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Of 176 pyogenic liver abscess patients related to biliary disorders, there were 48 pyogenic liver abscess patients (27.3%) caused by extended\u2010spectrum beta\u2010lactamase\u2010producing Enterobacteriaceae. Within 67 pyogenic liver abscess patients caused by Enterobacteriaceae expressing extended\u2010spectrum beta\u2010lactamases, the occurrences of 48 pyogenic liver abscess patients (71.6%) were associated with biliary disorders. When compared with pyogenic liver abscess patients caused by non\u2010extended\u2010spectrum beta\u2010lactamase\u2010producing Enterobacteriaceae, there were significantly greater incidences of polymicrobial infections, bacteremia, pulmonary infection, recurrence and death in pyogenic liver abscess patients caused by extended\u2010spectrum beta\u2010lactamase\u2010producing Enterobacteriaceae. Carbapenems remain mainstay drugs against extended\u2010spectrum beta\u2010lactamase\u2010producing <jats:italic>E.\u00a0coli<\/jats:italic> and <jats:italic>K.\u00a0pneumoniae<\/jats:italic>. Independent risk factors for occurrence of pyogenic liver abscess caused by extended\u2010spectrum beta\u2010lactamase\u2010producing Enterobacteriaceae were biliary disorders including extra\u2010 and intrahepatic cholangiolithiasis and an abnormal bilioenteric communication between bile and gut, a treatment history of malignancy such as operation and chemotherapy, pulmonary infection, and diabetes mellitus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pyogenic liver abscess caused by extended\u2010spectrum beta\u2010lactamase\u2010producing Enterobacteriaceae isolates mainly occurs in patients with biliary disorders or with a treatment history of malignancy. The mainstay of treatment remains carbapenems in combination with adequate aspiration or drainage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13267","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T06:45:07Z","timestamp":1476341107000},"page":"727-734","source":"Crossref","is-referenced-by-count":28,"title":["Biliary diseases as main causes of pyogenic liver abscess caused by extended\u2010spectrum beta\u2010lactamase\u2010producing Enterobacteriaceae"],"prefix":"10.1111","volume":"37","author":[{"given":"Shao\u2010Hua","family":"Shi","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery, First Affiliated Hospital Zhejiang University  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Ning","family":"Feng","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery, First Affiliated 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