Wang Jing, Yan Yan, Xue Xinying, Wang Kaifei, Shen Dingxia
Department of Microbiology, Chinese PLA General Hospital, Beijing, China.
J Int Med Res. 2013 Aug;41(4):1088-97. doi: 10.1177/0300060513487645. Epub 2013 May 31.
To perform a retrospective comparison of the clinical and radiological features of Klebsiella pneumoniae (KP)-associated and non-KP-associated pyogenic liver abscesses (PLA) in Chinese patients.
Patients with confirmed diagnoses of bacterial liver abscess at three Beijing hospitals were enrolled. Clinical isolates from liver abscesses were used to determine serology and expression of hypermucoviscosity genes. Basic clinical, ultrasonographic (US) and computed tomography (CT) data were recorded and compared between patients with KP- and non-KP-associated PLA.
A total of 101 (77.10%) and 30 (22.90%) cases were due to KP and non-KP pathogens, respectively. Compared with the non-KP cohort, the KP cohort demonstrated a significantly higher incidence of underlying diabetes mellitus, and more gas-forming abscesses, as demonstrated by US and CT examinations. Prior abdominal surgery or chemoradiation therapy was significantly associated with non-KP cases. The non-KP group had a higher chance of a clear edge, compared with the KP group, on pre-contrast CT images.
KP and non-KP-associated PLA have distinctive risk factors and unique US and CT features, in Chinese patients.
对中国患者中肺炎克雷伯菌（KP）相关性和非KP相关性化脓性肝脓肿（PLA）的临床和影像学特征进行回顾性比较。
纳入北京三家医院确诊为细菌性肝脓肿的患者。利用肝脓肿的临床分离株确定血清学和高黏液性基因的表达。记录并比较KP相关性和非KP相关性PLA患者的基本临床、超声（US）和计算机断层扫描（CT）数据。
分别有101例（77.10%）和30例（22.90%）病例归因于KP和非KP病原体。与非KP队列相比，KP队列中潜在糖尿病的发病率显著更高，并且如US和CT检查所示，产气脓肿更多。既往腹部手术或放化疗与非KP病例显著相关。在增强前CT图像上，与KP组相比，非KP组脓肿边缘更清晰的可能性更高。
在中国患者中，KP相关性和非KP相关性PLA具有不同的危险因素以及独特的US和CT特征。
