<i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature
<b>Background</b>: <i>Klebsiella pneumoniae</i> liver abscess (KLAS) is a potentially life-threatening condition with variable outcomes. Identifying risk factors for mortality is crucial for improving patient management. We aimed to analyze factors associated with in-hospital...
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2025-06-01
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| author | Octavian Enciu Elena-Adelina Toma Valentin Calu Dumitru Cătălin Pîrîianu Andrei Ludovic Poroșnicu Adrian Miron Mircea Ioan Popa |
| author_facet | Octavian Enciu Elena-Adelina Toma Valentin Calu Dumitru Cătălin Pîrîianu Andrei Ludovic Poroșnicu Adrian Miron Mircea Ioan Popa |
| author_sort | Octavian Enciu |
| collection | DOAJ |
| description | <b>Background</b>: <i>Klebsiella pneumoniae</i> liver abscess (KLAS) is a potentially life-threatening condition with variable outcomes. Identifying risk factors for mortality is crucial for improving patient management. We aimed to analyze factors associated with in-hospital mortality in a cohort of patients with KLAS and review current diagnostic and treatment challenges. <b>Methods</b>: We retrospectively analyzed clinical, laboratory, microbiological, and treatment data from 20 patients admitted with KLAS. Patients were divided into survivor (<i>n</i> = 15) and non-survivor (<i>n</i> = 5) groups. Univariate analyses were performed using appropriate statistical tests to compare groups and identify mortality-related factors. <b>Results</b>: The overall in-hospital mortality rate was 25.0% (5/20). Factors significantly associated with mortality included undergoing laparotomy drainage (60.0% vs. 6.7%, <i>p</i> = 0.018) and developing in-hospital complications (80.0% vs. 6.7%, <i>p</i> = 0.002). Laparoscopic drainage was significantly associated with survival (93.3% vs. 40.0%, <i>p</i> = 0.026). Trends toward increased mortality were observed with diabetes mellitus and higher glucose levels at admission. Despite <i>p</i>-values < 0.05 from prior Fisher’s exact test, and the fact that ESBL positivity (OR = 22, 95% CI 0.86–571.32) and septic shock at admission (OR = 16.08, 95% CI 0.75–343.64) showed a very high point estimate for risk of mortality, the association was not statistically significant in our study. <b>Conclusions</b>: Mortality in this KLAS cohort was considerable. The necessity for open drainage and the development of in-hospital complications emerged as significant predictors of death, while other independent risk factor such as diabetes mellitus, high blood glucose levels at admission, septic shock at admission, and ESBL-positive strains indicated a trend towards unfavorable outcomes. These findings underscore the importance of aggressive sepsis management and addressing antimicrobial resistance. Conflicting results regarding the statistical significance of independent risk factors due to a limited sample size highlight the need for larger studies to confirm these findings. |
| format | Article |
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| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-d9630cc0a6a24a9e94e88cbb2b9747f42025-06-25T13:42:24ZengMDPI AGDiagnostics2075-44182025-06-011512153310.3390/diagnostics15121533<i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the LiteratureOctavian Enciu0Elena-Adelina Toma1Valentin Calu2Dumitru Cătălin Pîrîianu3Andrei Ludovic Poroșnicu4Adrian Miron5Mircea Ioan Popa6Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 05047 Bucharest, Romania<b>Background</b>: <i>Klebsiella pneumoniae</i> liver abscess (KLAS) is a potentially life-threatening condition with variable outcomes. Identifying risk factors for mortality is crucial for improving patient management. We aimed to analyze factors associated with in-hospital mortality in a cohort of patients with KLAS and review current diagnostic and treatment challenges. <b>Methods</b>: We retrospectively analyzed clinical, laboratory, microbiological, and treatment data from 20 patients admitted with KLAS. Patients were divided into survivor (<i>n</i> = 15) and non-survivor (<i>n</i> = 5) groups. Univariate analyses were performed using appropriate statistical tests to compare groups and identify mortality-related factors. <b>Results</b>: The overall in-hospital mortality rate was 25.0% (5/20). Factors significantly associated with mortality included undergoing laparotomy drainage (60.0% vs. 6.7%, <i>p</i> = 0.018) and developing in-hospital complications (80.0% vs. 6.7%, <i>p</i> = 0.002). Laparoscopic drainage was significantly associated with survival (93.3% vs. 40.0%, <i>p</i> = 0.026). Trends toward increased mortality were observed with diabetes mellitus and higher glucose levels at admission. Despite <i>p</i>-values < 0.05 from prior Fisher’s exact test, and the fact that ESBL positivity (OR = 22, 95% CI 0.86–571.32) and septic shock at admission (OR = 16.08, 95% CI 0.75–343.64) showed a very high point estimate for risk of mortality, the association was not statistically significant in our study. <b>Conclusions</b>: Mortality in this KLAS cohort was considerable. The necessity for open drainage and the development of in-hospital complications emerged as significant predictors of death, while other independent risk factor such as diabetes mellitus, high blood glucose levels at admission, septic shock at admission, and ESBL-positive strains indicated a trend towards unfavorable outcomes. These findings underscore the importance of aggressive sepsis management and addressing antimicrobial resistance. Conflicting results regarding the statistical significance of independent risk factors due to a limited sample size highlight the need for larger studies to confirm these findings.https://www.mdpi.com/2075-4418/15/12/1533KLAS<i>Klebsiella</i> liver abscessabdominal sepsisantimicrobial resistanceinvasive liver abscess |
| spellingShingle | Octavian Enciu Elena-Adelina Toma Valentin Calu Dumitru Cătălin Pîrîianu Andrei Ludovic Poroșnicu Adrian Miron Mircea Ioan Popa <i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature Diagnostics KLAS <i>Klebsiella</i> liver abscess abdominal sepsis antimicrobial resistance invasive liver abscess |
| title | <i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature |
| title_full | <i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature |
| title_fullStr | <i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature |
| title_full_unstemmed | <i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature |
| title_short | <i>Klebsiella pneumoniae</i> Invasive Liver Abscess Syndrome (Klas/Ilas)—Experience of a Single Center and Up-to-Date Review of the Literature |
| title_sort | i klebsiella pneumoniae i invasive liver abscess syndrome klas ilas experience of a single center and up to date review of the literature |
| topic | KLAS <i>Klebsiella</i> liver abscess abdominal sepsis antimicrobial resistance invasive liver abscess |
| url | https://www.mdpi.com/2075-4418/15/12/1533 |
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