Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2020; 12(10): 816-828
Published online Oct 27, 2020. doi: 10.4254/wjh.v12.i10.816
Increased incidence of and microbiologic changes in pyogenic liver abscesses in the Mexican population
Juanita Pérez-Escobar, Wagner Ramirez-Quesada, Daniel Alejandro Calle-Rodas, Luis Alberto Chi-Cervera, Nalu Navarro-Alvarez, Jorge Aquino-Matus, Juan Pablo Ramírez-Hinojosa, Carlos Moctezuma-Velázquez, Aldo Torre
Juanita Pérez-Escobar, Wagner Ramirez-Quesada, Daniel Alejandro Calle-Rodas, Luis Alberto Chi-Cervera, Nalu Navarro-Alvarez, Carlos Moctezuma-Velázquez, Aldo Torre, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
Jorge Aquino-Matus, Juan Pablo Ramírez-Hinojosa, Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Mexico City 14080, Mexico
Author contributions: Pérez-Escobar J and Ramirez-Quesada W contributed equally to this manuscript: Designed the study, performed the research, and wrote the paper; Calle-Rodas DA, Chi-Cervera LA, Aquino-Matus J, and Ramírez-Hinojosa JP collected information from medical charts; Navarro-Alvarez N, Moctezuma-Velázquez C and Torre A contributed to the analysis and supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
Informed consent statement: Patients were not required to give informed consent because the data were obtained from medical charts. This was a retrospective study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Aldo Torre, MD, PhD, Attending Doctor, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, No.15, Vasco de Quiroga, Belisario Domínguez Secc 16, Mexico City 14080, Mexico. detoal@yahoo.com
Received: May 25, 2020
Peer-review started: May 25, 2020
First decision: June 12, 2020
Revised: June 26, 2020
Accepted: August 16, 2020
Article in press: August 16, 2020
Published online: October 27, 2020
Processing time: 151 Days and 21.6 Hours
ARTICLE HIGHLIGHTS
Research background

In Mexico, the epidemiology of pyogenic liver abscess (PLA) is unknown, with some small case series. This study recruited patients from two high-level hospitals in Mexico.

Research motivation

PLA is a rare medical condition that has had a change in its etiology in recent years; however, more studies are needed to determine the epidemiology of PLA in Mexico.

Research objectives

The aim of this study was to describe the current clinical, demographic, and microbiologic characteristics of PLAs in two high-volume centers in Mexico. These data will allow us to understand the behavior of this disease in Mexico.

Research methods

This is a retrospective analysis of patients with PLA from two high-level hospitals in Mexico. A chart review was performed to evaluate the clinical, demographic and microbiologic characteristics of PLA. A multivariate analysis was performed to identify independent risk factors associated with mortality.

Research results

The main isolated microorganisms were ESBL-Escherichia coli and Klebsiella pneumoniae. The inpatient mortality rate was 63%. In multivariate analysis, immunocompromised state, ESBL-Escherichia coli, and Klebsiella pneumoniae were independent predictors of high risk mortality

Research conclusions

An increased prevalence in both referral centers has been noted. The mortality rate was significantly higher compared to previously reported rates worldwide, reaching 63%. There was a steady shift to a predominant Klebsiella pneumoniae-related abscess.

Research perspectives

As a retrospective review, our study is limited. Prospective studies that monitor the mortality rate are required, which in this study was high compared to that reported in other series.