{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T20:55:38Z","timestamp":1767905738244,"version":"3.49.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the clinical features of elderly patients with blood culture-positive bacterial liver abscess (BLA) and improve diagnostic and treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Elderly BLA patients admitted to our hospital from December 2018 to December 2023 were included in the study. Diagnostic tests included routine blood analysis, biochemistry, C-reactive protein (CRP), procalcitonin (PCT), imaging, and cultures of blood or pus. Treatments involved anti-infective therapy, ultrasound-guided abscess drainage, and supportive care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>(1) Elderly patients with blood culture-positive BLA had higher rates of prolonged hospital stays (\u22652\u202fweeks), ICU admission, biliary system diseases, hepatitis B infection, maximum body temperature\u202f\u2265\u202f39\u00b0C, and qSOFA scores \u22652 compared to controls (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05)0. (2) Laboratory findings showed higher levels of total bilirubin (\u226534.2\u202f\u03bcmol\/L), ALT (\u226550\u202fU\/L), serum creatinine (\u226580\u202f\u03bcmol\/L), PCT (\u22655\u202fng\/mL), and lower platelet counts (\u2264100\u202f\u00d7\u202f10<jats:sup>9<\/jats:sup>\/L) in the research group (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). ESBL-positive cases and liver abscesses \u22645\u202fcm were more common in the research group (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). (3) Complications such as pleural effusion, ascites, pulmonary infections, and extrahepatic abscesses were significantly more frequent in the blood culture-positive group (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). (4) Microbiological analysis indicated that <jats:italic>Klebsiella pneumoniae<\/jats:italic> was the leading pathogen (87.93%), followed by <jats:italic>Escherichia coli<\/jats:italic>. For ESBL-positive infections, <jats:italic>E. coli<\/jats:italic> was dominant (75.76%), especially in patients with biliary diseases (75.56%). (5) Logistic regression identified prolonged hospital stay, hepatitis B infection, biliary system diseases, temperature\u202f\u2265\u202f39\u00b0C, PCT \u22655, and abscess size \u22645\u202fcm as independent risk factors for blood culture-positive BLA. (6) The combined diagnostic indicator showed good predictive ability (AUC\u202f=\u202f0.840, sensitivity 76.6%, specificity 72.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elderly patients with biliary diseases, hepatitis B, high PCT levels (\u22655\u202fng\/mL), small abscesses (\u22645\u202fcm), and fever (\u226539\u00b0C) are at higher risk for blood culture-positive BLA. <jats:italic>Klebsiella pneumoniae<\/jats:italic> remains the predominant pathogen (87.93%), highlighting the need for prompt empirical antibiotic therapy. The combined diagnostic model offers reliable predictive value for this condition. We developed a predictive model aimed at assisting clinicians in identifying high-risk patients prone to bloodstream infections secondary to BLA. This model provides valuable guidance for clinicians in formulating more rational and individualized treatment strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1555056","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T07:34:09Z","timestamp":1742456049000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of clinical characteristics of elderly patients with blood culture-positive bacterial liver abscess"],"prefix":"10.3389","volume":"12","author":[{"given":"Hui-Fang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Wen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan-Shan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Wen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Qin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1080\/20009666.2020.1831745","article-title":"Epidemiological, clinical, microbiological, and risk factors of pyogenic liver abscess: an 18-years retrospective single-center analysis","volume":"11","author":"Alkomos","year":"2021","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1111\/liv.14760","article-title":"Clinical characteristics and management of 1572 patients with pyogenic liver abscess: a 12-year retrospective study","volume":"41","author":"Yin","year":"2021","journal-title":"Liver Int"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1186\/s12879-021-06325-y","article-title":"Clinical features and development of Sepsis in Klebsiella pneumoniae infected liver abscess patients: a retrospective analysis of 135 cases","volume":"21","author":"Li","year":"2021","journal-title":"BMC Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12968\/hmed.2024.0206","article-title":"Clinical characteristics and risk factors of Sepsis in patients with liver abscess","volume":"85","author":"Wang","year":"2024","journal-title":"Br J Hosp Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"976","DOI":"10.3390\/pathogens11090976","article-title":"Demographics, radiological findings, and clinical outcomes of Klebsiella pneumonia vs. non-Klebsiella pneumoniae pyogenic liver abscess: a systematic review and Meta-analysis with trial sequential analysis","volume":"11","author":"Chan","year":"2022","journal-title":"Pathogens"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3000605231180053","DOI":"10.1177\/03000605231180053","article-title":"Clinical manifestations, diagnosis, treatment, and outcome of pyogenic liver abscess: a retrospective study","volume":"51","author":"Wang","year":"2023","journal-title":"J Int Med Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2747","DOI":"10.1111\/liv.15034","article-title":"Population-based study of pyogenic liver abscess in Korea: incidence, mortality and temporal trends during 2007-2017","volume":"41","author":"Yoo","year":"2021","journal-title":"Liver Int"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"370","DOI":"10.4103\/sjg.sjg_17_21","article-title":"Clinical comparison of febrile and afebrile patients with pyogenic liver abscess: a two-Centre retrospective study","volume":"27","author":"Yu","year":"2021","journal-title":"Saudi J Gastroenterol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4013","DOI":"10.2147\/IDR.S416860","article-title":"The new changes of epidemiology, etiology, and clinical characteristics of pyogenic liver abscesses: a retrospective study in a Hospital in Northern China","volume":"16","author":"Cui","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"439","DOI":"10.3760\/cma.j.cn112138-20190610-00403","article-title":"Clinical characteristics of patients with Klebsiella pneumoniae pyogenic liver abscess","volume":"59","author":"Xu","year":"2020","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1186\/s12879-020-05142-z","article-title":"Clinical and computed tomography features of extended-spectrum \u03b2-lactamase-producing Klebsiella pneumoniae liver abscess","volume":"20","author":"Ren","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"300060520949404","DOI":"10.1177\/0300060520949404","article-title":"Analysis of the clinical characteristics of 202 patients with liver abscess associated with diabetes mellitus and biliary tract disease","volume":"48","author":"Song","year":"2020","journal-title":"J Int Med Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3037","DOI":"10.2147\/IDR.S470255","article-title":"Liver fibrosis scores as predictors of blood-culture-positive and Sepsis in patients with Klebsiella pneumoniae liver abscess","volume":"17","author":"Zhou","year":"2024","journal-title":"Infect Drug Resist"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1007\/s00134-022-06956-y","article-title":"How to use biomarkers of infection or sepsis at the bedside: guide to clinicians","volume":"49","author":"P\u00f3voa","year":"2023","journal-title":"Intensive Care Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3427","DOI":"10.2147\/IDR.S369988","article-title":"Epidemiological features of Klebsiella pneumoniae infection in the hepatobiliary system of patients in Yantai, China, based on clinical and genetic analyses","volume":"15","author":"Yang","year":"2022","journal-title":"Infect Drug Resist"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/s12876-024-03391-9","article-title":"Prognostic risk factors for pyogenic liver abscess caused by Klebsiella pneumoniae","volume":"24","author":"Lyu","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"466","DOI":"10.26355\/eurrev_202101_24416","article-title":"Procalcitonin and sepsis in the emergency department: an update","volume":"25","author":"Velissaris","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2669","DOI":"10.1007\/s00261-019-02389-2","article-title":"A retrospective study of pyogenic liver abscess caused primarily by Klebsiella pneumoniae vs. non-Klebsiella pneumoniae: CT and clinical differentiation","volume":"45","author":"Lee","year":"2020","journal-title":"Abdom Radiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1097\/MEG.0000000000002906","article-title":"Summary of clinical features of 1800 cases of pyogenic liver abscess","volume":"37","author":"Tian","year":"2024","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1186\/s12879-021-05873-7","article-title":"Maximal diameter of liver abscess independently predicts prolonged hospitalization and poor prognosis in patients with pyogenic liver abscess","volume":"21","author":"Lee","year":"2021","journal-title":"BMC Infect Dis"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"903","DOI":"10.2147\/IDR.S395428","article-title":"Demographics and clinical outcomes of culture-positive versus culture-negative pyogenic liver abscess in an Asian population","volume":"16","author":"Liu","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s11845-019-02041-4","article-title":"Pyogenic liver abscesses due to Escherichia coli are still related to worse outcomes","volume":"189","author":"Ruiz-Hern\u00e1ndez","year":"2020","journal-title":"Ir J Med Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1555056\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T07:34:13Z","timestamp":1742456053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1555056\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":22,"alternative-id":["10.3389\/fmed.2025.1555056"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1555056","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]},"article-number":"1555056"}}