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. 2021 Sep 10;21(1):939.
doi: 10.1186/s12879-021-06649-9.

Epidemiology and risk factors for pyogenic liver abscess in the Calgary Health Zone revisited: a population-based study

Jennifer A Losie  1   2 , John C Lam  2 , Daniel B Gregson  2   3   4 , Michael D Parkins  5   6
Affiliations

Epidemiology and risk factors for pyogenic liver abscess in the Calgary Health Zone revisited: a population-based study

Jennifer A Losie et al. BMC Infect Dis. .

Abstract

Background: Pyogenic liver abscess (PLA), although uncommon in North America, is associated with significant morbidity and mortality. We sought to re-examine the epidemiology, risk factors, and outcomes of PLA in a large, diverse Canadian health zone.

Methods: All Calgary Health Zone (CHZ) residents aged ≥20 with PLA between 2015 and 2017 were identified. Incidence and mortality rates were calculated using census data. Risk factors for PLA were identified using a multivariate analysis. Data was compared to 1999-2003 data, also collected in the CHZ.

Results: There were 136 patients diagnosed with PLA between 2015 and 2017. Incidence rate during this period increased significantly relative to 1999-2003 (3.7 vs 2.3 cases/100,000 population, p < 0.01), however, mortality rates remained similar. The microbiological composition of PLA did not change over this 15-year time period but the number of antimicrobial resistant isolates did increase (8% vs 1%, p = 0.04). The greatest risk factors for PLA relative to general populations included current malignancy, liver-transplant, end-stage renal disease, and cirrhosis. Thirty-day mortality was 7.4% and independent risk factors included polymicrobial bacteremia, absence of abscess drainage, congestive-heart failure, a history of liver disease, and admission bilirubin.

Conclusions: Pyogenic liver abscess is a health concern with rising incidence rate. The increasing prevalence of comorbidities in our population and factors that are associated with risk of PLA suggests this will continue to be an emerging diagnosis of concern. Increasing prevalence of antibiotic resistant organisms compounding unclear optimal treatment regimens is an issue that requires urgent study.

Keywords: Antibiotic resistance; Bacteremia; Biliary disease; Klebsiella pneumoniae; Polymicrobial; Streptococcus anginosus group.

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Conflict of interest statement

No author has relevant competing interests to report. None of the authors report any conflicts related to this study.

Figures

Fig. 1
Fig. 1
Incidence rate of PLA as a function of patient demographics over time
See this image and copyright information in PMC

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