{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:29:02Z","timestamp":1791473342004,"version":"4.3.4"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver abscesses are a cause of morbidity worldwide and their outcomes can vary remarkably in various regions of the world. In the United Arab Emirates (UAE) the clinical picture of liver abscesses is not fully understood. We aimed to fill this gap by analyzing the clinical features, microbiology, and outcomes for patients with liver abscess over a 12-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study of all adult patients (\u226518\u2009years) with confirmed diagnosis of liver abscess at Tawam Hospital, Al Ain, UAE, from January 2012 to January 2024. Electronic medical records were reviewed to extract demographic, clinical, laboratory, radiological, and microbiological data. Patients were then classified as either having pyogenic liver abscess (PLA) or amoebic liver abscess (ALA). Statistical analyses were performed to identify predictors of morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 158 patients screened, 79 had confirmed liver abscesses (71 pyogenic, 8 amoebic). The mean age was 56.8\u2009\u00b1\u200916.2\u2009years, with male predominance (65.8%). The commonest clinical findings were abdominal pain (73.4%), fever (68.4%), and nausea\/vomiting (45.6%). Diabetes mellitus was found in 35.4% of patients, while malignancy was identified in 30.4%.\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      was the most frequently isolated organism (40.0% of positive pus cultures), followed by\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (14.0%). However,\n                      <jats:italic>E. coli<\/jats:italic>\n                      , particularly ESBL-producing strains, showed disproportionately high mortality (80.0%) compared to\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      (2.6% mortality). The overall mortality rate was 15.2% (12\/79), with 83.3% (10\/12) directly attributable to liver abscess complications. ICU admission was required in 20.3% of cases. In univariate analysis, predictors of mortality included age &amp;gt;65\u2009years (OR 12.2, 95% CI 2.9\u201351.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), serum albumin &amp;lt;30\u2009g\/L (OR 17.6, 95% CI 2.2\u2013142.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and presence of multiple abscesses (OR 4.5, 95% CI 1.3\u201315.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The overwhelming majority of patients with liver abscesses at high-risk for complications respond favorably to antimicrobial therapy. However, the most striking finding was the unexpectedly observed mortality associated with\n                      <jats:italic>E. coli<\/jats:italic>\n                      , especially ESBL strains (80% mortality), something that underscores the need for rapid diagnosis and robust empiric coverage for resistant organisms in the severely ill. Our findings identify increased frequency of underlying malignancy which emerged as a major determinant of mortality, reinforcing the need for comprehensive cancer screening into the diagnostic workup of patients presenting with liver abscess.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1673473","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:29:24Z","timestamp":1765261764000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical characteristics and outcomes of liver abscesses: a 12-year retrospective analysis from a tertiary care center in the United Arab Emirates"],"prefix":"10.3389","volume":"12","author":[{"given":"Adnan","family":"Agha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Fareeduddin","family":"Farooqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noria Ghulam","family":"Nabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amatur Rehman","family":"Siddiqua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3915024","DOI":"10.1155\/grp\/3915024","article-title":"Incidence, risk factors, and subsequent health outcomes of pyogenic liver abscesses: a scoping review of evidence from population-based studies","volume":"2025","author":"Wang","year":"2025","journal-title":"Gastroenterol Res Pract"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1080\/23744235.2023.2190813","article-title":"Increasing incidence of pyogenic liver abscess in southern Sweden: a population-based study from 2011 to 2020","volume":"55","author":"Svensson","year":"2023","journal-title":"Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1002\/ueg2.12132","article-title":"Epidemiology of pyogenic liver abscesses in Germany: analysis of incidence, risk factors and mortality rate based on routine data from statutory health insurance","volume":"9","author":"Zimmermann","year":"2021","journal-title":"UEG J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1016\/S1542-3565(04)00459-8","article-title":"Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess","volume":"2","author":"Kaplan","year":"2004","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e21477","DOI":"10.7759\/cureus.21477","article-title":"Increased incidence of pyogenic liver abscess in a Midwest system with emphasis on rural impact","volume":"14","author":"Grassel","year":"2022","journal-title":"Cureus"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1016\/S1473-3099(12)70205-0","article-title":"Klebsiella pneumoniae liver abscess: a new invasive syndrome","volume":"12","author":"Siu","year":"2012","journal-title":"Lancet Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/S0140-6736(03)12830-9","article-title":"Amoebiasis","volume":"361","author":"Stanley","year":"2003","journal-title":"Lancet"},{"key":"ref8","volume-title":"International migration 2019: Highlights (ST\/ESA\/SER.A\/439)","year":"2019"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s40794-021-00140-8","article-title":"Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates","volume":"7","author":"Mousa","year":"2021","journal-title":"Trop Dis Travel Med Vacc"},{"key":"ref10","volume-title":"International statistical classification of diseases and related health problems: 10th revision (ICD-10)","year":"2016"},{"key":"ref11","volume-title":"International classification of diseases: Ninth revision (ICD-9)","year":"1977"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.5001\/omj.2014.69","article-title":"Epidemiology, clinical features and outcome of liver abscess: a single reference center experience in Qatar","volume":"29","author":"Abbas","year":"2014","journal-title":"Oman Med J"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.3748\/wjg.14.2089","article-title":"Predictive factors for early aspiration in liver abscess","volume":"14","author":"Khan","year":"2008","journal-title":"World J Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"528","DOI":"10.4103\/0256-4947.84635","article-title":"Liver abscess presentation and management in Saudi Arabia and the United Kingdom","volume":"31","author":"Albenmousa","year":"2011","journal-title":"Ann Saudi Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1186\/s12879-019-4127-8","article-title":"Clinical characteristics and treatment outcomes in a cohort of patients with pyogenic and amoebic liver abscess","volume":"19","author":"Neill","year":"2019","journal-title":"BMC Infect Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3947\/ic.2018.50.3.210","article-title":"Klebsiella pneumoniae liver abscess","volume":"50","author":"Jun","year":"2018","journal-title":"Infect 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Arabia","volume":"2019","author":"Ibrahim","year":"2019","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1128\/cmr.00096-12","article-title":"\u0392-Lactamase production in key gram-negative pathogen isolates from the Arabian peninsula","volume":"26","author":"Zowawi","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"ref21","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 (1971 -)"},{"key":"ref22","first-page":"ofad352","article-title":"A population-based study of unfavorable prognostic factors associated with pyogenic liver abscess. Open forum infectious diseases","author":"Bl\u00e4ckberg","year":"2023"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"677799","DOI":"10.3389\/fsurg.2021.677799","article-title":"Clinical significance of serum albumin\/globulin ratio in patients with pyogenic liver abscess","volume":"8","author":"Zhang","year":"2021","journal-title":"Front Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1097\/IPC.0000000000000486","article-title":"Pyogenic liver abscess: review of 38 cases in cancer patients","volume":"25","author":"Jaiswal","year":"2017","journal-title":"Infect Dis Clin Pract"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1111\/hpb.12332","article-title":"Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: a systematic review and meta-analysis","volume":"17","author":"Cai","year":"2015","journal-title":"HPB"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.amjsurg.2015.03.002","article-title":"Percutaneous drainage for giant pyogenic liver abscess\u2014is it safe and sufficient?","volume":"211","author":"Ahmed","year":"2016","journal-title":"Am J Surg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"10","DOI":"10.36346\/sarjs.2025.v06i02.001","article-title":"An update on current management of liver abscess: review article","volume":"6","author":"Kumar","year":"2025","journal-title":"SAR J Surg"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"4752880","DOI":"10.1155\/2022\/4752880","article-title":"Pyogenic liver abscess: contemporary trends in a tertiary institute","volume":"2022","author":"Boaz","year":"2022","journal-title":"Int J Clin Pract"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1673473\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:29:25Z","timestamp":1765261765000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1673473\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":28,"alternative-id":["10.3389\/fmed.2025.1673473"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1673473","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]},"article-number":"1673473"}}