Repeat blood culture positive for B. pseudomallei indicates an increased risk of death from melioidosis

Melioidosis, a bacterial infection caused by Burkholderia pseudomallei, is notoriously difficult to cure despite appropriate antimicrobial therapy and has a mortality rate of up to 40%. We demonstrate that a blood culture positive for B. pseudomallei taken at the end of the first and/or second week...

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Published inThe American journal of tropical medicine and hygiene Vol. 84; no. 6; pp. 858 - 861
Main Authors Limmathurotsakul, Direk, Wuthiekanun, Vanaporn, Wongsuvan, Gumphol, Pangmee, Sukanya, Amornchai, Premjit, Teparrakkul, Prapit, Teerawattanasook, Nittaya, Day, Nicholas P J, Peacock, Sharon J
Format Journal Article
LanguageEnglish
Published United States The American Society of Tropical Medicine and Hygiene 01.06.2011
Subjects
Adolescent
Adult
Burkholderia pseudomallei
Burkholderia pseudomallei - isolation & purification
Burkholderia pseudomallei - pathogenicity
Female
Follow-Up Studies
Humans
Logistic Models
Male
Melioidosis - blood
Melioidosis - diagnosis
Melioidosis - microbiology
Melioidosis - mortality
Middle Aged
Multivariate Analysis
Prognosis
Short Report
Sputum - microbiology
Suppuration - microbiology
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Summary:Melioidosis, a bacterial infection caused by Burkholderia pseudomallei, is notoriously difficult to cure despite appropriate antimicrobial therapy and has a mortality rate of up to 40%. We demonstrate that a blood culture positive for B. pseudomallei taken at the end of the first and/or second week after hospitalization for melioidosis is a strong prognostic factor for death (adjusted odds ratio = 4.2, 95% confidence interval = 2.1-8.7, P < 0.001 and adjusted odds ratio = 2.6, 95% confidence interval = 1.1-6.0, P = 0.03, respectively). However, repeat cultures of respiratory secretions, urine, throat swabs, or pus/surface swabs provide no prognostic information. This finding highlights the need for follow-up blood cultures in patients with melioidosis.
Bibliography:ObjectType-Article-1
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ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.2011.10-0618