{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:57:35Z","timestamp":1784138255923,"version":"3.55.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Recurrence of amebic liver abscess (ALA), once considered unusual, is increasingly being reported, despite proper management. Realizing the endemicity of ALA in the study setup, this 2-year follow-up study was conducted to investigate the recurrent cases and study the associated factors. A total of 101 confirmed cases of ALA were followed up for a period of 2 years. Recurrent cases were studied for associated bacterial flora, presence of resistance genes (<jats:italic>nim<\/jats:italic>), level of matrix metalloproteinase 3 and MMP-9, and genotypes of <jats:italic>Entamoeba histolytica<\/jats:italic> and statistically compared with the nonrecurrent cases as controls. Recurrence rates of 8.9% (nine patients) were detected. The presence of <jats:italic>Prevotella<\/jats:italic> along with an increased level of MMP-9 in abscess fluid and large size of abscesses (11 \u00d7 10.8 cm) was found to be significantly associated with recurrence in ALA. Among the nine cases, the presence of <jats:italic>nimE<\/jats:italic> gene was detected in two (22.2%) patients. The genotyping of <jats:italic>E. histolytica<\/jats:italic> strains showed that in seven (77.7%) cases, the genotype of <jats:italic>E. histolytica<\/jats:italic> was the same in the primary and recurrent samples. This study reports a high rate of recurrence in the cases of ALA, hinting toward the gradual development of clinical resistance toward the commonly used drug. The presence of <jats:italic>nim<\/jats:italic> gene and <jats:italic>Prevotella<\/jats:italic> in abscess fluid along with increased MMP-9 levels and large abscess size could be important predictors of recurrent ALA.<\/jats:p>","DOI":"10.4269\/ajtmh.20-0074","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T12:07:01Z","timestamp":1610453221000},"page":"1383-1387","source":"Crossref","is-referenced-by-count":18,"title":["Factors Associated with High Rates of Recurrence of Amebic Liver Abscess (ALA) in North India"],"prefix":"10.4269","volume":"104","author":[{"given":"Aradhana","family":"Singh","sequence":"first","affiliation":[{"name":"1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Banerjee","sequence":"additional","affiliation":[{"name":"1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunit Kumar","family":"Shukla","sequence":"additional","affiliation":[{"name":"2Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/4\/article-p1383.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/4\/article-p1383.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T12:34:38Z","timestamp":1617798878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/4\/article-p1383.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,7]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-0074","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,7]]}}}