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Risk Factors of Septic Metastatic Infection among Patients with Klebsiella pneumoniae Liver Abscess in Singapore: A Case–Control Study

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  • 1 Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore;
  • | 2 Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore;
  • | 3 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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ABSTRACT.

Metastatic infection resulting from Klebsiella pneumoniae liver abscess (KPLA) results in high mortality and morbidity. This study aimed to determine the risk factors associated with metastatic infection among patients with KPLA in Singapore. A retrospective case–control analysis among adult patients admitted to the National University Hospital with KPLA between 2013 and 2017 was conducted. Univariate and multivariate regression analysis was conducted. Of the 116 KPLA patients, 38.8% had pulmonary metastatic infection. Length of hospital stay (P = 0.001) and intensive care unit admissions (P = 0.044) were significantly longer and greater, respectively, among the patients with metastatic infection. Sepsis-induced hypotension (adjusted odds ratio [AOR], 4.88; 95% CI, 1.1–21.69), breathlessness (AOR, 5.10; 95% CI, 1.42–18.27), and abscess size (AOR, 1.02; 95% CI, 1.01–1.03) were associated independently with septic metastatic infection. Patients with KPLA who had breathlessness and larger abscess size are at a greater risk of septic metastatic infection.

Author Notes

Address correspondence to Junxiong Pang, Tahir Foundation Building, 12 Science Dr. 2, #10-01 Singapore 117549, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. E-mail: pangv@hotmail.com

Authors’ addresses: Shilpa Mukherjee, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, and Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore, E-mail: shilpa_mukherjee@nuhs.edu.sg. Sophia Archuleta, Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore, and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, E-mail: sophia@nus.edu.sg. Junxiong Pang, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, E-mail: pangv@hotmail.com.

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