关键词: 肺炎克雷伯菌, 大肠埃希菌, 细菌性肝脓肿, 肺炎克雷伯菌肝脓肿, 大肠埃希菌肝脓肿, 糖尿病, 胆道疾病, C反应蛋白, 降钙素原, 血小板, 白蛋白

Abstract: Objective To compare the clinical characteristics of Klebsiella pneumoniae liver abscess (KPLA) and Escherichia coli liver abscess (ECLA), and provide a basis for the diagnosis and treatment of different types of bacterial liver abscess (BLA).Methods A retrospective analysis was conducted on 169 hospitalized patients diagnosed with BLA at the 988th Hospital of the Joint Logistics Support Force from January 2000 to June 2023. Based on etiology, they were divided into KP group (91 cases) and EC group (55 cases). The general conditions, underlying diseases, clinical manifestations, laboratory tests, imaging findings, treatment methods, antibiotic selection, length of hospital stay, and disease outcomes of the two groups were compared.Results There was no significant difference in age and gender between the KP group and EC group (P>0.05); In terms of basic diseases, the proportion of patients in KP group with diabetes (64.8%) was significantly higher than that in EC group (21.8%), and the proportion of patients in EC group with biliary diseases (41.8%) was significantly higher than that in KP group (8.8%) (P<0.05); In terms of clinical manifestations, fever and chills were the main clinical manifestations in both groups, with no significant difference (P>0.05). The proportion of right upper abdominal pain in the KP group was lower than that in the EC group (P<0.05); In terms of laboratory tests, platelet count and albumin levels in the KP group were significantly lower than those in the EC group, while the inflammatory indicators of procalcitonin and C-reactive protein were significantly higher than those in the EC group (P<0.05); In terms of imaging manifestations, both KP group and EC group were mainly characterized by a single lesion in the right lobe of the liver, and there was no significant difference between the two groups (P>0.05); In terms of treatment, the KP group and EC group were mainly treated with antibiotics and puncture drainage, which were 86.8% and 80.0%, respectively, with no significant difference (P>0.05); In the selection of antibiotic types, carbapenems were mainly used in the KP group, accounting for 57.1%, while cephalosporins and other antibiotics were mainly used in the EC group, accounting for 61.8%. The usage rate of carbapenems in the KP group was significantly higher than that in the EC group (P<0.05); In terms of hospitalization time, the KP group was significantly longer than the EC group (P<0.05); In terms of disease progression, the improvement rates of both groups were relatively high, at 89.0% and 92.7%, respectively, with no significant difference (P>0.05).Conclusion KP is the main pathogen of BLA. KPLA is often associated with diabetes, while ECLA is often associated with biliary diseases; KPLA has a more severe condition, with higher levels of procalcitonin, C-reactive protein, platelet infection related indicators, and more significant albumin consumption; KPLA treatment mainly uses carbapenems, while the ECLA group mainly uses cephalosporins and other antibiotics. The overall treatment cycle of KPLA is relatively long.

Key words: Klebsiella pneumoniae, Escherichia coli, Bacterial liver abscess, Klebsiella pneumoniae liver abscess, Escherichia coli liver abscess, Diabetes, Biliary tract diseases, C-reactive protein, Procalcitonin, Platelets, Albumin