Clinical features and outcome of patients with cutaneous melioidosis during a nosocomial outbreak in a temperate region of Australia

Clark, Benjamin M.; Merritt, Adam J.; Inglis, Timothy J. J.; Manning, Laurens

doi:10.1111/imj.13752

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…It is also plausible that wearing open footwear, increased water exposure together with changes in environmental conditions during summer might also lead to increased rates of LLC caused by gram‐negative organisms such as Burkholderia pseudomallei. However, in WA the proportion of total LLC cases caused by these pathogens is likely to be very low …”

Section: Discussionmentioning

confidence: 99%

Seasonal and regional patterns of lower leg cellulitis in Western Australia

Manning

Cannon

Dyer

et al. 2019

Internal Medicine Journal

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In most non-tropical regions of WA, LLC is a summer disease, whilst in the warmer tropical regions of WA where year-round temperatures are higher, no seasonality was observed, but overall incidence of LLC presentations were higher. These findings may have important implications for public health messaging and research around prevention of LLC. This article is protected by copyright. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Seasonal and regional patterns of lower leg cellulitis in Western Australia

Manning

Cannon

Dyer

et al. 2019

Internal Medicine Journal

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“…An Australian report details the largest nosocomial melioidosis outbreak to date, secondary to contaminated saline and associated with soft tissue infections. All 6 cases developed superficial infection that resolved with parenteral and oral antimicrobial therapy (478). Cutaneous manifestations of melioidosis appear to be common in relation to contaminated medical or cleaning products (362,478,479).…”

Section: Clinical Presentationmentioning

confidence: 99%

Human Melioidosis

2020

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SUMMARY The causative agent of melioidosis, Burkholderia pseudomallei, a tier 1 select agent, is endemic in Southeast Asia and northern Australia, with increased incidence associated with high levels of rainfall. Increasing reports of this condition have occurred worldwide, with estimates of up to 165,000 cases and 89,000 deaths per year. The ecological niche of the organism has yet to be clearly defined, although the organism is associated with soil and water. The culture of appropriate clinical material remains the mainstay of laboratory diagnosis. Identification is best done by phenotypic methods, although mass spectrometric methods have been described. Serology has a limited diagnostic role. Direct molecular and antigen detection methods have limited availability and sensitivity. Clinical presentations of melioidosis range from acute bacteremic pneumonia to disseminated visceral abscesses and localized infections. Transmission is by direct inoculation, inhalation, or ingestion. Risk factors for melioidosis include male sex, diabetes mellitus, alcohol abuse, and immunosuppression. The organism is well adapted to intracellular survival, with numerous virulence mechanisms. Immunity likely requires innate and adaptive responses. The principles of management of this condition are drainage and debridement of infected material and appropriate antimicrobial therapy. Global mortality rates vary between 9% and 70%. Research into vaccine development is ongoing.

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“…16 However, a large American study of MI patients by Grubbs et al showed that length of stay and in-hospital mortality were not higher in LEP patients when adjusted for receipt of cardiac catheterisation or surgery. 17 STEMI care is much more streamlined than care of non-ST elevation ACS and our study only included those undergoing PCI which may explain the similarity between our results and those of Grubbs et al 17 Streamlining of STEMI management with PCI and the use of clinical pathways with a checklist approach, such as those used across our health network, is likely to be an important contributor in ensuring that equal care is provided to all patients regardless of English-speaking capacity. Implementing similar care pathways in other areas of cardiology and healthcare in general may help to ensure LEP patients are not disadvantaged in their care.…”

Section: Brief Communicationsmentioning

confidence: 60%

Impact of limited English proficiency on presentation and outcomes of patients undergoing primary percutaneous coronary intervention for ST‐elevation myocardial infarction

Biswas

Seman

Cox

et al. 2018

Internal Medicine Journal

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Doctor-patient language discordance has been shown to lead to worse clinical outcomes. In this study of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction at an Australian health service, we demonstrated that limited English proficiency (LEP) is an independent predictor of prolonged symptom-to-door time, but does not lead to worse 30-day mortality compared with English-proficient patients. More effort needs to be placed in providing public health education in varied languages to encourage early presentation to hospital for patients with LEP.

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Clinical features and outcome of patients with cutaneous melioidosis during a nosocomial outbreak in a temperate region of Australia

Cited by 7 publications

References 15 publications

Seasonal and regional patterns of lower leg cellulitis in Western Australia

Seasonal and regional patterns of lower leg cellulitis in Western Australia

Human Melioidosis

Impact of limited English proficiency on presentation and outcomes of patients undergoing primary percutaneous coronary intervention for ST‐elevation myocardial infarction

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