Metabolic Characterization of Peripheral Host Responses to Drainage-Resistant Klebsiella pneumoniae Liver Abscesses by Serum 1H-NMR Spectroscopy

Chang, Zhihui; Wang, Hairui; Li, Beibei; Liu, Zhaoyu; Zheng, Jiahe

doi:10.3389/fcimb.2018.00174

Cited by 8 publications

(4 citation statements)

References 32 publications

(38 reference statements)

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“…CT revealed multiloculation in only half of the patients with ESBL-producing KPLA, which was significantly lesser than those with non-ESBLproducing KPLA. KPLA has been shown to typically manifest with multiloculation and poor liquification on CT [37]. Similar characteristics were reported by Kim et al, which were referred to as the "turquoise sign" [38].…”

Section: Discussionsupporting

confidence: 70%

Clinical and computed tomography features of extended-spectrum β-lactamase-producing Klebsiella pneumoniae liver abscess

et al. 2020

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Background: Klebsiella pneumoniae (KP) is the primary pathogen associated with pyogenic liver abscesses (PLAs). Moreover, there has been an increase in the proportion of extended-spectrum beta-lactamase (ESBL)-producing KP. However, the clinical and computed tomography (CT) features of liver abscesses caused by ESBL-producing KP have not been separately described. We aimed to compare the clinical and CT features present in patients with ESBL-producing and non-ESBL-producing KP as well as to determine the risk factors for ESBL-producing KP liver abscesses (KPLAs). Methods: We performed a retrospective analysis of data obtained from the medical records of patients with a first episode of KPLA admitted to Shengjing Hospital of China Medical University between May 2015 and May 2019. We compared the clinical and CT features between patients with ESBL-producing and non-ESBL-producing KPLA. Results: We enrolled 100 patients with KPLA (14 and 86 in the ESBL-producing and non-ESBL-producing groups, respectively). There was no significant between-group difference in the proportion of patients with comorbid diabetes (71.43% vs. 66.2%, p = 0.086). The ESBL-producing KPLA group had a greater proportion of patients with a history of biliary disease (78.57% vs. 26.74%, p < 0.001) and gastrointestinal malignancy (50% vs. 6.98%, p < 0.001). Multivariate regression analysis showed that a history of biliary disease was an independent risk factor for ESBL-producing KPLA. Compared with the non-ESBL-producing KPLA group, the ESBL-producing KPLA group had a significantly higher intensive care unit (ICU) admission rate (28.57% vs. 2.33%, p < 0.001). All ESBL-producing KP isolates were susceptible to carbapenems and amikacin. Only the presence of multiloculation on CT was found to be significantly different between the groups (50% vs. 82.56%, p = 0.012). Conclusions: The presence of biliary disease was an independent risk factor for ESBL-producing KPLA. Patients with ESBLproducing KPLA had a higher ICU admission rate, with only half of patients having evidence of multiloculation on CT.

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Section: Discussionsupporting

confidence: 70%

Clinical and computed tomography features of extended-spectrum β-lactamase-producing Klebsiella pneumoniae liver abscess

et al. 2020

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“…Radiomics may be more valuable for the purposes of analysis [31]. In another study of ours, the hosts' metabolic characteristics underwent nuclear magnetic resonance (NMR) analysis to evaluate the drainage resistance phenomenon of KPLA, and five key metabolites were identified which might be potential targets for guiding novel therapeutics [14]. This indicates that the occurrence and progress of a liver abscess could be further explored using functional imaging methods that can reflect metabolic characteristics, such as magnetic resonance spectroscopy and molecular imaging [32].…”

Section: Discussionmentioning

confidence: 98%

“…Same as our previous reports [6,13,14]. Briefly, in addition to percutaneous drainage therapy, all patients received antibiotic therapy (most commonly third-generation cephalosporins, ciprofloxacin, or carbapenem antibiotics) for their abscesses.…”

Section: Treatmentmentioning

confidence: 99%

The increased recurrence rate of liver abscess caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae

Wang

Ren

Chang

et al. 2020

Eur J Clin Microbiol Infect Dis

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Background The pathogenic bacterium Klebsiella pneumoniae (KP) is the major causative agent of pyogenic liver abscess (PLA). But reports about the prognosis of KP-caused PLA (KPLA) are rare. This study aimed to ascertain the recurrence rate of KPLA after initial treatment, and its contributing factors. Methods The medical records data were retrospectively analyzed of KPLA patients who were admitted to Shengjing Hospital of China Medical University from January 2012 to January 2018. According to whether or not there was recurrence of KPLA during follow-up, the patients were divided into a 'recurrence' and a 'non-recurrence' group. The clinical and CT characteristics of patients were compared between the two groups, and those factors related to KPLA recurrence were further analyzed. Results A total of 110 patients who had first-time episodes of KPLA were included into the study. The average follow-up time was 3.65±2.18 years. Twenty (18.18%) KPLA patients experienced recurrence. Those in the recurrence group had a significantly greater incidence of extended-spectrum βlactamase (ESBL) production compared to the non-recurrence group (30.0% vs 8.89%, P=0.018). Diabetes, biliary tract disease, and history of malignancy was not associated with recurrence (all P>0.05). No difference in the CT characteristics of KPLA (including abscess size, location, whether multilocular, gas production of KPLA, and thrombophlebitis) was found between the two groups. Multivariate regression analysis showed that ESBL production (OR, 6.3; 95% CI, 1.02-38.59; P=0.04) was an independent risk factor for the recurrence of KPLA. Conclusions KPLA has a high recurrence rate, and ESBL production is a risk factor for recurrent KPLA.

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“…The relationship between these genes and the invasiveness of KPLA should be verified via further research. In addition, KPLA is characterized by solid or multiloculated, which brings difficulties to drainage (Chang et al, 2018). Whether these characteristics are associated with the above-mentioned pathogenic genes is also worth exploring in the future.…”

Section: Discussionmentioning

confidence: 99%

Metagenome Analysis of the Bacterial Characteristics in Invasive Klebsiella Pneumoniae Liver Abscesses

Zhang

Wang

Guo

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundKlebsiella pneumoniae liver abscess (KPLA) combined with extrahepatic migratory infection (EMI) is defined as invasive KPLA (IKPLA) and is associated with a poor prognosis. The mechanism of IKPLA formation is yet to be elucidated. In this study, metagenomic sequencing was used to compare the bacterial characteristics between IKPLA and KPLA to explore the underlying mechanism of invasiveness.MethodsClinical details, imaging, and microbial features were retrospectively evaluated by medical record review. Metagenomic sequencing was performed on the pus samples of liver abscesses whose culture results were indicative of monomicrobial Klebsiella pneumoniae (K. pneumoniae). Bacterial diversity and composition in IKPLA and KPLA were comparatively analyzed, and the key pathways and genes that may affect invasiveness were further explored.ResultsSixteen patients were included in this study. Five patients with EMI were included in the IKPLA group, and the other eleven patients without EMI were assigned to the KPLA group. There was no statistical difference in the hypermucoviscous phenotype and serotype of K. pneumoniae between the two groups. The bacterial diversity of IKPLA was lower than that of KPLA. The abundant taxa in the IKPLA group were primarily species of unclassified Enterobacteriaceae and K. pneumoniae. The KPLA group had a high abundance of the genera Tetrasphaera and Leuconostoc. Metabolic pathway genes represented most of the enriched genes in IKPLA. Fourteen pathogenic genes with significant differences in abundance were identified between the two groups, including ybtS, fepC, phoQ, acrB, fimK, magA, entC, arnT, iucA, fepG, oqxB, entA, tonB, and entF (p < 0.001).ConclusionThe diversity and bacterial composition of IKPLA were significantly different from those of KPLA. Microbiological changes in the abscess, activation of the related metabolic pathways, and the pathogenic gene expression may constitute a novel mechanism that regulates the invasiveness of KPLA.

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Metabolic Characterization of Peripheral Host Responses to Drainage-Resistant Klebsiella pneumoniae Liver Abscesses by Serum 1H-NMR Spectroscopy

Cited by 8 publications

References 32 publications

Clinical and computed tomography features of extended-spectrum β-lactamase-producing Klebsiella pneumoniae liver abscess

Clinical and computed tomography features of extended-spectrum β-lactamase-producing Klebsiella pneumoniae liver abscess

The increased recurrence rate of liver abscess caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae

Metagenome Analysis of the Bacterial Characteristics in Invasive Klebsiella Pneumoniae Liver Abscesses

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