Clinical Characteristics Of Bacterial Liver Abscess In Patients With Type 2 Diabetes Mellitus

Objective To compare the clinical characteristics and prognosis of bacterial liver abscess in patients with or without type 2 diabetes mellitus in order to guide clinical diagnosis and treatment.Methods The clinical data of 110 patients with bacterial liver abscess at the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed.Among them,45 cases with type 2 diabetes mellitus and 65 cases without type 2 diabetes mellitus were enrolled in this study.The demographic data,clinical signs and symptoms,laboratory findings,pathogenic results,imaging findings,therapy and prognosis were compared between the two groups.Differences among the quantitative data with normal distribution were compared using t test,while count data were compared with?2 test or Fisher exact test,multivariate logistic regression was used to determine the prognostic risk factors of two groups.Results Fever as initial symptom in diabetic group and non?diabetic group were37 cases and 40 cases,respectively,while abdominal pain presented in 7 cases and 22cases of the two groups,respectively,both with statistically significant difference(?2=5.417 and 4.582,respectively,both P<0.05).AS for laboratory examination,neutrophil counts in the two groups were(12.87±8.83)×10/L and(10.24±4.86)×10/L,respectively,the percentages of neutrophils were 0.841±0.077and 0.799±0.103,respectively,albumin levels were(28.36±4.65)g/L and(30.67±6.16)g/L,respectively,withstatisticallysignificantdifference(t=2.010,t=2.317,t=-2.265,respectively,all P<0.05).Patients with elevated blood urea nitrogen in the two groups were 13 cases and 8 cases,respectively,patients with elevated creatinine were 9 cases and 4 cases,respectively,with statistically significant difference(?~2=4.733 and 4.892,respectively,both P<0.05).In diabetic group,pus culture was positive in 13 out of 19 cases,and blood cultures was positive in 7 out of 21 cases.In non-diabetic group,9 of 13 cases were positive for pus culture,and 6 of 25 cases were positive for blood culture.The positive rates of Klebsiella pneumoniae in the two groups were 37.5%(15/40)and 15.8%(6/38),with statistically significant difference(?~2=4.669,P=0.031).The effective rates of the two groups with glycemic control were84.4%(38/45)and 84.6%(55/65),and the mortality rates of the two groups were2.2%(1/45)and 1.5%(1/65).Multivariate Logistic regression showed that multiple abscess(OR=34.61,95%CI:1.601-748.457,P=0.024)was prognostic risk factors and invasive intervention(OR=0.028,95%CI:0.001-0.984,P=0.049)was protective factor inthediabetesmellitusgroup.Hypoalbuminemia(OR=14.793,95%CI:1.605-136.322,P=0.017)and the history of abdominal surgery within two years(OR=7.624,95%CI:1.294-44.913,P=0.025)were prognostic risk factors in the non-diabetic group.Conclusions Patients with bacterial liver abscesses with type 2 diabetes were more likely to have fever as the first symptom than those without type 2 diabetes.The neutrophil ratio and count in diabetic group were higher,albumin was lower,renal function was more severe,and Klebsiella pneumoniae infection rate is also higher in diabetic group.Patients with bacterial liver abscess and diabetes mellitus,multiple abscesses are risk factors that affect prognosis.In clinical practice,attention should be paid to invasive treatment in time.