Beyond the abscess: Klebsiella pneumoniae liver abscess combined with bloodstream infection

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Abstract
Objective: The clinical characteristics of Klebsiella pneumoniae liver abscess (KPLA) and Klebsiella pneumoniae bloodstream infection (KP-BSI) are often reported, while the risk factors for KPLA combined with KP bloodstream infection (KPLA/KP-BSI) among KPLA are largely unknown. Therefore, this study aimed to investigate the clinical characteristics, risk factors, and outcomes of patients with KPLA complicated by KP-BSI. Methods: A retrospective study from May 2013 to October 2020 at a tertiary hospital compared KPLA patients with and without KP-BSI, analyzing clinical data. Results: Among all liver abscess cases during the study period, Klebsiella pneumoniae was the most common pathogen, accounting for 76.0% of isolates. Of 233 KPLA patients, 68.7% were male with a median age of 60.5 years. KPLA/KP-BSI occurred in 27.9%. Patients with KPLA/KP-BSI had higher male prevalence, abdominal surgery history, and higher APACHE II, SOFA, and CCI scores (p 10 cm reduced the risk (aOR 0.144). KPLA/KP-BSI was associated with worse outcomes, including higher septic shock, acute kidney injury, transfusion rates, organ dysfunction, pneumonia, longer hospital stays, and higher mortality (all p10 cm is protective. KPLA/KP-BSI is associated with significantly higher rates of septic shock, organ dysfunction, and in-hospital mortality, warranting heightened clinical attention.

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