Clinical characteristics of 70 cases of Klebsiella pneumoniae liver abscess
10.16718/j.1009-7708.2018.01.003
- VernacularTitle:肺炎克雷伯菌肝脓肿70例临床分析
- Author:
Liu WU
1
;
Jie ZHANG
;
Lin SUN
;
Qin FAN
;
Wenhong ZHANG
;
Lingyun SHAO
Author Information
1. 上海中医药大学附属普陀医院感染科
- Keywords:
bacterial liver abscess;
clinical characteristic;
Klebsiella pneumoniae;
invasive syndrome
- From:
Chinese Journal of Infection and Chemotherapy
2018;18(1):11-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical characteristics of and our experience in managing Klebsiella pneumoniae liver abscess.Methods The clinical data of 323 patients with bacterial liver abscess treated at three hospitals in Shanghai from January 2013 to March 2016 were analyzed retrospectively.Results Bacterial culture Klebsiella pneumoniae was identified in 70 cases.Compared with the patients with K.pneumoniae,the patients without K.pneumoniae had significantly higher prevalence of biliary tract complications (P=0.038),higher neutrophil percentage (P=0.002) and greater abscess diameter (P=0.015).However,the patients with K.pneumoniae showed relatively higher rate of treatment failure.Invasive syndrome was identified in 7 (10％) of the patients with K.pneumoniae,such as endophthalmitis,meningitis.The patients with invasive syndrome showed significantly higher prevalence of biliary tract diseases (P=0.078),more severe thrombocytopenia at early stage (P=0.004) and higher serum bilirubin level (P=0.043).The patients receiving surgical treatment (surgical operation and ultrasound-guided puncture) were associated with significantly shorter hospital stay (15.5± 8.6)d than the patients managed with medical therapy alone (20.1 ± 17.4) d (P=0.029).Conclusions K.pneumoniae is one of the most common pathogens of bacterial liver abscess.K.pneumoniae is relatively susceptible to cephalosporins and fluoroquinolones.Attention should be paid to the incidence of invasive syndrome at early stage.Antimicrobial therapy should be administered timely,especially for the patients complicated with thrombocytopenia or apparent jaundice.Ultrasound-guided percutaneous drainage can shorten hospital stay and reduce mortality.
