Analysis of clinical and microbiological characteristics of invasive Klebsiella pneumoniae liver abscess syndrome.

Background: Invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS) is emerging as a new disease worldwide, threatening human health. This study aimed to investigate the clinical and microbiological features of IKPLAS in order to detect this syndrome early and select antibiotics appropriately.

Methods: Medical data from patients in Tongji Hospital, China, diagnosed with Klebsiella pneumoniae liver abscess (KPLA) between 2015 and 2023 was collected and analyzed retrospectively.

Results: The study included 208 patients with KPLA, 41 with IKPLAS, and 167 with non-IKPLAS (NIKPLAS). Multivariate logistic regression analysis demonstrated that symptoms in other organ systems (including ocular, pulmonary, and neurological symptoms) (p = 0.001) and a sequential organ failure assessment (SOFA) score ≥ 4 within 48 h of admission (P = 0.002) were significant risk factors for IKPLAS. Patients with IKPLAS had a higher risk of developing multiple organ dysfunction (MODS), and a PCT ≥ 10 ng/mL was identified as an independent risk factor for MODS (p = 0.01). IKPLAS was associated with significantly prolonged hospital stays and unfavorable outcomes (all p < 0.05). There were no significant differences in microbiological characteristics between IKPLAS and NIKPLAS, including the antimicrobial susceptibility pattern and resistance profile of Klebsiella pneumoniae (KP) (all p > 0.05). In this study, KP isolates were susceptible to most antibiotics, with low rates of drug resistance. Specifically, a total of five carbapenem-resistant strains (2.6%) and seven multidrug-resistant strains (3.6%) were detected, all of which were derived from the NIKPLAS group.

Conclusions: Symptoms in other organ systems and the SOFA score ≥ 4 within 48 h of admission were significant predictors for IKPLAS. This study elucidated the antimicrobial susceptibility profile of liver abscess-associated KP strains, providing a reference for the early initiation of rational and effective antimicrobial therapy in patients with KPLA.