Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics

Authors: Yi-Tsung Lin, Fu-Der Wang, Ping-Feng Wu, Chang-Phone Fung

Published in: BMC Infectious Diseases | Issue 1/2013

Login to get access

Abstract

Background

Klebsiella pneumoniae liver abscess (KPLA) has been reported with increasing frequency in East Asian countries in the past 3 decades, especially in Taiwan and Korea. Diabetes is a well-known risk factor for KPLA and highly associated with septic metastatic complications from KPLA. We investigated the association of glycemic control in diabetic patients with the clinical characteristics of KPLA in Taiwan.

Methods

Adult diabetic patients with KPLA were identified retrospectively in a medical center from January 2007 to January 2012. Clinical characteristics were compared among patients with different levels of current hemoglobin A1c (HbA1c). Risk factors for metastatic infection from KPLA were analyzed.

Results

Patients with uncontrolled glycemia (HbA1c ≥ 7%) were significantly younger than those with controlled glycemia (HbA1c < 7%). Patients with uncontrolled glycemia had the trend to have a higher rate of gas-forming liver abscess, cryptogenic liver abscess, and metastatic infection than those with controlled glycemia. Cryptogenic liver abscess and metastatic infection were more common in the poor glycemic control group (HbA1c value >; 10%) after adjustment with age. HbA1c level and abscess < 5 cm were independent risk factors for metastatic complications from KPLA.

Conclusions

Glycemic control in diabetic patients played an essential role in the clinical characteristics of KPLA, especially in metastatic complications from KPLA.
Literature
1.
Kim JK, Chung DR, Wie SH, Yoo JH, Park SW: Risk factor analysis of invasive liver abscess caused by the K1 serotype Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis. 2009, 28: 109-111. 10.1007/s10096-008-0595-2.CrossRefPubMed
2.
Chung DR, Lee SS, Lee HR, Kim HB, Choi HJ, Eom JS, Kim JS, Choi YH, Lee JS, Chung MH, Kim YS, Lee H, Lee MS, Park CK, Korean Study Group for Liver Abscess: Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect. 2007, 54: 578-583. 10.1016/j.jinf.2006.11.008.CrossRefPubMed
3.
Yeh KM, Kurup A, Siu LK, Koh YL, Fung CP, Lin JC, Chen TL, Chang FY, Koh TH: Capsular serotype K1 or K2, rather than magA and rmpA, is a major virulence determinant for Klebsiella pneumoniae liver abscess in Singapore and Taiwan. J Clin Microbiol. 2007, 45: 466-471. 10.1128/JCM.01150-06.CrossRefPubMed
4.
Lok KH, Li KF, Li KK, Szeto ML: Pyogenic liver abscess: clinical profile, microbiological characteristics, and management in a Hong Kong hospital. J Microbiol Immunol Infect. 2008, 41: 483-490.PubMed
5.
Fung CP, Chang FY, Lee SC, Hu BS, Kuo BI, Liu CY, Ho M, Siu LK: A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis?. Gut. 2002, 50: 420-424. 10.1136/gut.50.3.420.CrossRefPubMedPubMedCentral
6.
Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC: Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis. 2007, 45: 284-293. 10.1086/519262.CrossRefPubMed
7.
Kohayagawa Y, Nakao K, Ushita M, Niino N, Koshizaki M, Yamamori Y, Tokuyasu Y, Fukushima H: Pyogenic liver abscess caused by Klebsiella pneumoniae genetic serotype K1 in Japan. J Infect Chemother. 2009, 15: 248-251. 10.1007/s10156-009-0695-7.CrossRefPubMed
8.
Tsai FC, Huang YT, Chang LY, Wang JT: Pyogenic liver abscess as endemic disease, Taiwan. Emerg Infect Dis. 2008, 14: 1592-1600. 10.3201/eid1410.071254.CrossRefPubMedPubMedCentral
9.
Lin YT, Liu CJ, Chen TJ, Chen TL, Yeh YC, Wu HS, Tseng CP, Wang FD, Tzeng CH, Fung CP: Pyogenic liver abscess as the initial manifestation of underlying hepatocellular carcinoma. Am J Med. 2011, 124: 1158-1164. 10.1016/j.amjmed.2011.08.012.CrossRefPubMed
10.
Lin YT, Liu CJ, Chen TJ, Fung CP: Long-term mortality of patients with septic ocular or central nervous system complications from pyogenic liver abscess: A population-based study. PLoS One. 2012, 7 (3): e33978-10.1371/journal.pone.0033978.CrossRefPubMedPubMedCentral
11.
Liu YC, Cheng DL, Lin CL: Klebsiella pneumoniae liver abscess associated with septic endophthalmitis. Arch Intern Med. 1986, 146: 1913-1916. 10.1001/archinte.1986.00360220057011.CrossRefPubMed
12.
Cheng DL, Liu YC, Yen MY, Liu CY, Wang RS: Septic metastatic lesions of pyogenic liver abscess. Their association with Klebsiella pneumoniae bacteremia in diabetic patients. Arch Intern Med. 1991, 151: 1557-1559. 10.1001/archinte.1991.00400080059010.CrossRefPubMed
13.
Lee SS, Chen YS, Tsai HC, Wann SR, Lin HH, Huang CK, Liu YC: Predictors of septic metastatic infection and mortality among patients with Klebsiella pneumoniae liver abscess. Clin Infect Dis. 2008, 47: 642-650. 10.1086/590932.CrossRefPubMed
14.
Sheu SJ, Kung YH, Wu TT, Chang FP, Horng YH: Risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess: 20-year experience in southern Taiwan. Retina. 2011, 31: 2026-2031. 10.1097/IAE.0b013e31820d3f9e.CrossRefPubMed
15.
Yang PW, Lin HD, Wang LM: Pyogenic liver abscess associated with septic pulmonary embolism. J Chin Med Assoc. 2008, 71: 442-447. 10.1016/S1726-4901(08)70146-1.CrossRefPubMed
16.
Muller LM, Gorter KJ, Hak E, Goudzwaard WL, Schellevis FG, Hoepelman AI, Rutten GE: Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005, 41: 281-288. 10.1086/431587.CrossRefPubMed
17.
Thomsen RW, Jepsen P, Sørensen HT: Diabetes mellitus and pyogenic liver abscess: risk and prognosis. Clin Infect Dis. 2007, 44: 1194-1201. 10.1086/513201.CrossRefPubMed
18.
Foo NP, Chen KT, Lin HJ, Guo HR: Characteristics of pyogenic liver abscess patients with and without diabetes mellitus. Am J Gastroenterol. 2010, 105: 328-335. 10.1038/ajg.2009.586.CrossRefPubMed
19.
Wang JH, Liu YC, Lee SS, Yen MY, Chen YS, Wang JH, Wann SR, Lin HH: Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin Infect Dis. 1998, 26: 1434-1438. 10.1086/516369.CrossRefPubMed
20.
Lin YC, Lu MC, Tang HL, Liu HC, Chen CH, Liu KS, Lin C, Chiou CS, Chiang MK, Chen CM, Lai YC: Assessment of hypermucoviscosity as a virulence factor for experimental Klebsiella pneumoniae infections: comparative virulence analysis with hypermucoviscosity-negative strain. BMC Microbiology. 2011, 11: 50-10.1186/1471-2180-11-50.CrossRefPubMedPubMedCentral
21.
Yang CS, Tsai HY, Sung CS, Lin KH, Lee FL, Hsu WM: Endogenous klebsiella endophthalmitis associated with pyogenic liver abscess. Ophthalmology. 2007, 114: 876-880. 10.1016/j.ophtha.2006.12.035. e2CrossRefPubMed
22.
Chen SC, Lee YT, Lai KC, Cheng KS, Jeng LB, Wu WY, Wu WY, Chen CC, Lee MC: Risk factors for developing metastatic infection from pyogenic liver abscesses. Swiss Med Wkly. 2006, 136: 119-126.PubMed
23.
Braiteh F, Golden MP: Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome. Int J Infect Dis. 2007, 11: 16-22. 10.1016/j.ijid.2005.10.006.CrossRefPubMed
24.
Lee CJ, Jung DS, Jung SH, Baik JH, Lee JH, Cho YR, Go BS, Lee SW, Han SY, Lee DH: Comparison of liver abscess between diabetic patients and non-diabetic patients. Korean J Hepatol. 2005, 11: 339-349.PubMed
25.
26.
Mark S: Glycemic control and complications in type 2 diabetes mellitus. Am J Med. 2010, 123: S3-S11. 10.1016/j.amjmed.2009.12.004.CrossRef
27.
Joshi N, Caputo GM, Weitekamp MR, Karchmer AW: Infections in Patients with Diabetes Mellitus. N Engl J Med. 1999, 341: 1906-1912. 10.1056/NEJM199912163412507.CrossRefPubMed
28.
Kornum JB, Thomsen RW, Riis A, Lervang HH, Schønheyder HC, Sørensen HT: Diabetes, glycemic control, and risk of hospitalization with pneumonia: a population-based case-control study. Diabetes Care. 2008, 31: 1541-1545. 10.2337/dc08-0138.CrossRefPubMedPubMedCentral
29.
Gornik I, Gornik O, Gasparovic V: HbA1c is outcome predictor in diabetic patients with sepsis. Diabetes Res Clin Pract. 2007, 77: 120-125. 10.1016/j.diabres.2006.10.017.CrossRefPubMed
30.
Yang YS, Siu LK, Yeh KM, Fung CP, Huang SJ, Hung HC, Lin JC, Chang FY: Recurrent Klebsiella pneumoniae liver abscess: clinical and microbiological characteristics. J Clin Microbiol. 2009, 47: 3336-3339. 10.1128/JCM.00918-09.CrossRefPubMedPubMedCentral
31.
Lin JC, Siu LK, Fung CP, Tsou HH, Wang JJ, Chen CT, Lin JC, Chang FY: Impaired phagocytosis of capsular serotypes K1 or K2 Klebsiella pneumoniae in type 2 diabetes mellitus patients with poor glycemic control. J Clin Endocrinol Metab. 2006, 91: 3084-3087. 10.1210/jc.2005-2749.CrossRefPubMed
32.
Lederman ER, Crum NF: Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol. 2005, 100: 322-331. 10.1111/j.1572-0241.2005.40310.x.CrossRefPubMed
33.
Saccente M: Klebsiella pneumoniae liver abscess, endophthalmitis, and meningitis in a man with newly recognized diabetes mellitu. Clin Infect Dis. 1999, 29: 1570-1571. 10.1086/313539.CrossRefPubMed
Metadata
Title
Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics
Authors
Yi-Tsung Lin
Fu-Der Wang
Ping-Feng Wu
Chang-Phone Fung
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-56

Other articles of this Issue 1/2013

BMC Infectious Diseases 1/2013 Go to the issue

Research article

Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis

Research article

A cross-sectional study to estimate high-risk human papillomavirus prevalence and type distribution in Italian women aged 18–26 years

Case report

Babesia microti:an unusual travel-related disease

Research article

Predictors of mortality among TB-HIV Co-infected patients being treated for tuberculosis in Northwest Ethiopia: a retrospective cohort study

Research article

Multi-drug resistant toxigenic Vibrio cholerae O1 is persistent in water sources in New Bell-Douala, Cameroon

Research article

Incidence, clinical spectrum, diagnostic features, treatment and predictors of paradoxical reactions during antibiotic treatment of Mycobacterium ulceransinfections
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits