Abstract:Objective: To analyze the clinical characteristics and risk factors associated with invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS).Methods: A retrospective analysis was conducted on the clinical data of 442 patients with Klebsiella pneumoniae liver abscess admitted to the Affiliated Hospital of Chengde Medical University from August 1, 2014, to June 31, 2023. The patients were divided into the IKPLAS group (431 cases) and the non-IKPLAS group (11 cases). Clinical features were compared between the two groups. Univariate and multivariate logistic regression analyses were used to identify risk factors for IKPLAS in Klebsiella pneumoniae liver abscess patients.Results: Univariate analysis indicated that diabetes, perihepatic abscess, neutrophil ratio, hemoglobin level, gas-containing abscess, and SOFA score were associated with the development of IKPLAS in patients with Klebsiella pneumoniae liver abscess. Multivariate logistic regression analysis identified diabetes at admission [OR=8.922 (95%CI: 1.676~47.505)], neutrophil ratio, and hemoglobin level as independent risk factors for IKPLAS, with OR values of 0.947 (95%CI:0.903~0.997) and 0.970 (95% CI:0.949~0.997), respectively.Conclusion: Diabetes, decreased neutrophil ratio, and reduced hemoglobin are independent risk factors for the development of IKPLAS in patients with Klebsiella pneumoniae liver abscess.
[1] 李祺,颜玉.细菌性肝脓肿的临床研究进展[J].牡丹江医学院学报,2021,42(1):127-131. [2] Blackberg A,Jonsson A,Svensson E,et al.A population-based study of unfavorable prognostic factors associated with pyogenic liver abscess[J].Open Forum Infect Dis,2023,10(8):352. [3] Chen Y,Gong Y,Song B,et al.Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: a case report and Literature Review[J].Immun Inflamm Dis,2023,11(7):943. [4] Wakabayashi SI,Kimura T,Tanaka N,et al.Invasive liver abscess syndrome accompanied by spondylodiscitis: a case report and review of the literature[J].Clin Gastroenterol,2020,13(5):927-934. [5] Iwadare T,Kimura T,Sugiura A,et al.Pyogenic liver abscess associated with klebsiella oxytoca: mimicking invasive liver abscess syndrome[J].Heliyon,2023,9(11):21537. [6] Chan KS,Chia CTW,Shelat VG.Demographics,radiological findings,and clinical outcomes of klebsiella pneumonia vs.Non-klebsiella pneumoniae pyogenic liver abscess: a systematic review and meta-analysis with trial sequential analysis[J].Pathogens,2022,11(9):976. [7] Sun R,Zhang H,Xu Y,et al.Klebsiella pneumoniae-related invasive liver abscess syndrome complicated by purulent meningitis: a review of the literature and description of three cases[J].BMC Infect Dis,2021,21(1):15. [8] Namikawa H,Oinuma KI,Yamada K,et al.Predictors of hypervirulent Klebsiella pneumoniae infections: a systematic review and meta-analysis[J].Hosp Infect,2023(134):153-160. [9] Kumar S,Payal N,Srivastava VK,et al.Neutrophil extracellular traps and organ dysfunction in sepsis[J].Clin Chim Acta,2021(523):152-162. [10] 常甜.297例细菌性肝脓肿临床特点及预后分析[D].山西医科大学,2023.