Clinical Features and Epidemiology of Melioidosis Pneumonia: Results From a 21-Year Study and Review of the Literature

Meumann, Ella M.; Cheng, Allen; Ward, Linda; Currie, Bart J.

doi:10.1093/cid/cir808

Cited by 159 publications

(149 citation statements)

References 32 publications

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“…This study also showed that three factors associated with death included pulmonary presentation, blood urea nitrogen level, and white blood cell count. Pulmonary presentation had the highest adjusted OR among all predictors and was also previously reported as the most common presentation of melioidosis [12,13]. Pulmonary presentation was found in 51% of patients who had melioidosis [5,15].…”

Section: Discussionsupporting

confidence: 54%

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What clinical factors are associated with mortality in septicemic melioidosis? A report from an endemic area

Domthong

Chaisuksant

Sawanyawisuth

2016

J Infect Dev Ctries

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Introduction: Melioidosis, caused by Burkholderia pseudomallei, has high mortality, particularly in its septicemic form. Data on the factors associated with mortality from melioidosis are still limited. Methodology: All patients (≥ 15 years of age) who were positive for melioidosis by blood culture in the year 2009 were enrolled. The study was conducted at Khon Kaen Hospital, Thailand. Patients were divided into two groups: surviving and deceased. Multivariate logistic regression was used to identify factors associated with death by three models: clinical, laboratory, and combined. Results: There were 97 patients who had blood cultures positive for melioidosis. The mortality rate was 54.17% (52 patients). The clinical presentation model found one significant factor associated with mortality from septicemic melioidosis: pulmonary presentation. Two factors were statistically significant for death as determined by the laboratory model: white blood cell count (WBC) and blood urea nitrogen (BUN) value. For the combined model, three significant factors were associated with death: pulmonary presentation, WBC, and BUN. The adjusted odds ratios (95% confidence interval) of the three factors were 10.739 (3.300-34.953), 0.930 (0.877-0.985), and 1.057 (1.028-1.087), respectively. Conclusions: Three clinical factors associated with mortality in septicemic melioidosis were pulmonary presentation, white blood cell count, and blood urea nitrogen level. Physicians should be aware of high mortality if septicemic melioidosis patients have these clinical features. Aggressive treatment may be needed.

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Section: Discussionsupporting

confidence: 54%

“…Seventy-one percent of patients who died from septicemic melioidosis in this study also had pulmonary problems, while only 27.27% of patients who survived had pulmonary problems (Table 1). Patients with acute pneumonia from melioidosis had a high risk of septic shock, acute respiratory distress syndrome, and death [6,13].…”

Section: Discussionmentioning

confidence: 99%

What clinical factors are associated with mortality in septicemic melioidosis? A report from an endemic area

Domthong

Chaisuksant

Sawanyawisuth

2016

J Infect Dev Ctries

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“…Melioidosis mainly occurs in the rainy season. 6 The bacteria reach the body by inhalation or ingestion of contaminated water or food. Peak incidence occurs in the 4 and 5 decade and studies from different parts of world have shown a distinct male predominance, that is 69%, 75%, and 62% of patients, respectively from Australia, 6 Malaysia, 7 and Thailand.…”

Section: Discussionmentioning

confidence: 99%

“…6 The bacteria reach the body by inhalation or ingestion of contaminated water or food. Peak incidence occurs in the 4 and 5 decade and studies from different parts of world have shown a distinct male predominance, that is 69%, 75%, and 62% of patients, respectively from Australia, 6 Malaysia, 7 and Thailand. 8 Although healthy people may get melioidosis, the major risk factors include diabetes (present in 23-60% of patients), heavy alcohol use (in 12-39%), chronic pulmonary disease (in 12-27%), chronic renal disease (in 10-27%), thalassemia (in 7%), glucocorticoid therapy (in <5%), and cancer (in <5%).…”

Section: Discussionmentioning

confidence: 99%

Melioidosis Presenting as Fever and Jaundice: A Rare Presentation

Tyagi

Shah

Sharma

et al. 2014

Journal of Clinical and Experimental Hepatology

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Melioidosis caused by the environmental Gram-negative bacillus Burkholderia pseudomallei is endemic in northern Australia and Southeast Asia and is being described increasingly from south and west coastal regions of India. Melioidosis is known to have high mortality (14-50%) and the risk factors associated with it are diabetes mellitus and heavy alcohol abuse. Melioidosis primarily presents as pneumonia, genitourinary infection and bacteremia. We present a case of Melioidosis from North India, a 56-year-old diabetic male, presenting with fever and jaundice. His blood culture was positive for the B. pseudomallei. The hepatic involvement was in the form of jaundice with serum bilirubin value of more than 12 mg/dL, hepatic enzymes more than ten times high and without hepatic abscess. He improved with intravenous antibiotics with complete normalization of liver function tests. ( J CLIN EXP HEPATOL 2014;4:172-174)

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“…[3][4][5][6][7] The increased incidence of melioidosis generally arises after heavy monsoonal rains, cyclones, or typhoons have occurred, leading to a shift toward the inhalation of B. pseudomallei that is significantly correlated with pneumonia, bacteremia, septic shock, and a high mortality rate. [8][9][10] The extraordinary survival period of B. pseudomallei, which ranges from months to years in the endemic regions during the dry season and in a laboratory setting, highlights its persistence, adaptability, and ability to survive. [11][12][13] An examination of B. pseudomallei maintained in distilled water at 25°C for 16 years provided evidence of its ability to survive under extreme conditions.…”

Section: Introductionmentioning

confidence: 99%

Morphological Alteration and Survival of Burkholderia pseudomallei in Soil Microcosms

Kamjumphol¹,

Chareonsudjai²,

Taweechaisupapong³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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The resilience of Burkholderia pseudomallei, the causative agent of melioidosis, was evaluated in control soil microcosms and in soil microcosms containing NaCl or FeSO4 at 30°C. Iron (Fe(II)) promoted the growth of B. pseudomallei during the 30-day observation, contrary to the presence of 1.5% and 3% NaCl. Scanning electron micrographs of B. pseudomallei in soil revealed their morphological alteration from rod to coccoid and the formation of microcolonies. The smallest B. pseudomallei cells were found in soil with 100 μM FeSO4 compared with in the control soil or soil with 0.6% NaCl (P < 0.05). The colony count on Ashdown's agar and bacterial viability assay using the LIVE/DEAD® BacLight™ stain combined with flow cytometry showed that B. pseudomallei remained culturable and viable in the control soil microcosms for at least 120 days. In contrast, soil with 1.5% NaCl affected their culturability at day 90 and their viability at day 120. Our results suggested that a low salinity and iron may influence the survival of B. pseudomallei and its ability to change from a rod-like to coccoid form. The morphological changes of B. pseudomallei cells may be advantageous for their persistence in the environment and may increase the risk of their transmission to humans.

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Clinical Features and Epidemiology of Melioidosis Pneumonia: Results From a 21-Year Study and Review of the Literature

Abstract: Melioidosis pneumonia is often a rapidly progressive illness with high mortality, particularly among those with multilobar disease. Risk factors have been identified, and early diagnosis and treatment should be priorities.

Cited by 159 publications

References 32 publications

What clinical factors are associated with mortality in septicemic melioidosis? A report from an endemic area

What clinical factors are associated with mortality in septicemic melioidosis? A report from an endemic area

Melioidosis Presenting as Fever and Jaundice: A Rare Presentation

Morphological Alteration and Survival of Burkholderia pseudomallei in Soil Microcosms

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