非糖尿病患者肝脓肿的出现及包膜类型分布。
The emergence of liver abscess in non-diabetic patients and the distribution of capsular types.
作者信息
Chuang Chien, Fan Wen-Chien, Lin Yi-Tsung, Wang Fu-Der
机构信息
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Beitou District, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
出版信息
Gut Pathog. 2016 Oct 18;8:46. doi: 10.1186/s13099-016-0128-y. eCollection 2016.
BACKGROUND
is the most common pathogen of community-acquired pyogenic liver abscess in East Asia. Diabetes mellitus (DM) is a well-established risk factor for liver abscess (KPLA). However, reports regarding the emergence of KPLA in non-diabetic patients are limited.
RESULTS
A total 230 patients with KPLA from a medical center in Taiwan were identified retrospectively. The rate of DM in patients with KPLA was 44.4 % in 2011, 57.9 % in 2012, 44.9 % in 2013, 35.0 % in 2014, and 53.5 % in 2015. Diabetic patients had higher rate of gas-forming abscesses than non-diabetic patients, but the clinical outcomes were not different. The six virulent capsular types (K1, K2, K5, K20, K54, and K57) accounted for 90.2 % of all isolates, and were more prevalent in non-diabetic than diabetic patients (93.9 vs 85.9 %, = 0.048). The six virulent capsular types were also more prevalent in the group with optimal glycemic levels (Non-DM and DM with HbA1c level <7 %) than the DM group with HbA1c level ≥7 % (93.9 vs 84.3 %, = 0.022).
CONCLUSION
liver abscess has emerged in non-diabetic patients in Taiwan. Diabetic patients were at higher risk of acquiring gas-forming abscesses. Non diabetic patients and diabetic patients with optimal glycemic levels are more susceptible to the virulent capsular types of .
背景
在东亚地区，[病原体名称未给出]是社区获得性化脓性肝脓肿最常见的病原体。糖尿病（DM）是肝脓肿（KPLA）公认的危险因素。然而，关于非糖尿病患者发生KPLA的报道有限。
结果
回顾性确定了台湾一家医疗中心的230例KPLA患者。2011年KPLA患者的糖尿病发生率为44.4%，2012年为57.9%，2013年为44.9%，2014年为35.0%，2015年为53.5%。糖尿病患者形成气性脓肿的发生率高于非糖尿病患者，但临床结局并无差异。六种强毒荚膜型（K1、K2、K5、K20、K54和K57）占所有分离株的90.2%，在非糖尿病患者中比糖尿病患者更常见（93.9%对85.9%，P = 0.048）。六种强毒荚膜型在血糖水平最佳组（非糖尿病患者和糖化血红蛋白水平<7%的糖尿病患者）中也比糖化血红蛋白水平≥7%的糖尿病组更常见（93.9%对84.3%，P = 0.022）。
结论
台湾地区非糖尿病患者中出现了KPLA。糖尿病患者发生气性脓肿的风险更高。非糖尿病患者和血糖水平最佳的糖尿病患者更容易感染[病原体名称未给出]的强毒荚膜型。
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