中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

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

DOI: 10.3969/j.issn.1001-5256.2020.01.026
  • Received Date: 2019-07-24
  • Published Date: 2020-01-20
  • 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.

     

  • [1] ONG GY,CHANGCHIEN CS,LEE CM,et al. Liver abscess complicating transcatheter arterial embolization:A rare but serious complication. A retrospective study after 3878 procedures[J]. Eur J Gastroenterol Hepatol,2004,16(8):737-742.
    [2] ELIAS D,di PIETROANTONIO D,GACHOT B,et al. Liver abscess after radiofrequency ablation of tumors in patients with a biliary tract procedure[J]. Gastroenterol Clin Biol,2006,30(6-7):823-827.
    [3] MEZHIR JJ,FONG Y,FLEISCHER D,et al. Pyogenic abscess after hepatic artery embolization:A rare but potentially lethal complication[J]. J Vasc Interv Radiol,2011,22(2):177-182.
    [4] CHEN C,CHEN PJ,YANG PM,et al. Clinical and microbiological features of liver abscess after transarterial embolization for hepatocellular carcinoma[J]. Am J Gastroenterol,1997,92(12):2257-2259.
    [5] SHIN JU,KIM KM,SHIN SW,et al. A prediction model for liver abscess developing after transarterial chemoembolization in patients with hepatocellular carcinoma[J]. Dig Liver Dis,2014,46(9):813-817.
    [6] KIM MH,CHOI MS,CHOI YS,et al. Clinical features of liver abscess developed after radiofrequency ablation and transarterial chemoembolization for hepatocellular carcinoma[J]. Korean J Hepatol,2006,12(1):55-64.
    [7] LV WF,LU D,HE YS,et al. Liver abscess formation following transarterial chemoembolization:Clinical features,risk factors,bacteria spectrum,and percutaneous catheter drainage[J].Medicine(Baltimore),2016,95(17):e3503.
    [8] SHIBATA T,YAMAMOTO Y,YAMAMOTO N,et al. Cholangitis and liver abscess after percutaneous ablation therapy for liver tumors:Incidence and risk factors[J]. J Vasc Interv Radiol,2003,14(12):1535-1542.
    [9] WANG YM,WANG N,XU Y,et al. Severe complications after microwave ablation in 7403 cases with liver cancer[J]. Chin J Hepatobiliary Surg,2016,22(10):655-660.(in Chinese)王延明,王能,许赟,等.微波消融治疗7403例肝癌的严重并发症[J].中华肝胆外科杂志,2016,22(10):655-660.
    [10] SUN W,XU F,LI X,et al. A case series of liver abscess formation after transcatheter arterial chemoembolization for hepatic tumors[J]. Chin Med J(Engl),2017,130(11):1314-1319.
    [11] CHOI D,LIM HK,KIM MJ,et al. Liver abscess after percutaneous radiofrequency ablation for hepatocellular carcinomas:Frequency and risk factors[J]. AJR Am J Roentgenol,2005,184(6):1860-1867.
    [12] ZHOU YQ,ZENG M,ZHOU J,et al. Drug resistance of Enterobacteriaceae bacteria causing liver abscess[J]. J Clin Hepatol,2018,34(8):1750-1753.(in Chinese)周宜庆,曾敏,周洁,等.导致肝脓肿的肠杆菌科细菌的耐药性分析[J].临床肝胆病杂志,2018,34(8):1750-1753.
    [13] HU FP,GUO Y,ZHU DM,et al. Antimicrobial resistance profile of clinical isolates in hospitals across China:Report from the CHINET Surveillance Program,2017[J]. Chin J Infect Chemother,2018,18(3):241-251.(in Chinese)胡付品,郭燕,朱德妹,等.2017年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2018,18(3):241-251.
    [14] ZHAO XJ,DENG LH,SHI DS,et al. Analysis of resistance mechanism of carbapenem-resistant Klebsiella pneumoniae[J]. Chin J Nosocomiol,2015,25(17):3851-3853,3883.(in Chinese)赵晓杰,邓丽华,施德仕,等.耐碳青霉烯类肺炎克雷伯菌耐药机制研究[J].中华医院感染学杂志,2015,25(17):3851-3853,3883.
    [15] LIU CL,XU HY,ZHANG ZP,et al. Analysis of antimicrobial resistance in Enterococcus isolates from 2009 to 2013[J].Chin J Infect Chemother,2015,15(2):142-145.(in Chinese)刘春林,徐红云,张志鹏,等.2009-2013年肠球菌属临床感染及耐药性分析[J].中国感染与化疗杂志,2015,15(2):142-145.
    [16] WANG S,HAO YH,YANG W,et al. Incidence and risk factors of liver abscess after radiofrequency ablation for liver cancer[J]. Chin J Interv Imaging Ther,2018,15(1):37-41.(in Chinese)王凇,郝艳红,杨薇,等.肝癌射频消融后肝脓肿的发生率及危险因素分析[J].中国介入影像与治疗学,2018,15(1):37-41.
    [17] WU YM,ZHOU RM,LIANG HM,et al. Clinical characteristics and predisposing factors for liver abscess formation after chemoembolization of hepatic malignancy[J/CD]. Chin J Clinicians(Electronic Edition),2011,5(2):343-346.(in Chinese)吴育民,周汝明,梁惠民,等.肝癌化疗栓塞并发肝脓肿的临床特点及易感因素分析[J/CD].中华临床医师杂志(电子版),2011,5(2):343-346.
    [18] GESCHWIND JF,KAUSHIK S,RAMSEY DE,et al. Influence of a new prophylactic antibiotic therapy on the incidence of liver abscesses after chemoembolization treatment of liver tumors[J]. J Vasc Interv Radiol,2002,13(11):1163-1166.
    [19] CHUANG JH,LEE SY,CHEN WJ,et al. Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction:Implication in the pathogenesis of postoperative cholangitis[J]. World J Surg,2001,25(12):1512-1518.
    [20] JIA Z,TU J,CAO C,et al. Liver abscess following transarterial chemoembolization for the treatment of hepatocellular carcinoma:A retrospective analysis of 23 cases[J]. J Cancer Res Ther,2018,14(Supplement):s628-s633.
  • Relative Articles

    [1]Yishan LIU, Lanting ZHANG, Yunyu ZHAO, Fanpu JI, Qinglei ZENG. Management of hepatitis C in children and pregnant women[J]. Journal of Clinical Hepatology, 2024, 40(4): 654-658. doi: 10.12449/JCH240402
    [2]Xiaoping ZOU. Advances in endoscopic retrograde cholangiopancreatography in diagnosis and treatment of pancreatic diseases in children[J]. Journal of Clinical Hepatology, 2022, 38(12): 2687-2692. doi: 10.3969/j.issn.1001-5256.2022.12.002
    [3]Qiu JIN, Jing YANG, Honglin MA, Pingju LI, Shaoshan HU, Qingqing LIU. Value of different scoring systems in predicting the severity and prognosis of hyperlipidemic acute pancreatitis[J]. Journal of Clinical Hepatology, 2022, 38(11): 2551-2557. doi: 10.3969/j.issn.1001-5256.2022.11.022
    [4]Qiu JIN, Jing YANG, Honglin MA, Pingju LI, Shaoshan HU, Qingqing LIU. Research advances in the value of related markers in predicting the severity and prognosis of acute pancreatitis[J]. Journal of Clinical Hepatology, 2022, 38(12): 2877-2881. doi: 10.3969/j.issn.1001-5256.2022.12.038
    [5]Lijian YANG, Honglai XU, Yuelong HUANG, Xueli LI, Xiubing CHEN. Complete rupture of the pancreas and duodenum caused by car accident in children: A case report[J]. Journal of Clinical Hepatology, 2021, 37(11): 2653-2654. doi: 10.3969/j.issn.1001-5256.2021.11.035
    [6]Yuqing CHEN, Peiling LI, Lu ZHANG, Huan XU, Yan PENG, Xiaowei TANG. Clinical and prognostic features of hypertriglyceridemic pancreatitis during pregnancy[J]. Journal of Clinical Hepatology, 2021, 37(5): 1164-1168. doi: 10.3969/j.issn.1001-5256.2021.05.036
    [7]Zhong Rui, Yan YongFeng, Jiang Xin, Xu Huan, Peng Yan, Wang Min, Fu WenGuang, Tang XiaoWei. Clinical features of acute pancreatitis with metabolic syndrome and influencing factors for prognosis[J]. Journal of Clinical Hepatology, 2020, 36(8): 1794-1798. doi: 10.3969/j.issn.1001-5256.2020.08.023
    [8]Yan YongFeng, Jiang Xin, Zhong Rui, Xu Huan, Peng Yan, Tang XiaoWei. Clinical features and prognosis of acute pancreatitis with nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(5): 1091-1096. doi: 10.3969/j.issn.1001-5256.2020.05.028
    [9]JIANG Xin, YAN YongFeng, ZHONG Rui, XU Huan, PENG Yan, TANG XiaoWei. Influence of serum triglyceride level on the prognosis of acute biliary pancreatitis[J]. Journal of Clinical Hepatology, 2020, 36(11): 2509-2514. doi: 10.3969/j.issn.1001-5256.2020.11.022
    [10]An WenHui, He XuChang, Yang Jing, Ren BeiBei, Zhang Xue, Leng Jiao, Luo Run. Value of early admission scoring systems in predicting the severity and prognosis of acute pancreatitis[J]. Journal of Clinical Hepatology, 2020, 36(6): 1342-1346. doi: 10.3969/j.issn.1001-5256.2020.06.030
    [11]Yuan Jing, Meng Fei, Tang XiaoWei, Chen Xia, Peng Yan. Clinical features and prognosis of acute pancreatitis in pregnancy[J]. Journal of Clinical Hepatology, 2019, 35(1): 138-142. doi: 10.3969/j.issn.1001-5256.2019.01.026
    [12]Lu YeFeng, Xia Qiang, Qiu BiJun, Feng MingXuan, Wan Ping. An analysis of related issues in long-term survival in children after liver transplantation[J]. Journal of Clinical Hepatology, 2019, 35(11): 2396-2401. doi: 10.3969/j.issn.1001-5256.2019.11.004
    [13]Nan YueMin, Li DongDong, Kong LingBo. Focus on the treatment of chronic hepatitis C in children[J]. Journal of Clinical Hepatology, 2018, 34(2): 246-250. doi: 10.3969/j.issn.1001-5256.2018.02.006
    [14]Yan YanYan, Xie XinBao, Wang JianShe. An excerpt of management of acute pancreatitis in the pediatric population: a clinical report from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee(2018)[J]. Journal of Clinical Hepatology, 2018, 34(5): 982-986. doi: 10.3969/j.issn.1001-5256.2018.05.011
    [15]Gao Fan, Qi XingShun, Hou Yue, Guo XiaoZhong. Association between pancreatitis and fatty liver disease[J]. Journal of Clinical Hepatology, 2017, 33(1): 40-45. doi: 10.3969/j.issn.1001-5256.2017.01.008
    [16]Wu Jie, Liu YuFei, Kong WenWen, Wang ChaoXia. Advances in the diagnosis and treatment of pediatric acute pancreatitis[J]. Journal of Clinical Hepatology, 2017, 33(6): 1196-1200. doi: 10.3969/j.issn.1001-5256.2017.06.039
    [17]Gan Yu, Dong Yi, Zhang HongFei, Xu ZhiQiang, Chen DaWei, Wang LiMin, Wang FuChuan, Yan JianGuo, Zhu ShiShu. Clinical characteristics and outcomes of drug-induced liver injury in children: a study of 184 cases[J]. Journal of Clinical Hepatology, 2015, 31(8): 1244-1247. doi: 10.3969/j.issn.1001-5256.2015.08.015
    [18]Zhang Zhen, Sheng ChuQiao, Qi Ji, Li YuMei. Clinical analysis and prognostic judgment of artificial extracorporeal liver support therapy for pediatric acute liver failure [J]. Journal of Clinical Hepatology, 2015, 31(8): 1262-1265. doi: 10.3969/j.issn.1001-5256.2015.08.019
    [19]Zhang Jian. Correlation between malnutrition and prognosis of hepatitis A in Uygur children[J]. Journal of Clinical Hepatology, 2015, 31(8): 1235-1237. doi: 10.3969/j.issn.1001-5256.2015.08.013
    [20]Niu ChunYan, Yan Rong, Tian Yu, Ma HuiXia, Jiao ShuJiang. The prevalence of fatty liver disease and its relationship with metabolic syndrome[J]. Journal of Clinical Hepatology, 2010, 26(2): 167-169.
  • Cited by

    Periodical cited type(4)

    1. 沈芳,黄语嫣. 非诺贝特对高脂血症性急性胰腺炎患者的影响. 中外医学研究. 2024(07): 30-34 .
    2. 温扬敏,田力,蔡炼,邱丹缨. 兖州卷柏水提物对急性酒精性肝损伤小鼠保肝及肠道菌群的影响. 中成药. 2023(06): 2016-2022 .
    3. 李真真,白杨,黄婷. 非诺贝特联合胰岛素治疗2型糖尿病合并非酒精性脂肪性肝病患者疗效观察. 肝脏. 2022(01): 103-105+122 .
    4. 李欣坪,王蒙蒙,王子晨,方琼莲,林玉萍. 滇黄芩茎叶乙醇提取物及其不同溶剂萃取部位的抗氧化和降脂活性研究. 中国药房. 2021(02): 220-225 .

    Other cited types(4)

  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1324) PDF downloads(223) Cited by(8)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return