Clinical features of Klebsiella Pneumonia-induced bacterial liver abscess
Objective The purpose of this study was to summarize the clinical features of Klebsiella Pneumonia(KP)-induced bacterial liver abscess(PLA).Methods 110 patients with PLA were encountered in our hospital between January 2017 and May 2022,and all patients were treated by needle puncture and drainage under US guidance at base of intravenous administration of antibiotics.Serum high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)and fibrinogen(Fib)levels were detected.Results Out of the 110 patients with PLA,the bacteria culture found positive in 70(63.6%)patients,including KP in48 cases(68.6%),Escherichia Coli in7 cases(10.0%),Streptococcus in4 cases(5.7%),Staphylococcus in3 cases(4.3%),Enterococcus Faecalis in 3 cases(4.3%),Enterococcus Faecalis in 2 cases(2.8%)and others in 3 cases(4.3%);the KP-induced PLA(KPLA)accounted for 68.6%(48/70),and non-KP-induced PLA(N-KPLA)for 31.4%(22/70);the age of patients with KPLA was 58(49,66)yr,much younger than[65(61,74)yr,P<0.05]in patients with N-KPLA;there were significant differences as respect to the incidences of concomitant diabetes,biliary operation histories and biliary infections between the two groups(56.2%,8.3%and 14.6%vs.22.7%,27.3%and 45.4%,P<0.05);the sCr,serum hs-CRP,PCT and Fib levels in patients with KPLA were 88.7(60.8,115.4)μmol/L,170.5(86.3,240.5)mg/L,20.2(9.8,31.5)ng/L and 6.4(5.0,7.8)g/L,all significant different compared to[100.3(62.3,145.0)μmol/L,132.6(60.6,181.2)mg/L,26.8(13.4,40.6)ng/L and 5.3(4.3,7.1)g/L]in patients with N-KPLA(P<0.05);the imaging scan found that the incidences of thin wall of intrahepatic abscess,separated abscess and liquidation of abscess in patients with KPLA were 83.3%,62.5%and 97.9%,all much higher than 54.5%,31.8%and 72.7%(P<0.05)in patients with N-KPLA;the short-term recovery rate in the 48 patients with KPLA was 70.8%,a little bit higher than 59.1%in patients with N-KPLA,and the hospital stay were20(15,28)d and22(16,28)d(P>0.05)between the two groups.Conclusion The common pathogen of PLA is KP,followed by Escherichia Coli.The clinicians should take the clinical features of PLA,especially those with KP infections,might help making an appropriate measures to deal with it.
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