Gas Formation in Pyogenic Liver Abscess Is Independently Correlated with Diabetes Mellitus but not with Pathogenic Bacteria

Abstract

Background Gas formation is a typical imaging feature of pyogenic liver abscess (PLA). However, the underlying mechanism of gas formation and its impact on the clinical characteristics of PLA remains unclear. The current study investigated the clinical characteristics of gas-forming PLA (GFPLA) and explored risk factors for GFPLA from both the host and pathogenic bacterium perspectives. Results The GFPLA group exhibited greater disease severity and a higher in-hospital mortality rate. The proportions of patients with diabetes mellitus (DM, P < 0.001) and biliary abnormality (P = 0.001) were higher in the GFPLA group. DM was an independent risk factor for GFPLA, whereas the time from symptom onset to CT and positivity for Klebsiella pneumoniae and Escherichia coli were not independent risk factors for GFPLA. 16S rDNA sequencing revealed no significant differences in bacterial community richness, diversity, evenness, and composition between the groups(P all > 0.05). In vitro fermentation experiments illustrated that high glucose levels was associated with greater gas production by both Klebsiella pneumoniae and Escherichia coli than low glucose levels (both P < 0.01). Conclusion GFPLA was associated with more severe disease and greater in-hospital mortality than non-GFPLA. Gas formation in PLA might be related to high blood glucose levels, but not to pathogenic bacteria composition.