OBJECTIVE  To analyze the clinical features, etiological characteristics, treatment and prognosis of patients with liver abscess-induced sepsis, comparing those with and without diabetes mellitus, and to provide references for clinical diagnosis and treatment.

METHODS  A retrospective analysis was conducted on the clinical data of 124 patients with bacterial liver abscess-induced sepsis admitted to Linyi Central Hospital from Jan. 2020 to Jun. 2024. Based on the presence of diabetes mellitus, patients were divided into a diabetes group （n=56） and a non-diabetes group （n=68）. Clinical data were collected from the electronic medical record system, including sex, age, body mass index （BMI）, underlying diseases, symptoms and signs, laboratory test indicators, etiological results, imaging characteristics, length of hospital stay, treatment and outcomes. Clinical features and prognosis were compared between the two groups.

RESULTS  The platelet count in the diabetes group was （150.80±65.08）×10⁹/L, which was lower than that in the non-diabetes group. Alanine aminotransferase, total bilirubin and procalcitonin levels were （169.53±56.99） U/L, （37.89±21.40） μmol/L and （8.98±5.16） ng/L, respectively, all higher than those in the non-diabetes group （all P＜0.05）. The proportion of patients with a solitary abscess in the diabetes group （92.86%） was higher than that in the non-diabetes group （P＜0.001）. Liver abscesses predominantly located in the right lobe （n=86, 69.35%）, followed by the left lobe （n=31, 25.00%）. However, no statistically significant difference was observed in abscess location between the two groups. Blood and/or pus cultures were performed for all patients, identifying Klebsiella pneumoniae （n=94, 75.81%） and Escherichia coli （n=12, 9.67%）, with no statistically significant differences between the two groups. The time to procalcitonin normalization and hospital costs in the diabetes group were （9.46±2.51） days and （32 688.53±6 568.51） RMB, respectively, both longer （higher） than those in the non-diabetes group （P＜0.05）.

CONCLUSIONS  Patients with bacterial liver abscess-induced sepsis and diabetes mellitus more commonly present with a solitary abscess and have a higher infection rate with K. pneumoniae. These patients are more likely to progress to septic shock, have prolonged hospital stays, and incur higher medical costs. Active glycemic control is therefore an important measure in their management.