Kim Seung Woo, Kwon Geun-Yong, Kim Bongyoung, Kwon Donghyok, Shin Jaeseung, Bae Geun-Ryang
Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
Division of HIV and Tuberculosis Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
Osong Public Health Res Perspect. 2015 Dec;6(6):363-8. doi: 10.1016/j.phrp.2015.10.014. Epub 2015 Nov 14.
Melioidosis is a potentially fatal infectious disease caused by the environmental anaerobic Gram-negative bacillus Burkholderia pseudomallei. Melioidosis is endemic to areas of northern Australia and Southeast Asia. With increasing international travel and migration, imported cases of melioidosis are being reported regularly. Here, we summarize the 11 cases of melioidosis reported in South Korea from 2003 to 2014.
Tracing epidemiological investigations were performed on every patient reported to the National Surveillance System since 2011. A systematic literature search was performed to identify melioidosis cases that occurred prior to 2011.
The overall fatality rate was 36.4%. All the patients had visited Southeast Asia where melioidosis is endemic. The stay in the endemic region ranged from 4 days to 20 years. Of the seven patients who developed initial symptoms after returning to South Korea, the time interval between returning to South Korea and symptom onset ranged from 1 day to 3 years. The remaining four patients developed symptoms during their stay in the endemic region and were diagnosed with melioidosis in South Korea. Seven (63.6%) patients possessed at least one risk factor, all of whom were diabetic. Pneumonia was the most frequent clinical manifestation, but the patients showed a wide spectrum of clinical features, including internal organ abscesses, a mycotic aneurysm of the aorta, and coinfection with tuberculosis.
An early diagnosis and initiation of the appropriate antibiotics can reduce the mortality of melioidosis. Consequently, increased awareness of the risk factors and clinical features of melioidosis is required.
类鼻疽是一种由环境性厌氧革兰氏阴性杆菌伯克霍尔德菌属假鼻疽杆菌引起的潜在致命性传染病。类鼻疽在澳大利亚北部和东南亚地区为地方病。随着国际旅行和移民的增加，类鼻疽输入病例时有报道。在此，我们总结了2003年至2014年韩国报告的11例类鼻疽病例。
对自2011年起向国家监测系统报告的每例患者进行追溯性流行病学调查。进行系统的文献检索以确定2011年之前发生的类鼻疽病例。
总死亡率为36.4%。所有患者均曾前往类鼻疽为地方病的东南亚地区。在地方病流行区的停留时间从4天到20年不等。在返回韩国后出现初始症状的7例患者中，从返回韩国到症状出现的时间间隔为1天到3年。其余4例患者在地方病流行区停留期间出现症状，并在韩国被诊断为类鼻疽。7例（63.6%）患者至少有一项危险因素，所有这些患者均为糖尿病患者。肺炎是最常见的临床表现，但患者表现出广泛的临床特征，包括内脏脓肿、主动脉霉菌性动脉瘤以及合并肺结核感染。
早期诊断并开始使用适当的抗生素可降低类鼻疽的死亡率。因此，需要提高对类鼻疽危险因素和临床特征的认识。
