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


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. 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 β-lactamase (ESBL) production compared with the non-recurrence group (30.0% vs 8.89%, P = 0.018). Diabetes, biliary tract disease, and history of malignancy were 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. Our findings emphasize that KPLA has a high recurrence rate and ESBL production is an independent risk factor for recurrent KPLA.

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Klebsiella pneumoniae


Klebsiella pneumoniae liver abscess


pyogenic liver abscess


extended-spectrum β-lactamase


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The study was supported by the National Natural Science Foundation of China (Grant No. 81901856) and the 345 Talent Project in Shengjing hospital of China Medical University.

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Corresponding author

Correspondence to Zhihui Chang.

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The Ethics Committee in Shengjing Hospital of China Medical University granted approval for this retrospective study, with a waiver of informed consent because the medical records of the subjects were de-identified to ensure patient confidentiality.

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The authors declare that they have no competing interests.

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Wang, H., Ren, Y., Chang, Z. et al. The increased recurrence rate of liver abscess caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis 39, 1315–1320 (2020).

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  • Klebsiella pneumonia
  • Liver abscess
  • Extended-spectrum β-lactamase (ESBL)
  • Recurrence