Clinical Presentations of Melioidosis and Antibiogram of Burkholderia pseudomallei: An 8-year Study in a Tertiary Care Center, South India

Kundoly Velayudhan Suseela, A. Alex, Subi Das
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Abstract

Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in tropical countries. In nonendemic areas, the disease is rarely suspected because of varying clinical presentations and only a few attempts are made to isolate the pathogen. Many cases are left underdiagnosed or underreported in geographical areas where the disease is not endemic. This study aimed to analyze the clinical presentations, comorbidities, and antibiotic susceptibility patterns in patients with melioidosis in a tertiary care center. A retrospective study was done on culture-confirmed melioidosis patients admitted to a tertiary care center, from January 2015 to December 2022. Relevant information on clinical presentations, mortality rate, comorbidities, and antibiogram was collected from hospital medical records. A total of 73 culture-confirmed cases of melioidosis were included in the study. Common clinical presentations were pneumonia (n = 35, 47.9%), septicemia (n = 13, 17.8%), and deep abscesses (n = 9, 12.3%). The mortality rate from melioidosis was 15.1% (n = 11). No significant difference was found in the mortality rate between pneumonia and septicemia groups (P = 0.716). Diabetes mellitus (DM) was the major comorbidity detected (n = 56, 76.7%). Isolates were susceptible to ceftazidime (n = 71, 97.3%), meropenem (n = 71, 97.3%), and co-trimoxazole (n = 60, 82.2%). Common clinical presentations of melioidosis in our setting were pneumonia and septicemia. DM was the major comorbidity. Nearly one in six patients died. Ceftazidime and meropenem were the effective antibiotics. These findings may help physicians to make an early microbiological diagnosis which is essential to reduce mortality.
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Melioidosis 的临床表现与假马勒伯克霍尔德氏菌的抗生素图谱:印度南部一家三级医疗中心的一项为期 8 年的研究
Melioidosis 是由假马来伯克霍尔德氏菌(Burkholderia pseudomallei)引起的一种传染病,在热带国家流行。在非流行地区,由于临床表现各异,很少有人怀疑这种疾病,也只有少数人试图分离病原体。在该疾病未流行的地区,许多病例被漏诊或少报。本研究旨在分析一家三级医疗中心中类鼻疽患者的临床表现、合并症和抗生素敏感性模式。 该研究对2015年1月至2022年12月在一家三级医疗中心收治的经培养确诊的类鼻疽患者进行了回顾性研究。研究人员从医院病历中收集了临床表现、病死率、合并症和抗生素图谱等相关信息。 研究共纳入73例经培养确诊的类鼻疽病例。常见的临床表现为肺炎(35例,占47.9%)、脓毒血症(13例,占17.8%)和深部脓肿(9例,占12.3%)。类鼻疽的死亡率为 15.1%(11 人)。肺炎组和败血症组的死亡率无明显差异(P = 0.716)。糖尿病(DM)是发现的主要合并症(n = 56,76.7%)。分离菌株对头孢他啶(n = 71,97.3%)、美罗培南(n = 71,97.3%)和联合新诺明(n = 60,82.2%)敏感。 在我们的病例中,常见的类鼻疽临床表现为肺炎和脓毒血症。糖尿病是主要合并症。近六分之一的患者死亡。头孢他啶和美罗培南是有效的抗生素。这些发现可帮助医生及早做出微生物学诊断,这对降低死亡率至关重要。
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审稿时长
27 weeks
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