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Volume 38 Issue 7
Jul.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(7): 1584-1589

Clinical features of Klebsiella pneumoniae liver abscess and influencing factors for prognosis

DOI: 10.3969/j.issn.1001-5256.2022.07.023

  • Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

Research funding:

Beijing Municipal Science and Technology Commission (D171100003117005);

Digestive Medical Coordinated Development Center of Beijing Municipal Administration (XXZ0402);

Beijing Hospitals Authority of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201808)

More Information
  • Corresponding author: XIE Wen, xiewen6218@163.com(ORCID: 0000-0002-7314-8175)
  • Received Date: 2021-11-29
  • Accepted Date: 2022-03-08
  • Published Date: 2022-07-20
    Abstract
  •   Objective  To investigate the clinical features of Klebsiella pneumoniae liver abscess and the influencing factors for prognosis.  Methods  A retrospective analysis was performed for the patients with liver abscess who were hospitalized and had positive blood culture or pus culture in Beijing Ditan Hospital, Capital Medical University, from January 2010 to January 2020, and according to the results of etiology, these patients were divided into Klebsiella pneumoniae group (KP group) and non-Klebsiella pneumoniae group (non-KP group). Clinical features were compared between the two groups. The two-independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A multivariate logistic regression analysis was used to identify independent influencing factors for poor prognosis, and a nomogram predictive model was established based on these factors. Index of concordance (C-index) was used for internal validation, and a decision curve analysis was also performed.  Results  A total of 89 patients with liver abscess were enrolled, with 48 patients in the KP group and 41 in the non-KP group. Compared with the non-KP group, the KP group had a significantly higher proportion of patients with type 2 diabetes mellitus (χ2=12.508, P < 0.001), hypertension (χ2=4.215, P=0.04), or fatty liver disease (χ2=6.832, P=0.009) and a significantly lower proportion of patients with a medical history of malignant tumor (χ2=15.039, P < 0.001), human immunodeficiency virus infection (χ2=15.039, P < 0.001), or a medical history of gallstones (χ2=5.834, P=0.016), as well as a significantly lower proportion of patients with the outcome of death (χ2=4.115, P=0.042). Compared with the non-KP group, the KP group had significantly higher levels of leukocyte count (Z=-2.087, P=0.037), hemoglobin (t=4.67, P < 0.001), fibrinogen (Z=-3.300, P=0.001), C-reactive protein (Z=-3.276, P=0.001), procalcitonin (Z=-0.361, P < 0.001), and alanine aminotransferase (Z=-2.436, P=0.015). The multivariate logistic regression analysis showed that sepsis (odds ratio [OR]=9.110, 95% confidence interval [CI]: 1.268-65.443, P=0.028), pulmonary infection (OR=17.720, 95%CI: 2.661-118.010, P=0.003), and low albumin level (OR=0.815, 95%CI: 0.692-0.960, P=0.016) were the risk factors for poor prognosis of liver abscess, while ultrasound-guided abscess puncture therapy (OR=8.551, 95%CI: 1.549-47.195, P=0.014) was a protective factor for relatively good prognosis of liver abscess.  Conclusion  KP liver abscess may be more likely to occur in patients with diabetes mellitus, hypertension, and fatty liver disease. Sepsis, pulmonary infection, and low albumin level are the risk factors for poor prognosis of liver abscess, while ultrasound-guided abscess puncture is a protective factor for relatively good prognosis. Intervention treatment based on the nomogram predictive model established in this study can effectively improve the prognosis of patients with liver abscess.

     

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