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Klebsiella pneumoniae와 Non-Klebsiella pneumoniae에 의한 화농성 간농양의 특성 및 당뇨병이 미치는 영향

Other Titles
 Clinical Characteristics of Pyogenic Liver Abscess with Klebsiella pneumoniae or Non-Klebsiella pneumoniae and Its Prognosis Associated with Diabetes Mellitus 
Authors
 우성일  ;  권혁춘  ;  최영화  ;  신승수  ;  김창오  ;  김효열  ;  박윤선  ;  박윤수  ;  송영구  ;  염준섭  ;  윤희정  ;  이꽃실  ;  최성호  ;  최준용  ;  홍성관  ;  김준명 
Citation
 INFECTION AND CHEMOTHERAPY (감염과 화학요법), Vol.38(2) : 77-84, 2006 
Journal Title
INFECTION AND CHEMOTHERAPY (감염과 화학요법)(감염과 화학요법)
ISSN
 1598-8112 
Issue Date
2006
Keywords
Liver abscess ; Diabetes Mellitus ; Klebsiella pneumoniae
Abstract
Background: Although the most common pathogen of liver abscess was Escherichia coli in the past, there has been an increasing number of reports on liver abscess caused by Klebsiella pneumoniae, especially in Asia and its more frequent occurrence in diabetes mellitus. Our study was to clarify the different clinical characteristics and prognostic factors of K. pneumoniae and non-K. pneumoniae liver abscess in patients with or without diabetes.
Materials and Methods: We reviewed medical records of pyogenic liver abscess diagnosed by defined criteria at 7 different tertiary care hospitals in Seoul and Gyeonggi Province from January 2000 to December 2003 retrospectively.
Results: Of the 248 cases, 86 cases (34.7%) of patients were diabetic. Cryptogenic cause (73.4%) was the most frequent portal of entry in liver abscess and 58 cases (23.4%) were the secondary following biliary disease. There were no differences in portal of entry between DM group and non- DM group. The most common organism was K. pneumoniae (70.2%) followed by E. coli (11.5%) and α-hemolytic streptococcus (5.2%). There were no significant differences in causative organism of liver abscess between DM group and non-DM group as K. pneumoniae was dominant pathogen [76.6% in DM group vs 66.2% in non-DM group (P=0.11)]. The metastatic complication occurred in 15 cases (8.6%) and found more frequently in DM group (P=0.042). All of the metastatic abscesses were found in liver abscess caused by K. pneumoniae (P=0.007). Ten patients died and the overall mortality rate was 4.1%. The factors associated with mortality were level of serum creatinine, past history of intra-abdominal surgery and underlying biliary malignancy.
Conclusion: The most commom pathogen of the pyogenic liver abscess is K. pneumoniae and the metastatic complications are usually found in liver abscess caused by K. pneumoniae, especially more frequently in patients with diabetes than in patients without diabetes.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111024
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