MICROBIOLOGY OF LIVER AND SPLEEN ABSCESSES

To study the aerobic and anaerobic microbiology of liver and spleen ab scesses and correlate the results with predisposing factors, potential causes and routes of infection, clinical and laboratory data of 48 pa tients with liver abscesses and 29 with spleen abscesses treated betwe en 1970 and 1990 were reviewed retrospectively. In liver abscesses, a total of 116 isolates (2.4 isolates/specimen) was obtained; 43 were ae robic and facultative species (0.9 isolates/specimen) and 73 were anae robic species or microaerophilic streptococci (1.5 isolates/specimen). Aerobic bacteria only were isolated from 12 (25%) abscesses, anaerobi c bacteria only from eight (17%), and mixed aerobic and anaerobic bact eria from 28 (58%); polymicrobial infection was present in 38 (79%). T he predominant aerobic and facultative isolates were Escherichia coli (11 isolates), Streptococcus group D (8), Klebsiella pneumonia (5) and Staphylococcus aureus (4). The predominant anaerobes were Peptostrept acoccus spp. (18 isolates), Bacteroides spp. (13), Fusobacterium spp. (10), Clostridium spp. (10) and Prevotella spp. (4). There were 12 iso lates of microaerophilic streptococci. S. aureus and beta-haemolytic s treptococci were associated with trauma; Streptococcus group D, Ii. pn eumoniae and Clostridium spp. with biliary disease; and Bacteroides sp p. and Clostridium spp. with colonic disease. In splenic abscesses, a total of 56 isolates (1.9 isolates/specimen) was obtained; 23 were aer obic and facultative species (0.8 isolates/specimen), 31 were anaerobi c species or micro-aerophilic streptococci (1.1 isolates/specimen) and two were Candida albicans. Aerobic bacteria only were isolated from n ine (31%) abscesses, anaerobic bacteria from eight (28%), mixed aerobi c and anaerobic bacteria from 10 (34%) and C. albicans in two (7%); po lymicrobial infection was present in 16 (55%). The predominant aerobic and facultative isolates were E. coli (5 isolates), Proteus mirabilis (3), Streptococcus group D (3), K. pneumoniae (3) and S. aureus (4). The predominant anaerobes were Peptostreptococcus spp. (11 isolates), Bacteroides spp. (5), Fusobacterium spp. (3) and Clostridium spp. (3). S. aureus, K. pneumoniae and Streptococcus group D were associated wi th endocarditis, E. coli with urinary tract and abdominal infection, B acteroides spp. and Clostridium spp. with abdominal infection and Fuso bacterium spp. with respiratory infection.