Gu Li, Wang Yue, Wang Han, Xu Dong
Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
BMC Infect Dis. 2025 Apr 29;25(1):626. doi: 10.1186/s12879-025-10981-9.
Invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS) is emerging as a new disease worldwide, threatening human health. This study aimed to investigate the clinical and microbiological features of IKPLAS in order to detect this syndrome early and select antibiotics appropriately.
Medical data from patients in Tongji Hospital, China, diagnosed with Klebsiella pneumoniae liver abscess (KPLA) between 2015 and 2023 was collected and analyzed retrospectively.
The study included 208 patients with KPLA, 41 with IKPLAS, and 167 with non-IKPLAS (NIKPLAS). Multivariate logistic regression analysis demonstrated that symptoms in other organ systems (including ocular, pulmonary, and neurological symptoms) (p = 0.001) and a sequential organ failure assessment (SOFA) score ≥ 4 within 48 h of admission (P = 0.002) were significant risk factors for IKPLAS. Patients with IKPLAS had a higher risk of developing multiple organ dysfunction (MODS), and a PCT ≥ 10 ng/mL was identified as an independent risk factor for MODS (p = 0.01). IKPLAS was associated with significantly prolonged hospital stays and unfavorable outcomes (all p < 0.05). There were no significant differences in microbiological characteristics between IKPLAS and NIKPLAS, including the antimicrobial susceptibility pattern and resistance profile of Klebsiella pneumoniae (KP) (all p > 0.05). In this study, KP isolates were susceptible to most antibiotics, with low rates of drug resistance. Specifically, a total of five carbapenem-resistant strains (2.6%) and seven multidrug-resistant strains (3.6%) were detected, all of which were derived from the NIKPLAS group.
Symptoms in other organ systems and the SOFA score ≥ 4 within 48 h of admission were significant predictors for IKPLAS. This study elucidated the antimicrobial susceptibility profile of liver abscess-associated KP strains, providing a reference for the early initiation of rational and effective antimicrobial therapy in patients with KPLA.
侵袭性肺炎克雷伯菌肝脓肿综合征（IKPLAS）在全球范围内正成为一种新疾病，威胁着人类健康。本研究旨在调查IKPLAS的临床和微生物学特征，以便早期发现该综合征并合理选择抗生素。
回顾性收集并分析了2015年至2023年在中国同济医院诊断为肺炎克雷伯菌肝脓肿（KPLA）患者的医疗数据。
该研究纳入了208例KPLA患者，其中41例为IKPLAS，167例为非IKPLAS（NIKPLAS）。多因素逻辑回归分析表明，其他器官系统的症状（包括眼部、肺部和神经系统症状）（p = 0.001）以及入院48小时内序贯器官衰竭评估（SOFA）评分≥4（P = 0.002）是IKPLAS的重要危险因素。IKPLAS患者发生多器官功能障碍（MODS）的风险更高，降钙素原（PCT）≥10 ng/mL被确定为MODS的独立危险因素（p = 0.01）。IKPLAS与住院时间显著延长和不良预后相关（所有p < 0.05）。IKPLAS和NIKPLAS之间的微生物学特征无显著差异，包括肺炎克雷伯菌（KP）的抗菌药物敏感性模式和耐药谱（所有p > 0.05）。在本研究中，KP分离株对大多数抗生素敏感，耐药率较低。具体而言，共检测到5株碳青霉烯耐药菌株（2.6%）和7株多重耐药菌株（3.6%），均来自NIKPLAS组。
其他器官系统的症状和入院48小时内SOFA评分≥4是IKPLAS的重要预测指标。本研究阐明了肝脓肿相关KP菌株的抗菌药物敏感性概况，为KPLA患者早期启动合理有效的抗菌治疗提供了参考。
