Characteristics of gas-forming pyogenic liver abscess caused by Klebsiella pneumoniae and Clostridi perfringens

Abstract Background: Gas-forming pyogenic liver abscess is a life-threatening disease with poor prognosis commonly caused by 2 bacteria, Klebsiella pneumoniae and Clostridium perfringens . Due to its low incidence and associated high mortality rate, it is important to study the biological characteristics of the disease. The aim of this study was to conduct a worldwide review of literature on gas-forming pyogenic liver abscess caused by K. pneumoniae and C. perfringens . Methods: We searched PubMed and Web of Science databases from January 2009 to March 2019, with published in English. All relevant articles were accessed in full text. The manual search included references of retrieved articles. Finally, 35 publications were selected for review. Results: The results showed that more cases of gas-forming pyogenic liver abscess in Asia were caused by K. pneumoniae than by C. perfringens (P=0.011). The prevalence of diabetes mellitus in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae was higher than caused by C. perfringens (P=0.032). The survival rate of patients with gas-forming pyogenic liver abscess caused by K. pneumoniae who received surgical debridement or drainage was higher than caused by C. perfringens (P=0.002). Conclusions: The prevalence of diabetes mellitus was higher in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae than in patients caused by C. perfringens .