The increased recurrence rate of liver abscess caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae

被引:16
作者
Wang, Hairui [1 ]
Ren, Yue [1 ]
Chang, Zhihui [1 ]
Liu, Zhaoyu [1 ]
机构
[1] China Med Univ, Dept Radiol, Shengjing Hosp, 36 Sanhao St, Shenyang 110004, Peoples R China
基金
中国国家自然科学基金;
关键词
Klebsiella pneumonia; Liver abscess; Extended-spectrum beta-lactamase (ESBL); Recurrence; CT CHARACTERISTICS; RISK-FACTORS; INFECTIONS; EPIDEMIOLOGY; ASSOCIATION; MORTALITY; FEATURES; IMPACT;
D O I
10.1007/s10096-020-03848-1
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The pathogenic bacterium Klebsiella pneumoniae (KP) is the major causative agent of pyogenic liver abscess (PLA). But reports about the prognosis of KP-caused PLA (KPLA) are rare. This study aimed to ascertain the recurrence rate of KPLA after initial treatment and its contributing factors. A total of 110 patients who had first-time episodes of KPLA were included into the study. The average follow-up time was 3.65 +/- 2.18 years. Twenty (18.18%) KPLA patients experienced recurrence. Those in the recurrence group had a significantly greater incidence of extended-spectrum beta-lactamase (ESBL) production compared with the non-recurrence group (30.0% vs 8.89%, P = 0.018). Diabetes, biliary tract disease, and history of malignancy were not associated with recurrence (all P > 0.05). No difference in the CT characteristics of KPLA (including abscess size, location, whether multilocular, gas production of KPLA, and thrombophlebitis) was found between the two groups. Multivariate regression analysis showed that ESBL production (OR, 6.3; 95% CI, 1.02-38.59; P = 0.04) was an independent risk factor for the recurrence of KPLA. Our findings emphasize that KPLA has a high recurrence rate and ESBL production is an independent risk factor for recurrent KPLA.
引用
收藏
页码:1315 / 1320
页数:6
相关论文
共 32 条
[1]   Highlights lecture EANM 2016: "Embracing molecular imaging and multi-modal imaging: a smart move for nuclear medicine towards personalized medicine" [J].
Aboagye, Eric O. ;
Kraeber-Bodere, Francoise .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2017, 44 (09) :1559-1574
[2]   Metabolic Characterization of Peripheral Host Responses to Drainage-Resistant Klebsiella pneumoniae Liver Abscesses by Serum 1H-NMR Spectroscopy [J].
Chang, Zhihui ;
Wang, Hairui ;
Li, Beibei ;
Liu, Zhaoyu ;
Zheng, Jiahe .
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY, 2018, 8
[3]   Computed Tomography Features of Septic Pulmonary Embolism Caused by Klebsiella pneumoniae Liver Abscess Associated With Extrapulmonary Metastatic Infection [J].
Chang, Zhihui ;
Gong, Zheng ;
Zheng, Jiahe ;
Ma, Yujia ;
Liu, Zhaoyu .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 2016, 40 (03) :364-369
[4]   Analysis of clinical and CT characteristics of patients with Klebsiella pneumoniae liver abscesses: an insight into risk factors of metastatic infection [J].
Chang, Zhihui ;
Zheng, Jiahe ;
Ma, Yujia ;
Liu, Zhaoyu .
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, 2015, 33 :50-54
[5]   Long-term Outcome of Pyogenic Liver Abscess Factors Related With Abscess Recurrence [J].
Cheng, Hsiu-Chi ;
Chang, Wei-Lun ;
Chen, Wei-Ying ;
Kao, Ai-Wen ;
Chuang, Chiao-Hsing ;
Sheu, Bor-Shyang .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 2008, 42 (10) :1110-1115
[6]   Current epidemiology, genetic evolution and clinical impact of extendedspectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae [J].
Chong, Yong ;
Shimoda, Shinji ;
Shimono, Nobuyuki .
INFECTION GENETICS AND EVOLUTION, 2018, 61 :185-188
[7]   Impact of Cefepime Therapy on Mortality among Patients with Bloodstream Infections Caused by Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli [J].
Chopra, Teena ;
Marchaim, Dror ;
Veltman, Jennifer ;
Johnson, Paul ;
Zhao, Jing J. ;
Tansek, Ryan ;
Hatahet, Dania ;
Chaudhry, Khawar ;
Pogue, Jason M. ;
Rahbar, Hiro ;
Chen, Ting-Yi ;
Thientu Truong ;
Rodriguez, Victor ;
Ellsworth, Joseph ;
Bernabela, Luigino ;
Bhargava, Ashish ;
Yousuf, Adnan ;
Alangaden, George ;
Kaye, Keith S. .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2012, 56 (07) :3936-3942
[8]   Characterization of an Outbreak of Extended-Spectrum -Lactamase-Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit in Italy [J].
Corbella, Marta ;
Caltagirone, Mariasofia ;
Gaiarsa, Stefano ;
Mariani, Bianca ;
Sassera, Davide ;
Bitar, Ibrahim ;
Muzzi, Alba ;
Migliavacca, Roberta ;
Scudeller, Luigia ;
Stronati, Mauro ;
Cambieri, Patrizia .
MICROBIAL DRUG RESISTANCE, 2018, 24 (08) :1128-1136
[9]   Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes [J].
Czerwonko, Matias E. ;
Huespe, Pablo ;
Bertone, Santiago ;
Pellegrini, Pablo ;
Mazza, Oscar ;
Pekolj, Juan ;
de Santibanes, Eduardo ;
Ho Hyon, Sung ;
de Santibanes, Martin .
HPB, 2016, 18 (12) :1023-1030
[10]   Risk factors and molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Xiamen, China [J].
Deng, Jie ;
Li, Yan-Ting ;
Shen, Xu ;
Yu, Yi-Wen ;
Lin, Hui-Ling ;
Zhao, Qi-Feng ;
Yang, Tian-Ci ;
Li, Shu-Lian ;
Niu, Jian-Jun .
JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE, 2017, 11 :23-27