Chen Jingjing, Wang Xinyi, Wang Qihui, Tian Sufei, Li Fushun, Wang Ruixuan, Chang Zhihui, Chu Yunzhuo
Department of Laboratory Medicine, National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.
Research Unit of Medical Laboratory, Chinese Academy of Medical Sciences, Beijing, China.
Front Microbiol. 2025 Aug 26;16:1650703. doi: 10.3389/fmicb.2025.1650703. eCollection 2025.
This study aimed to investigate the clinical and microbiological characteristics of invasive and noninvasive liver abscesses (KPLAs) and elucidate the risk factors for invasive KPLA.
We conducted a case-control study involving 50 patients with invasive KPLA and 50 patients with noninvasive KPLA from two medical centers between 2019 and 2024. Demographic and clinical data were collected for all patients from the hospital medical records system. Univariate and multivariate analyses were then performed to compare the characteristics of invasive and noninvasive KPLAs. In addition, antimicrobial resistance testing and whole-genome sequencing were performed for 50 strains from one medical center.
The comparison of patients with invasive and noninvasive KPLAs revealed that diabetes mellitus, smoking history, drinking history, smaller maximum diameter of abscess, neutrophil count, fasting blood glucose, blood urea nitrogen, and length of hospital stay were independent risk factors for invasive KPLA. Phylogenetic analysis revealed that strains from patients with invasive and noninvasive KPLAs were intermingled. ST23 with K1 serotype was the predominant sequence type (66.0%), followed by ST65 with K2 serotype. Multilocus sequence types, capsular serotypes, antimicrobial resistance patterns, virulence genes, and SNPs of strains isolated from patients with invasive and noninvasive KPLAs showed no significant differences between the two patient groups.
Overall, our results indicate that patients' contaminant conditions, such as poor glycemic control, smoking history, and drinking history, rather than bacterial virulence, contribute to the development of invasive KPLA.
本研究旨在调查侵袭性和非侵袭性肝脓肿（KPLAs）的临床和微生物学特征，并阐明侵袭性KPLA的危险因素。
我们进行了一项病例对照研究，纳入了2019年至2024年间来自两个医疗中心的50例侵袭性KPLA患者和50例非侵袭性KPLA患者。从医院病历系统中收集了所有患者的人口统计学和临床数据。然后进行单因素和多因素分析，以比较侵袭性和非侵袭性KPLAs的特征。此外，对来自一个医疗中心的50株菌株进行了抗菌药物敏感性测试和全基因组测序。
侵袭性和非侵袭性KPLA患者的比较显示，糖尿病、吸烟史、饮酒史、脓肿最大直径较小、中性粒细胞计数、空腹血糖、血尿素氮和住院时间是侵袭性KPLA的独立危险因素。系统发育分析表明，侵袭性和非侵袭性KPLA患者的菌株相互混杂。ST23与K1血清型是主要的序列类型（66.0%），其次是ST65与K2血清型。从侵袭性和非侵袭性KPLA患者分离的菌株的多位点序列类型、荚膜血清型、抗菌药物耐药模式、毒力基因和单核苷酸多态性在两组患者之间没有显著差异。
总体而言，我们的结果表明，患者的污染状况，如血糖控制不佳、吸烟史和饮酒史，而非细菌毒力，是侵袭性KPLA发生的原因。
