Abstract
BackgroundKlebsiella pneumoniae is a primary pathogen of pyogenic liver abscess (PLA). However, little data are available on combination with sepsis. In this study, we aimed to evaluate the clinical characteristics and prognostic differences of PLA patients with sepsis.MethodsThis retrospective cohort study was conducted to investigate 135 patients with confirmed Klebsiella pneumoniae-caused liver abscesses (KPLA) from a tertiary teaching hospital, from 2013 to 2019. The patients were divided into two groups, KPLA with sepsis and KPLA without sepsis. The demographic characteristics, clinical features as well as laboratory and microbiologic findings were analyzed.ResultsA total of 135 patients with KPLA were analyzed. The mean age of patients was 60.9 ± 12.7 years, and the percentage of men was 59.3%. Among them, 37/135 (27.4%) of patients had sepsis and the mortality rate was 1.5%. The most common symptom was fever (91.1%). KPLA patients with sepsis had a significantly higher proportion of frailty, diarrhea, fatty liver, chronic renal insufficiency, and hepatic dysfunction compared to KPLA patients without sepsis (p < 0.05). Antibiotic therapy and percutaneous drainage were most frequently therapeutic strategy. Furthermore, the incidences of sepsis shock and acute respiratory distress syndrome were higher in the sepsis group compared to the non-sepsis group. As for metastatic infections, the lung was the most common site. In addition, KPLA patients with sepsis showed respiratory symptoms in 11 patients, endophthalmitis in 4 patients, and meningitis in 1 patient.ConclusionOur findings emphasize that KPLA patients combined with or without sepsis have different clinical features, but KPLA patients with sepsis have higher rates of complications and metastatic infections. Taken together, further surveillance and control of septic spread is essential for KPLA patients.
Highlights
Pyogenic liver abscess (PLA) is a common intraabdominal infectious disease, which is caused by various bacteria
Klebsiella pneumoniae-caused liver abscess (KPLA) was first reported in the 1980s in Taiwan [4], and the incidence of Klebsiella pneumoniae causing pyogenic liver abscess (PLA) was from 30% in the 1980s to over 80% in the 1990s among all causal pathogens [5]
Study design This study was a retrospective review of all patients who were diagnosed as KPLA (International Classification of Disease, Clinical Modification 572.0) and hospitalized in the Taizhou Hospital of Zhejiang Province, a 1500-bed tertiary teaching hospital located in east China, from January 2013 to December 2019
Summary
Pyogenic liver abscess (PLA) is a common intraabdominal infectious disease, which is caused by various bacteria. Recent findings showed a much higher incidence of PLA in Taiwan (17.6 per 100,000 individuals) than that in northeast China (5.7 per 100,000 individuals), and the United States (3.59 per 100,000 individuals) [1]. In the past two decades, Klebsiella pneumoniae has been identified as the predominant pathogen of PLA in Asia [3]. Klebsiella pneumoniae-caused liver abscess (KPLA) was first reported in the 1980s in Taiwan [4], and the incidence of Klebsiella pneumoniae causing PLA was from 30% in the 1980s to over 80% in the 1990s among all causal pathogens [5]. Klebsiella pneumoniae is a primary pathogen of pyogenic liver abscess (PLA). We aimed to evaluate the clinical characteristics and prognostic differences of PLA patients with sepsis
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