Zhonghua yi xue za zhi · 2015
[The clinical and bacterial features of Klebsiella pnuemoniae liver abscess].
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Wu Hua, Li Dongdong, Wang Jing, Sun Yunfang, Ye Liyan, Shen Dingxia
Аннотация
OBJECTIVE: To summarize the clinical and bacterial features of Klebsiella pnuemoniae liver abscess (KPLA) in order to provide the basis for the diagnosis and treatment of KPLA.
METHODS: Retrospective study was conducted. One hundred and fifty-two medical records, from 3 teaching hospitals in Beijing, between January 2010 and December 2014, were collected. Among which 137 complete medical records were analyzed. String test was carried out to detect the hypermucoviscosity phenotype. PCR was performed to check the capsular serotype and the virulent genes. Disk diffusion method was operated to obtain the antimicrobial resistance rates. The results were analyzed by chi-square test.
RESULTS: KPLA occurred mostly in middle-aged, male and diabetes mellitus patients. 92.7% (127/137) patients had fever. 80.3% (110/137) of the KLPA were single abscess, among which 80.9% (89/110) were in the right lobe and 33.6% (46/137) had air cavities.74.5% (102/137) of the white blood cell count, 83.2% (114/137) of the neutrophils' percentage, 78.1% (107/137) of alanine aminotransferase and 51.8% (71/137) of the total billrubin were elevated. 87.5% (133/152) of the Klebsiella pnuemoniae (Kpn) appeared to be hypermucoviscous, K1 was the most popular serotype, the second was K2, and the positive rates of virulent genes rmpA and aerobactin were 82.9% (126/152) and 88.2% (134/152), respectively. Among the isolates from the KPLA without other hepatobiliary diseases, the portion of K1 serotype, the positive rates of rmpA and aerobactin were 65.7%, 94.9% and 96.0%, respectively, higher than those of the 28.9%, 50.0% and 68.4% from the KPLA with other hepatobiliary diseases, while the undefined serotype potion was lower (5.1% vs 26.3%), the differences were statistically significant (χ(2)=14.98, 38.40, 17.61, 10.65, all P<0.01). Most of Kpn were susceptible to antimicrobials.
CONCLUSIONS: KPLA has certain clinical features, and are mostly caused by hypervirulent isolates that are hypermucoviscous with rmpA and aerobactin genes. Most of the isolates are susceptible to antimicrobials.
METHODS: Retrospective study was conducted. One hundred and fifty-two medical records, from 3 teaching hospitals in Beijing, between January 2010 and December 2014, were collected. Among which 137 complete medical records were analyzed. String test was carried out to detect the hypermucoviscosity phenotype. PCR was performed to check the capsular serotype and the virulent genes. Disk diffusion method was operated to obtain the antimicrobial resistance rates. The results were analyzed by chi-square test.
RESULTS: KPLA occurred mostly in middle-aged, male and diabetes mellitus patients. 92.7% (127/137) patients had fever. 80.3% (110/137) of the KLPA were single abscess, among which 80.9% (89/110) were in the right lobe and 33.6% (46/137) had air cavities.74.5% (102/137) of the white blood cell count, 83.2% (114/137) of the neutrophils' percentage, 78.1% (107/137) of alanine aminotransferase and 51.8% (71/137) of the total billrubin were elevated. 87.5% (133/152) of the Klebsiella pnuemoniae (Kpn) appeared to be hypermucoviscous, K1 was the most popular serotype, the second was K2, and the positive rates of virulent genes rmpA and aerobactin were 82.9% (126/152) and 88.2% (134/152), respectively. Among the isolates from the KPLA without other hepatobiliary diseases, the portion of K1 serotype, the positive rates of rmpA and aerobactin were 65.7%, 94.9% and 96.0%, respectively, higher than those of the 28.9%, 50.0% and 68.4% from the KPLA with other hepatobiliary diseases, while the undefined serotype potion was lower (5.1% vs 26.3%), the differences were statistically significant (χ(2)=14.98, 38.40, 17.61, 10.65, all P<0.01). Most of Kpn were susceptible to antimicrobials.
CONCLUSIONS: KPLA has certain clinical features, and are mostly caused by hypervirulent isolates that are hypermucoviscous with rmpA and aerobactin genes. Most of the isolates are susceptible to antimicrobials.