title: The emergence ofKlebsiella pneumoniaeliver abscess in non-diabetic patients and the distribution of capsular types.
abstract: BACKGROUND
  Klebsiella pneumoniaeis the most common pathogen of community-acquired pyogenic liver abscess in East Asia. Diabetes mellitus (DM) is a well-established risk factor forK. pneumoniaeliver abscess (KPLA). However, reports regarding the emergence of KPLA in non-diabetic patients are limited.
  
  
  RESULTS
  A total 230 patients with KPLA from a medical center in Taiwan were identified retrospectively. The rate of DM in patients with KPLA was 44.4 % in 2011, 57.9 % in 2012, 44.9 % in 2013, 35.0 % in 2014, and 53.5 % in 2015. Diabetic patients had higher rate of gas-forming abscesses than non-diabetic patients, but the clinical outcomes were not different. The six virulent capsular types (K1, K2, K5, K20, K54, and K57) accounted for 90.2 % of allK. pneumoniaeisolates, and were more prevalent in non-diabetic than diabetic patients (93.9 vs 85.9 %,P= 0.048). The six virulent capsular types were also more prevalent in the group with optimal glycemic levels (Non-DM and DM with HbA1c level <7 %) than the DM group with HbA1c level ≥7 % (93.9 vs 84.3 %,P= 0.022).
  
  
  CONCLUSIONS
  Klebsiella pneumoniaeliver abscess has emerged in non-diabetic patients in Taiwan. Diabetic patients were at higher risk of acquiring gas-forming abscesses. Non diabetic patients and diabetic patients with optimal glycemic levels are more susceptible to the virulent capsular types ofK. pneumoniae.
authors: Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chien
authors: C
authors: Chuang
authors: Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Beitou District, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Wen-Chien
authors: WC
authors: Fan
authors: Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Beitou District, Taipei, 11217 Taiwan ; Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yi-Tsung
authors: YT
authors: Lin
authors: Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Beitou District, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Fu-Der
authors: FD
authors: Wang
keywords: Capsular type; Diabetes; Hemoglobin A1c; Klebsiella pneumoniae; Liver abscess