World journal of hepatology · 2026
Klebsiella pneumoniae as leading cause of pyogenic liver abscess: Three years study in Southern Vietnam.
СтатьяНазвание и аннотация: Перевод в очереди
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Mai-Phan Tuong-Anh, Thai Khanh-Phat, Le Kim-Long, Pham Tri-Nhan, Tran Minh-Quang, Pham Phu-Cuong, Duong Nhu Ngoc-Quynh, Trinh My-Tran, Le Nguyen-Khoi
Аннотация
BACKGROUND: Pyogenic liver abscess (PLA) is increasingly recognized worldwide. In Asia, Klebsiella pneumoniae (K. pneumoniae) has emerged as the predominant pathogen, yet contemporary data from Vietnam remain limited.
AIM: To determine the microbial spectrum of PLA and compare clinical, computed tomography (CT), management, and outcomes between K. pneumoniae and non-K. pneumoniae cases in Southern Vietnam.
METHODS: This retrospective cohort included adults with PLA managed at Nhan Dan Gia Dinh Hospital from June 2021 to June 2024. Of 123 cases, 17 were excluded (8 with unspecified Gram-negative bacilli, 9 without CT), leaving 106 patients (83 K. pneumoniae, 23 non-K. pneumoniae). Data on demographics, comorbidities, presentation, laboratory, imaging, microbiology, treatment, and outcomes were analyzed using standard parametric/nonparametric and χ 2/Fisher tests (two-sided α = 0.05).
RESULTS: Mean age was 59.2 years, and 67.0% were male. Diabetes was more frequent in K. pneumoniae (55.4% vs 30.4%; P = 0.034). C-reactive protein was higher in K. pneumoniae but not significant (229.9 mg/L vs 185.0 mg/L; P = 0.069). Aspartate aminotransferase was significantly elevated (P = 0.048) and alanine aminotransferase borderline (P = 0.065). On CT, K. pneumoniae abscesses more often had irregular margins (P = 0.038) and heterogeneous architecture (P = 0.003). K. pneumoniae predominated in pus (71.9%) and blood (78.6%) cultures. Source-control and hospital stay were similar. Mortality was 10.4% overall, occurring only in K. pneumoniae (13.3% vs 0%). Older age predicted poorer survival (odds ratio = 0.95; P = 0.029).
CONCLUSION: In Southern Vietnam, K. pneumoniae predominates in PLA, characterized by distinctive CT features and higher mortality, emphasizing early recognition, pathogen-directed therapy, and timely image-guided drainage.
AIM: To determine the microbial spectrum of PLA and compare clinical, computed tomography (CT), management, and outcomes between K. pneumoniae and non-K. pneumoniae cases in Southern Vietnam.
METHODS: This retrospective cohort included adults with PLA managed at Nhan Dan Gia Dinh Hospital from June 2021 to June 2024. Of 123 cases, 17 were excluded (8 with unspecified Gram-negative bacilli, 9 without CT), leaving 106 patients (83 K. pneumoniae, 23 non-K. pneumoniae). Data on demographics, comorbidities, presentation, laboratory, imaging, microbiology, treatment, and outcomes were analyzed using standard parametric/nonparametric and χ 2/Fisher tests (two-sided α = 0.05).
RESULTS: Mean age was 59.2 years, and 67.0% were male. Diabetes was more frequent in K. pneumoniae (55.4% vs 30.4%; P = 0.034). C-reactive protein was higher in K. pneumoniae but not significant (229.9 mg/L vs 185.0 mg/L; P = 0.069). Aspartate aminotransferase was significantly elevated (P = 0.048) and alanine aminotransferase borderline (P = 0.065). On CT, K. pneumoniae abscesses more often had irregular margins (P = 0.038) and heterogeneous architecture (P = 0.003). K. pneumoniae predominated in pus (71.9%) and blood (78.6%) cultures. Source-control and hospital stay were similar. Mortality was 10.4% overall, occurring only in K. pneumoniae (13.3% vs 0%). Older age predicted poorer survival (odds ratio = 0.95; P = 0.029).
CONCLUSION: In Southern Vietnam, K. pneumoniae predominates in PLA, characterized by distinctive CT features and higher mortality, emphasizing early recognition, pathogen-directed therapy, and timely image-guided drainage.