Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics.
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.
Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, No, 201, Sec, 2, Shih-Pai Road, 112, Taipei, Taiwan. ytlin8@vghtpe.gov.tw
Yi-Tsung
YT
Lin
Fu-Der
FD
Wang
Ping-Feng
PF
Wu
Chang-Phone
CP
Fung
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D048909:Diabetes Complications; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000209:etiology*; D007711:Klebsiella pneumoniae; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin