Abstract
In this study, we aimed to investigate the impact of aspirin on the risk of pyogenic liver abscess caused by Klebsiella pneumoniae (KP-PLA) and invasive KP-PLA syndrome (IKPS) in diabetic patients. Diabetic patients who were propensity-score matched were retrospectively included from hospital-based database. Kaplan–Meier approach with a log-rank test was used to compare the cumulative incidences of KP-PLA including IKPS between aspirin users and non-users. Totally, 63,500 patients were analyzed after propensity-score matching (1:1). Compared with that of non-users, the incidence of KP-PLA was significantly reduced in aspirin users (0.31% vs. 0.50%, p < 0.01), but not for that of IKPS (0.02% vs. 0.03%, p = 0.29). Patients taking aspirin for ≥ 90 days had a significantly lower risk for KP-PLA (hazard ratio, 0.67; 95%CI, 0.50–0.90). Females, taking clopidogrel or metformin for ≥ 90 days, and taking H2-blockers or proton pump inhibitors (PPIs) for ≥ 5 days were also associated with a lower risk of KP-PLA. However, cholangitis and a glycated hemoglobin ≥ 8.5% were associated with an increased risk of KP-PLA.
Highlights
In this study, we aimed to investigate the impact of aspirin on the risk of pyogenic liver abscess caused by Klebsiella pneumoniae (KP-Pyogenic liver abscess (PLA)) and invasive KP isolates that cause PLA (KP-PLA) syndrome (IKPS) in diabetic patients
We previously reported that aspirin enhanced the susceptibility of KP serotype K1 to leukocyte phagocytosis by reducing capsular polysaccharide (CPS) production; our multivariate analysis revealed that patients with community-acquired KP bacteremia who had recently used aspirin were at a lower risk of acquiring invasive KP-PLA syndrome[20]
The current study demonstrates that use of aspirin for > 90 days was associated with a lower risk of KP-PLA in diabetic patients without an increase in mortality
Summary
We aimed to investigate the impact of aspirin on the risk of pyogenic liver abscess caused by Klebsiella pneumoniae (KP-PLA) and invasive KP-PLA syndrome (IKPS) in diabetic patients. It was observed that phagocytosis of KP serotypes K1 and K2 by neutrophils was impaired in type 2 diabetic patients with poor glycemic control, and this was associated with an increased risk of metastatic complications[16,17]. We previously reported that aspirin enhanced the susceptibility of KP serotype K1 to leukocyte phagocytosis by reducing CPS production; our multivariate analysis revealed that patients with community-acquired KP bacteremia who had recently used aspirin were at a lower risk of acquiring invasive KP-PLA syndrome[20]. Previously been performed to investigate the association between KP-PLA, including invasive KP-PLA syndrome, and aspirin use
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