International Respiratory and Severe Illness Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
Kampong Cham Provincial Hospital, Kampong Cham.
Int J Tuberc Lung Dis. 2018 Dec 1;22(12):1481-1485. doi: 10.5588/ijtld.17.0294.
Melioidosis- infection-is increasingly recognized in Cambodia, a country with a high incidence of tuberculosis (TB). Melioidosis and TB can be clinically indistinguishable.
To quantify the proportion of patients with clinically suspected TB who had melioidosis by testing sputum for .
This was a prospective, 6-month cross-sectional single-center study at a Cambodian provincial referral hospital among patients with suspicion of TB who provided sputum specimens for testing. TB was diagnosed using sputum Xpert MTB/RIF molecular assay or culture; melioidosis was diagnosed using sputum culture for .
Of 404 patients evaluated for possible TB, 52 (12.9%, 95%CI 9.8-16.5) had TB. Four patients (1.0%, 95%CI 0.3-2.5) had melioidosis; none had concurrent TB or an existing medical risk factor for melioidosis, although two were farmers, an occupational risk factor.
One per cent of patients being evaluated for TB at a Cambodian provincial referral hospital had culture-proven respiratory melioidosis, a highly lethal infection. None had previously recognized medical conditions that would increase their risk of melioidosis. Testing for melioidosis should be considered in patients presenting with suspected TB in Cambodia.
在结核病（TB）高发的柬埔寨，人们对类鼻疽病（一种由伯克霍尔德菌引起的感染）的认识日益提高。类鼻疽病和结核病在临床上可能难以区分。
通过检测痰液中的 ，量化临床疑似结核病患者中患有类鼻疽病的比例。
这是在柬埔寨一家省级转诊医院进行的为期 6 个月的前瞻性、横断面单中心研究，纳入了疑似结核病并提供痰液标本进行检测的患者。结核病的诊断采用痰液 Xpert MTB/RIF 分子检测或培养；类鼻疽病的诊断采用痰液培养检测 。
在评估可能患有结核病的 404 名患者中，52 名（12.9%，95%CI 9.8-16.5）患有结核病。4 名患者（1.0%，95%CI 0.3-2.5）患有类鼻疽病；没有同时患有结核病或已知的类鼻疽病发病风险因素，尽管有 2 名患者是农民，这是一种职业风险因素。
在柬埔寨一家省级转诊医院接受结核病评估的患者中，有 1%的患者经培养证实患有呼吸道类鼻疽病，这是一种高度致命的感染。他们中没有已知的会增加类鼻疽病发病风险的既往医疗条件。在柬埔寨，对疑似结核病患者应考虑进行类鼻疽病检测。
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