University of Queensland Centre for Clinical Research, Royal Brisbane and Woman's Hospital, Herston, QLD 4029, Australia.
Department of Infectious Diseases, Mater Hospital Brisbane, South Brisbane, QLD 4101, Australia.
Trans R Soc Trop Med Hyg. 2022 Apr 4;116(4):328-335. doi: 10.1093/trstmh/trab125.
Melioidosis in an infection caused by Burkholderia pseudomallei, an organism endemic to tropical and subtropical regions.
This study describes the epidemiology of melioidosis in Townsville, QLD, Australia, as well as clinical features, risk factors associated with the disease, the burden of infection on the Aboriginal and Torres Strait Islander (ATSI) community and patient outcomes over time.
From 1997 to 2020, 128 patients were admitted to Townsville University Hospital. The total annual incidence of infection was 3.2 cases per 100 000 compared with 15.3 per 100 000 in the ATSI population. The majority of cases (n=82 [64%]) were male. Alcohol excess (55%) and diabetes mellitus (48%) were the most common risk factors. Bacteraemia occurred in 87 (70%) patients and pneumonia was the most common focus of infection in 84 (69%). The case fatality rate was 23%, with no difference for the ATSI population (6/32 [19%]). The presence of malignancy was the risk factor most associated with mortality (relative risk 2.7 [95% confidence interval 1.4-5.1], p=0.005).
The ATSI community was overrepresented in this study, however, there was no significant difference in adverse outcomes. The case fatality rate was higher than in other regions in Australia. This discrepancy may relate in part to the different risk groups seen in these settings coupled with potential organism variability.
类鼻疽病是由伯克霍尔德菌引起的感染，该菌是热带和亚热带地区的地方病。
本研究描述了澳大利亚昆士兰州汤斯维尔的类鼻疽病的流行病学，以及临床特征、与疾病相关的危险因素、感染对原住民和托雷斯海峡岛民（ATSI）社区的负担以及随时间推移的患者结局。
1997 年至 2020 年期间，有 128 名患者入住汤斯维尔大学医院。总的年感染发病率为每 100000 人 3.2 例，而在 ATSI 人群中为每 100000 人 15.3 例。大多数病例（n=82 [64%]）为男性。酒精过量（55%）和糖尿病（48%）是最常见的危险因素。87（70%）例患者发生菌血症，84（69%）例患者肺炎是最常见的感染部位。病死率为 23%，ATSI 人群无差异（6/32 [19%]）。存在恶性肿瘤是与死亡相关的危险因素（相对风险 2.7 [95%置信区间 1.4-5.1]，p=0.005）。
本研究中 ATSI 社区的代表性过高，但不良结局没有显著差异。病死率高于澳大利亚其他地区。这种差异可能部分与这些环境中不同的风险群体以及潜在的病原体变异性有关。
