Original Article
Clinical characteristics and prognosis factors of bacterial liver abscess patients with and without diabetes mellitus
Wu Qingqing, Pan Hongyi, Zheng Wei, Yin Qiaoqiao, Chu Shanshan, Bao Suxia, Zhang Jiajie, Tong Yongxi, Huang Haijun, Pan Hongying
Published 2019-02-25
Cite as Inter J Epidemionl Infect Dis, 2019,46(1): 55-60. DOI: 10.3760/cma.j.issn.1673-4149.2019.01.013
Abstract
ObjectiveTo assess the clinical characteristics and prognostic factors of bacterial liver abscess in patients with or without diabetes mellitus, and to provide clinical guides for the diagnosis and treatment.
MethodsA total of 208 patients with bacterial liver abscess were enrolled during January 2014 and January 2018 in Zhejiang Provincial People’s Hospital, including 67 patients with diabetes mellitus and 141 patients without diabetes mellitus. Clinical characteristics, laboratory examinntion, imaging findings, etiology results, treatment and prognosis were analyzed. Multiple logistic regression analysis was performed to analyze the prognosis between patients with and without diabetes.
ResultsThe majority of patients were male, and the fever was the most common symptom. The incidence of right upper abdominal pain in diabetic group was lower than that in non-diabetic group (32.84% vs 47.5%, χ2=3.999, P<0.05) . Compared with non-diabetic group, the neutrophil percentage and hemoglobin A1c were (84.0±6.8) % and (9.8±2.6) %, which were higher (t=2.263, 13.716, P<0.05) , while the albumin and hemoglobin were lower in diabetic group (t= -2.862, -2.034, P<0.05) . Klebsiella pneumonia was the most common pathogens and the positive ratewashigher in diabetic group (χ2=3.893, P<0.05) . Multivariate logistic regression analysis showed that multiple abscesses (OR=8.761, 95%CI: 1.364-56.259) and abscess size≥10 cm (OR=9.648, 95%CI: 1.496-62.232) were independent risk factors for poor prognosis in diabetic patients. Hypoalbuminemia (OR=2.794, 95%CI: 1.062-7.349) and abscess size≥10 cm (OR=3.777, 95%CI: 1.402-10.178) were independent risk factors for poor prognosis in non-diabetic patients.
ConclusionsDiabetic patients with liver abscess have atypical clinical characteristics and ware commonly caused by Klebsiella pneumonia. The size and number of abscesses may be associated with its prognosis.
Key words:
Liver abscess, pyogenic; Diabetes mellitus; Etiology; Risk factor
Contributor Information
Wu Qingqing
The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, China
Pan Hongyi
Department of Internal Medicine, Pujiang People’s Hospital, Jinhua 322200, Zhejiang, China
Zheng Wei
Department of Infectious Disease, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
Yin Qiaoqiao
Bengbu Medical University Clinical Medical College, Bengbu 233030, Anhui, China
Chu Shanshan
Department of Infectious Disease, Tiantai People’s Hospital, Taizhou 317200, Zhejiang, China
Bao Suxia
Department of Infectious Disease, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
Zhang Jiajie
Department of Infectious Disease, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
Tong Yongxi
Department of Infectious Disease, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
Huang Haijun
Department of Infectious Disease, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
Pan Hongying
Department of Infectious Disease, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China