter were the main pathogenic bacteria isolated from blood culture. A total of 64 strains of pathogenic organisms were detected in the ablation group,and Gram-negative bacteria,Gram-positive bacteria,and fungi accounted for 59. 4%,39. 1%,and 1. 6%,respectively; Escherichia coli,Klebsiella pneumonia,and Enterococcus faecalis were the main pathogenic bacteria isolated from liver pus culture,and Klebsiella pneumoniae,Escherichia coli,and Enterococcus faecalis were the main pathogenic bacteria isolated from blood culture. Drug susceptibility results showed that in the strains of Klebsiella pneumoniae and Escherichia coli,the ESBL-producing strains accounted for 26. 3%(5/19) and 43. 8%(7/16),respectively,and the carbapenem-resistantstrains accounted for 10. 5%(2/19) and 12. 5%(2/16),respectively. Klebsiella pneumoniae had a drug resistance rate of ≤10. 5% to third-generation cephalosporins,quinolones,aminoglycosides,piperacillin/tazobactam,and carbapenems,and Escherichia coli had a drug resistance rate of 43. 8%-62. 5% to the tested cephalosporins,quinolones,and penicillins,18. 8% to piperacillin/tazobactam,and 12. 5%to carbapenems. In the strains of Enterococcus faecium and Enterococcus faecalis,the vancomycin-resistant strains accounted for 13. 3%(2/15) and 0,respectively,and the linezolid-resistant strains accounted for 13. 3%(2/15) and 28. 6%(2/7),respectively,while no teicoplanin-resistant strains were detected. Conclusion Klebsiella pneumoniae,Escherichia coli,Enterococcus faecium,and Enterococcus faecalis are the main pathogenic bacteria of liver abscess after TACE/ablation for liver cancer,and drugs should be selected based on drug susceptibility results to reduce drug-resistant strains.