Volume 24, Number 2—February 2018
CME ACTIVITY - Synopsis
Hypervirulent Klebsiella pneumoniae in Cryptogenic Liver Abscesses, Paris, France
Benjamin Rossi, Maria Ludovica Gasperini, Véronique Leflon-Guibout, Alice Gioanni, Victoire de Lastours, Geoffrey Rossi, Safi Dokmak, Maxime Ronot, Olivier Roux, Marie-Hélène Nicolas-Chanoine, Bruno Fantin, and Agnès Lefort
Table 1
Characteristics of 31 patients with cryptogenic or noncryptogenic Klebsiella pneumoniae liver abscess, Hôpital Beaujon, Clichy, France, 2010−2015*
| Characteristic |
Cryptogenic liver abscess, n = 14 |
Noncryptogenic liver abscess, n = 17 |
p value |
| Median age, y | 62 | 63 | NS |
| Sex | |||
| M | 9 (65) | 12 (71) | NS |
| F | 5 (35) | 5 (29) | NS |
| Ethnic group | |||
| Caucasian | 5 (36) | 8(47) | NS |
| African | 6 (43) | 8(47) | NS |
| Asian | 3 (21) | 1 (6) | 0.3 |
| Healthcare related | 0 | 14 (82) | <0.000005 |
| Immunosuppression† | 0 | 9 (53) | <0.002 |
| Cancer | 0 | 7 (41) | <0.01 |
| Diabetes | 7 (50) | 7(41) | NS |
| Corticosteroids | 0 | 2 (12) | NS |
| Concurrent condition | 2 (14) | ||
| Cirrhosis | 0 | 2 (12) | NS |
| Renal insufficiency | 2 (14) | 1 (6) | NS |
| Heart failure | 0 | 0 | NS |
| Malnutrition | 0 | 2 (12) | NS |
| Clinical features | |||
| Fever | 10 (71) | 13 (76) | NS |
| Abdominal pain | 6 (43) | 8 (47) | NS |
| Severe sepsis | 4 (29) | 4 (24) | NS |
| Septic metastasis | 3 (21) | 0 | 0.08 |
| Biological features, median (IQR) | |||
| C-reactive protein, mg/L | 229 (246) | 96 (64) | NS |
| Bilirubin, mg/dL | 14 (10) | 22 (14) | NS |
| Morphologic features | |||
| Multiple abscesses | 4(29) | 8 (47) | 0.3 |
| Right liver localization | 12 (86) | 10 (59) | 0.1 |
| Bacteriological features | |||
| Polymicrobial | 0 | 11 (65) | 0.008 |
| Positive blood culture | 8/9 | 13/15 | NS |
| Positive pus culture | 11/11 | 11/12 | NS |
| Antimicrobial drug-resistance phenotype | |||
| Extended-spectrum β-lactamase | 0/13 | 3/14 | 0.2 |
| Drug susceptible | 7/13 | 5/14 | NS |
| Outcome | |||
| Death | 0 | 4(24) | 0.08 |
| Relapse | 0 | 7(41) | <0.01 |
| Follow-up, d, median (IQR) | 177 (445) | 391 (1,051) | NS |
*Values are no. (%) or no. positive./no. tested unless otherwise indicated. NS, not significant (p>0.05). IQR, interquartile range (IQR is the difference between the 25th and 75th percentiles and is shown as a sample value).
†Some patients had several causes of immunosuppression.
Page created: January 11, 2018
Page updated: January 11, 2018
Page reviewed: January 11, 2018
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