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

• Published in: BMC infectious diseases Vol. 13; no. 1; p. 56
• Main Authors: Lin, Yi-Tsung, Wang, Fu-Der, Wu, Ping-Feng, Fung, Chang-Phone
• Format: Journal Article
• Language: English
• Published: London BioMed Central 30.01.2013; BioMed Central Ltd; BMC
• Subjects: Abdomen; Abscess; Aged; Aged, 80 and over; Bacterial and fungal diseases; Bacterial pneumonia; Blood Glucose; Blood sugar; Care and treatment; Comparative analysis; Complications and side effects; Diabetes; Diabetes Complications; Diabetes therapy; Diabetics; Distribution; Female; Glycated Hemoglobin A; Glycosylated hemoglobin; Humans; Infectious Diseases; Internal Medicine; Klebsiella infections; Klebsiella Infections - diagnosis; Klebsiella Infections - etiology; Klebsiella pneumoniae; Liver; Liver Abscess - diagnosis; Liver Abscess - etiology; Liver diseases; Male; Medical centers; Medical Microbiology; Medical research; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Mortality; Parasitology; Patients; Pneumonia; Research Article; Retrospective Studies; Risk Factors; Studies; Tropical Medicine; Type 2 diabetes; Taiwan; HbA1c Level; Glycemic Control; Liver Abscess; Diabetic Patient; Poor Glycemic Control
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-13-56

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 (HbA 1c ). Risk factors for metastatic infection from KPLA were analyzed. Results Patients with uncontrolled glycemia (HbA 1c  ≥ 7%) were significantly younger than those with controlled glycemia (HbA 1c < 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 (HbA 1c value >; 10%) after adjustment with age. HbA 1c 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.