Characteristics of Klebsiella pneumoniae pyogenic liver abscess from 2010-2021 in a tertiary teaching hospital of South China

Pyogenic liver abscess (PLA) is a severe and potentially fatal infectious disease. Klebsiella pneumoniae is the predominant pathogen responsible for PLA. This study aims to investigate the clinical characteristics and prognostic factors of K. pneumoniae-induced pyogenic liver abscess (KP-PLA), particularly those caused by carbapenem-resistant K. pneumoniae (CRKP). PLA patients from January 2010 to December 2021 were performed to investigate the differences of K. pneumoniae from other etiologically infected PLA patients (N-KP-PLA). Univariate and multivariate logistic regression analyses were performed to compare prognostic factors between patients with carbapenem-resistant K. pneumoniae PLA (CRKP-PLA) and patients with carbapenem-sensitive K. pneumoniae PLA (CSKP-PLA). Univariate analysis demonstrated a significant association between KP-PLA and factors, including diabetes mellitus (P < 0.001), cholecystitis and cholelithiasis (P = 0.032), single abscess (P = 0.016) and abscesses with a diameter over 50 mm (P = 0.004), the CRKP group exhibited a higher prevalence of therapeutic interventions prior to K. pneumoniae infection, including abdominal surgery, mechanical ventilation, sputum suction, tracheal cannula, routine drainage of the abdominal cavity, and peripherally inserted central venous catheters (P< 0.05).Multivariate logistic regression analysis revealed that admission to the intensive care unit (ICU) was an independent risk factor associated with CRKP-PLA (odds ratio, 36; 95% confidence interval, 1.77–731.56; P = 0.020). The KP-PLA patients were significantly associated with diabetes and were more likely to have single abscesses larger than 50-mm. PLA patients with a history of admission to ICU or invasive therapeutic procedures should be given special consideration if combined with CRKP infection.