Development and validation of a predictive model for invasive syndrome in patients with Klebsiella pneumoniae liver abscess

作者：Liyong Zhang, Jiaqi Chen, Yuejin Qu, Xidong Cao, Jinhua Cui, Jian Li, Aijun Yu · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1663407 · 被引用次数：5 · 研究领域：Amoebic Infections and Treatments、Liver Disease and Transplantation、Abdominal Trauma and Injuries

Introduction Pyogenic liver abscess (PLA) is a life—threatening liver bacterial infection causing suppurative lesions. In Asia, hypervirulent Klebsiella pneumoniae (hvKP) is the main PLA pathogen, linked to invasive syndromes. Severe Klebsiella pneumoniae liver abscess (KPLA) manifestations, called invasive KPLA syndrome (IKPLAS), have acute onset, rapid progression and non-specific symptoms, often leading to poor prognosis if untreated. This study aimed to find risk factors and create a validated nomogram for predicting invasive syndrome in KPLA patients. Methods We retrospectively analyzed clinical data from 529 KPLA patients treated at Chengde Medical University Affiliated Hospital between August 1, 2014, and November 30, 2024. By using the 7:3 stratified random sampling method, the patients were assigned to two cohorts: derivation (n = 370) and validation (n = 159). Univariate and multivariate logistic regression analyses were performed to identify risk factors for invasive KPLA syndrome (IKPLAS). A predictive nomogram was constructed and evaluated for discrimination and clinical utility. Results Of the 529 enrolled patients, 33 patients (6.2%) developed IKPLAS (IKPLAS group), while the remaining 496 patients were included in the non-invasive group (NIKPLAS group). Both groups showed significant differences (P < 0.05) in the incidence of viral hepatitis, biliary disease, type 2 diabetes mellitus (T2DM), vomiting, pulmonary infection, and septic shock; C-reactive protein l...