Introduction
Methods
Study design
Microbiologic data
Data collection
Statistical analysis
Results
Demographic data and comorbidities
Characteristic | Total n = 135 | KPLA with sepsis n = 37 | KPLA without sepsis n = 98 | P value |
---|---|---|---|---|
Age (year) | 60.9 ± 12.7 | 61.1 ± 12.1 | 60.8 ± 13.0 | 0.902 |
Gender | 0.227 | |||
Male,n (%) | 80 (59.3) | 25 (67.6) | 55 (56.1) | |
Female,n (%) | 55 (40.7) | 12 (32.4) | 43 (43.9) | |
Symptoms | ||||
Body temperature (≥38.5 °C) | 80 (59.3) | 21 (56.8) | 59 (60.2) | 0.716 |
Fever | 123 (91.1) | 35 (94.6) | 88 (89.8) | 0.511a |
Chills | 81 (60.0) | 24 (64.9) | 57 (58.2) | 0.478 |
Abdominal pain | 58 (43.0) | 4 (10.8) | 54 (55.1) | 0.000 |
Nausea | 17 (12.6) | 5 (13.5) | 12 (12.2) | 0.843 |
Vomiting | 16 (11.9) | 7 (18.9) | 9 (9.2) | 0.119 |
Frailty | 24 (17.8) | 12 (32.4) | 12 (12.2) | 0.006 |
Diarrhea | 9 (6.7) | 7 (18.9) | 2 (2.0) | 0.002a |
Underlying conditions | ||||
Diabetes mellitus | 67 (50.0) | 20 (54.1) | 47 (48.0) | 0.528 |
Hypertension | 51 (37.8) | 17 (45.9) | 34 (34.7) | 0.229 |
Fatty liver | 16 (11.9) | 9 (24.3) | 7 (7.1) | 0.006 |
Cholelithiasis | 29 (21.5) | 4 (10.8) | 25 (25.5) | 0.064 |
Viral hepatitis | 32 (23.7) | 7 (18.9) | 25 (25.5) | 0.422 |
Cardiovascular diseases | 25 (18.5) | 5 (13.5) | 20 (20.4) | 0.358 |
Chronic renal insufficiency | 14 (10.4) | 13 (35.1) | 1 (1.0) | 0.000a |
Hepatic dysfunction | 21 (15.6) | 17 (45.9) | 4 (4.1) | 0.000a |
Abdominal surgery history | 9 (6.7) | 0 | 9 (9.2) | 0.063a |
Imaging and laboratory results
Characteristic | Total n = 135 | KPLA with sepsis n = 37 | KPLA without sepsis n = 98 | P value |
---|---|---|---|---|
Abscess location | ||||
Right lobe | 90 (66.7) | 25 (67.6) | 65 (66.3) | 0.891 |
Left lobe | 34 (25.2) | 9 (24.3) | 25 (25.5) | 0.887 |
Both lobes | 11 (8.1) | 3 (8.1) | 8 (8.2) | 1.000a |
Abscess size (cm) | ||||
< 5 | 26 (19.3) | 5 (13.5) | 21 (21.4) | 0.298 |
5–10 | 85 (63.0) | 24 (64.9) | 61 (62.2) | 0.779 |
> 10 | 24 (17.8) | 8 (21.6) | 16 (16.3) | 0.473 |
Laboratory findings | ||||
WBC > 9.5× 109/L | 105 (77.8) | 34 (91.9) | 71 (72.4) | 0.015 |
NE% > 75% | 119 (88.1) | 37 (100.0) | 82 (83.7) | 0.006a |
PLT < 125× 109/L | 38 (28.1) | 19 (51.4) | 19 (19.4) | 0.000 |
Hb < 110 g/L | 37 (27.4) | 5 (13.5) | 32 (32.7) | 0.026 |
CRP > 10 mg/L | 127 (94.1) | 37 (100.0) | 90 (91.8) | 0.106a |
PCT > 0.5 ng/ml | 120 (88.9) | 35 (94.6) | 85 (86.7) | 0.237a |
ALT > 50 U/L | 73 (54.1) | 23 (62.2) | 50 (51.0) | 0.247 |
AST > 40 U/L | 79 (58.5) | 25 (67.6) | 54 (55.1) | 0.190 |
ALP > 125 U/L | 100 (74.1) | 26 (70.3) | 74 (75.5) | 0.535 |
GGT > 60 U/L | 105 (77.8) | 30 (81.1) | 75 (76.5) | 0.571 |
T.Bil > 20.5 μmol/L | 44 (32.6) | 22 (59.5) | 22 (22.7) | 0.000 |
ALB< 40 g/L | 129 (95.6) | 37 (100.0) | 92 (93.9) | 0.188a |
FIB> 4 g/L | 128 (94.8) | 33 (89.2) | 95 (96.9) | 0.089a |
APTT> 42 s | 80 (59.3) | 20 (54.1) | 60 (61.2) | 0.449 |
BUN > 7.2 mmol/L | 41 (30.4) | 21 (56.8) | 19 (19.6) | 0.000 |
Cr > 97 μmol/L | 20 (14.8) | 12 (32.4) | 8 (8.2) | 0.000 |
Complications and treatments
Characteristic | Total n = 135 | KPLA with sepsis n = 37 | KPLA without sepsis n = 98 | P value |
---|---|---|---|---|
Complications | ||||
Sepsis shock | 8 (5.9) | 7 (18.9) | 1 (1.0) | 0.000a |
Acute Respiratory Distress Syndrome | 4 (3.0) | 4 (10.8) | 0 | 0.005a |
Acute kidney injury | 2 (1.5) | 2 (5.4) | 0 | 0.074 a |
Pleural effusion | 11 (8.1) | 4 (10.8) | 7 (7.1) | 0.493 a |
Spontaneous bacterial peritonitis | 2 (1.5) | 2 (5.4) | 0 | 0.074 a |
Metastatic infections | ||||
Lung | 11 (8.1) | 9 (24.3) | 2 (2.0) | 0.000a |
Eye | 4 (3.0) | 4 (10.8) | 0 | 0.005a |
CNS | 1 (0.7) | 1 (2.7) | 0 | 0.274a |
Others | 4 (3.4) | 3 (8.1) | 1 (1.0) | 0.063a |
Hospital length of stay, days | 14.5 ± 9.0 | 20.7 ± 9.5 | 12.2 ± 7.7 | 0.000 |
ICU admission | 14 (10.4) | 11 (29.7) | 3 (3.1) | 0.000a |
Readmission | 8 (5.9) | 2 (5.4) | 6 (6.1) | 1.000a |
Treatment | 0.696 | |||
Antibiotics alone | 7 (5.2) | 1 (2.7) | 6 (6.1) | |
Antibiotics+Percutaneous drainage | 122 (90.4) | 34 (91.9) | 88 (89.8) | |
Antibiotics+Surgical drainage | 6 (4.4) | 2 (5.4) | 4 (4.1) | |
Antibiotic drugs | ||||
Beta-lactamase inhibitors | 38 (28.1) | 18 (48.6) | 20 (20.4) | 0.001 |
The third generation of cephalosporin | 59 (43.7) | 18 (48.6) | 41 (41.8) | 0.477 |
Fluoroquinolone | 51 (37.8) | 17 (45.9) | 34 (34.7) | 0.229 |
Carbapenems | 96 (71.1) | 31 (83.8) | 65 (66.3) | 0.046 |
Metronidazole | 57 (42.2) | 16 (43.2) | 41 (41.8) | 0.883 |
Clinical outcomes | 0.074a | |||
Cured | 133 (98.5) | 35 (94.6) | 98 (100) | |
Died (Poor prognosis) | 2 (1.5) | 2 (5.4) | 0 |
Antimicrobial susceptibility
No. of isolates | Amoxicillin /clavulanic acid | Ampicillin/ sulbactam | Cefazolin | Ceftazidime | Ceftriaxone | Ciprofloxacin | Levofloxacin | Amikacin | Aztreonam | Imipenem | Meropenem | Gentamicin |
---|---|---|---|---|---|---|---|---|---|---|---|---|
2 | R | R | R | R | R | R | R | S | R | R | R | R |
2 | R | R | R | R | R | R | R | S | R | S | S | R |
2 | R | R | R | S | S | S | R | S | S | S | S | S |
2 | R | S | R | S | S | S | S | S | S | S | S | S |
127 | S | S | S | S | S | S | S | S | S | S | S | S |
Metastatic infection
Patient | Age, years | Sex | infection site | Underlying disease(s) | Severe complication(s) | Location of abscess | WBC (X109/L) | Neutrophil (%) | CRP (mg/L) | PCT (ng/ml) | Antibiotics history | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 60 | F | lung | HTN, chronic renal insufficiency | MODF,ARDS,AKI Septic shock, | Left side | 12.7 | 88 | 136 | 76 | IMP+LEV | Died |
2 | 55 | M | Lung peritoneum | DM | Septic shock | Right side | 12.6 | 92 | 316 | 157.7 | MEM + MXF | Survived |
3 | 58 | M | Lung eye | None | None | Right side | 14.2 | 81 | 74.1 | 0.49 | CRO+ LEV | Survived |
4 | 46 | M | Lung eye | HTN, DM, liver cirrhosis | Septic shock | Right side | 10 | 87.7 | 137.8 | 7.77 | IMP, TZP | Survived |
5 | 82 | F | Lung pleura | HTN, Cholelithiasis,Cardiovascular diseases | None | Right side, multiple | 15.6 | 88 | 104 | 1.55 | MXF + MEM | Survived |
6 | 50 | F | lung | chronic hepatitis | MODF,ARDS, Septic shock, DIC | Right side | 21.5 | 96.3 | 176.7 | 100 | CAZ, MEM + LEV | Survived |
7 | 32 | M | Lung | HTN, DM, | Septic shock, ARDS | Right side | 11.4 | 89.6 | 238.6 | 8.49 | IMP, CAZ | Survived |
8 | 83 | F | Lung | Cardiovascular diseases | Septic shock | Right side, multiple | 10.6 | 93.3 | 311.18 | 73 | CRO, SCF | Survived |
9 | 61 | M | Lung CNS eye | HTN, DM, Cardiovascular diseases | ARDS | Right side, multiple | 23.4 | 95.5 | 113.1 | 24.2 | CRO,TZP, MEM | Died |
10 | 48 | M | Lung eye | HTN, DM | None | Right side | 33.3 | 89.5 | 132.5 | 20.32 | TZP+ LEV | Survived |
11 | 53 | F | Lung pleura | HTN, DM, anemia | AKI | Right side | 9.3 | 94.2 | 267.9 | 23.25 | TZP, IMP, CAZ | Survived |
12 | 53 | F | pleura | DM, anemia | None | Left side | 10.4 | 82.5 | 130.8 | 25.8 | TZP | Survived |
Characteristics and outcome of KPLA patients with or without metastatic infections
Characteristic | Total n = 135 | KPLA with Metastatic infection n = 12 | KPLA without Metastatic infection n = 123 | P value |
---|---|---|---|---|
Age (year) | 60.9 ± 12.7 | 58.3 ± 12.2 | 61.1 ± 12.8 | 0.467 |
Gender | 0.494 | |||
Male,n(%) | 80 (59.3) | 6 (50.0) | 74 (60.2) | |
Female,n(%) | 55 (40.7) | 6 (50.0) | 49 (39.8) | |
Symptoms | ||||
Body temperature (≥38.5 °C) | 80 (59.3) | 7 (58.3) | 73 (59.3) | 0.945 |
Fever | 123 (91.1) | 11 (91.7) | 112 (91.1) | 1.000a |
Chills | 81 (60.0) | 8 (66.7) | 73 (59.3) | 0.621 |
Abdominal pain | 58 (43.0) | 6 (50.0) | 52 (42.3) | 0.606 |
Nausea | 17 (12.6) | 2 (16.7) | 15 (12.2) | 0.648a |
Vomiting | 16 (11.9) | 2 (16.7) | 14 (11.4) | 0.635a |
Frailty | 24 (17.8) | 2 (16.7) | 22 (17.9) | 1.000a |
Diarrhea | 9 (6.7) | 0 | 9 (7.3) | 1.000a |
Underlying conditions | ||||
Diabetes mellitus | 67 (50.0) | 7 (58.3) | 60 (48.8) | 0.528 |
Hypertension | 51 (37.8) | 6 (50.0) | 45 (36.6) | 0.360 |
Fatty liver | 16 (11.9) | 1 (8.3) | 15 (12.2) | 1.000a |
Cholelithiasis | 29 (21.5) | 1 (8.3) | 28 (22.8) | 0.461a |
Viral hepatitis | 32 (23.7) | 2 (16.7) | 30 (24.4) | 0.731a |
Cardiovascular diseases | 25 (18.5) | 3 (25.0) | 22 (17.9) | 0.696a |
Chronic renal insufficiency | 14 (10.4) | 5 (41.7) | 9 (7.3) | 0.000 |
Hepatic dysfunction | 21 (15.6) | 3 (25.0) | 18 (14.6) | 0.399a |
Abdominal surgery history | 9 (6.7) | 1 (8.3) | 8 (6.5) | 0.579a |
Abscess location | ||||
Right lobe | 90 (66.7) | 10 (83.3) | 80 (65.0) | 0.199 |
Left lobe | 34 (25.2) | 2 (16.7) | 32 (26.0) | 0.730a |
Both lobes | 11 (8.1) | 0 | 11 (8.9) | 0.598a |
Laboratory findings | ||||
WBC > 9.5× 109/L | 105 (77.8) | 10 (83.3) | 95 (77.2) | 0.628 |
NE% > 75% | 119 (88.1) | 12 (100.0) | 107 (87.0) | 0.359a |
PLT < 125 | 38 (28.1) | 7 (58.3) | 31 (25.2) | 0.015 |
Hb < 110 g/L | 37 (27.4) | 2 (16.7) | 35 (28.5) | 0.511a |
CRP > 10 mg/L | 127 (94.1) | 12 (100.0) | 105 (85.4) | 0.367a |
PCT > 0.5 ng/ml | 120 (88.9) | 12 (100.0) | 108 (87.8) | 0.360a |
ALT > 50 U/L | 73 (54.1) | 5 (41.7) | 68 (55.3) | 0.366 |
AST > 40 U/L | 79 (58.5) | 7 (58.3) | 72 (58.5) | 0.989 |
ALP > 125 U/L | 100 (74.1) | 10 (83.3) | 90 (73.2) | 0.443 |
GGT > 60 U/L | 105 (77.8) | 8 (66.7) | 97 (78.9) | 0.332 |
T.Bil > 20.5 μmol/L | 44 (32.6) | 7 (58.3) | 37 (30.3) | 0.049 |
ALB< 40 g/L | 129 (95.6) | 12 (100.0) | 117 (95.1) | 1.000a |
FIB> 4 g/L | 128 (94.8) | 11 (91.7) | 117 (95.1) | 0.487a |
APTT> 42 s | 80 (59.3) | 6 (50.0) | 74 (60.2) | 0.494 |
BUN > 7.2 mmol/L | 41 (30.4) | 8 (66.7) | 32 (26.2) | 0.003 |
Cr > 97 μmol/L | 20 (14.8) | 5 (41.7) | 15 (12.3) | 0.006 |
Treatment | 0.075 | |||
Antibiotics alone | 7 (5.2) | 0 | 7 (5.7) | |
Antibiotics+Percutaneous drainage | 122 (90.4) | 10 (83.3) | 112 (91.1) | |
Antibiotics+Surgical drainage | 6 (4.4) | 2 (16.7) | 4 (3.3) | |
Clinical outcomes | 0.007a | |||
Cured | 133 (98.5) | 10 (83.3) | 123 (100.0) | |
Poor prognosis | 2 (1.5) | 2 (16.7) | 0 |