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由肺炎克雷伯菌引起的化脓性肝脓肿的预后危险因素。

Prognostic risk factors for pyogenic liver abscess caused by Klebsiella pneumoniae.

机构信息

Department of Hepatobiliary Surgery, Dongyang People's Hospital, Affiliated Dongyang Hospital of Wenzhou Medical University, 60 West Wuning Road, Dongyang, Zhejiang, 322100, P.R. China.

出版信息

BMC Gastroenterol. 2024 Sep 3;24(1):298. doi: 10.1186/s12876-024-03391-9.

Abstract

BACKGROUND

Pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae can vary in severity, and several risk factors for the development of organ dysfunction in PLA have been implicated. However, few studies to date have explored the most common risk factors for clinical severity.

METHODS

We conducted a study on patients with PLA caused by Klebsiella pneumoniae between February 2013 and December 2022.Using logistic regression analysis, we sought to identify factors associated with positive blood culture, septic shock, and intensive care unit (ICU) admission.

RESULTS

After included 200 patients, we found that an elevated procalcitonin (PCT) level (p = 0.03), higher glucose level (p = 0.03), and lower total cholesterol (TC) level (p = 0.01) were associated with a higher likelihood of positive blood bacteriological culture. Additionally, an increased PCT level (p = 0.02) and lower TC level (p < 0.01) were associated with an elevated risk of septic shock. Furthermore, a higher PCT level (p < 0.01) was associated with a higher probability of ICU admission.

CONCLUSION

In patients with PLA caused by Klebsiella pneumoniae, the PCT, glucose, and TC levels were found to be associated with positive blood culture, septic shock, and ICU admission.

摘要

背景

由肺炎克雷伯菌引起的化脓性肝脓肿(PLA)的严重程度各异,并且已经涉及到几种与 PLA 器官功能障碍发展相关的风险因素。然而,迄今为止,很少有研究探讨与临床严重程度最常见的风险因素。

方法

我们对 2013 年 2 月至 2022 年 12 月期间由肺炎克雷伯菌引起的 PLA 患者进行了一项研究。使用逻辑回归分析,我们试图确定与阳性血培养、感染性休克和重症监护病房(ICU)入院相关的因素。

结果

纳入 200 例患者后,我们发现降钙素原(PCT)水平升高(p=0.03)、血糖水平升高(p=0.03)和总胆固醇(TC)水平降低(p=0.01)与血细菌培养阳性的可能性更高相关。此外,PCT 水平升高(p=0.02)和 TC 水平降低(p<0.01)与感染性休克风险增加相关。此外,PCT 水平升高(p<0.01)与 ICU 入院的可能性更高相关。

结论

在由肺炎克雷伯菌引起的 PLA 患者中,PCT、血糖和 TC 水平与阳性血培养、感染性休克和 ICU 入院相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef79/11373132/c221caa0089c/12876_2024_3391_Fig1_HTML.jpg

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