Kaewrakmuk Jedsada, Chusri Sarunyou, Hortiwakul Thanaporn, Kawila Soontara, Patungkaro Wichien, Jariyapradub Benjamas, Limvorapan Pattamas, Chiewchanyont Bongkoch, Thananchai Hathairat, Duangsonk Kwanjit, Tuanyok Apichai
Faculty of Medical Technology, Prince of Songkla University, Hatyai, Songkhla 90110, Thailand.
Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Trop Med Infect Dis. 2023 May 20;8(5):286. doi: 10.3390/tropicalmed8050286.
Melioidosis, caused by , is a notifiable disease associated with a high mortality rate in Thailand. The disease is highly endemic in northeast Thailand, while its prevalence in other parts of the country is poorly documented. This study aimed at improving the surveillance system for melioidosis in southern Thailand, where the disease was believed to be underreported. Two adjacent southern provinces, Songkhla and Phatthalung, were selected as the model provinces to study melioidosis. There were 473 individuals diagnosed with culture-confirmed melioidosis by clinical microbiology laboratories at four tertiary care hospitals in both provinces from January 2014 to December 2020. The median age was 54 years (IQR 41.5-64), 284 (60%) of the patients were adults ≥50 years of age, and 337 (71.2%) were male. We retrospectively analyzed 455 patients treated at either Songklanarind Hospital, Hatyai Hospital, Songkhla Provincial Hospital, or Phatthalung Provincial Hospital, of whom 181 (39.8%) patients died. The median duration from admission to death was five days (IQR 2-17). Of the 455 patients, 272 (57.5%) had at least one clinical risk factor, and 188 (39.8%) had diabetes. Two major clinical manifestations, bacteremia and pneumonia, occurred in 274 (58.1%) and 166 (35.2%) patients, respectively. In most cases, 298 (75%) out of 395 local patients were associated with rainfall. Over the seven years of the study, the average annual incidence was 2.87 cases per 100,000 population (95% CI, 2.10 to 3.64). This study has confirmed that these two provinces of southern Thailand are endemic to melioidosis; even though the incidence rate is much lower than that of the Northeast, the mortality rate is comparably high.
类鼻疽病由[病原体未提及]引起，是泰国一种需上报的疾病，死亡率很高。该病在泰国东北部高度流行，而在该国其他地区的流行情况记录较少。本研究旨在改善泰国南部类鼻疽病的监测系统，该地区的该病据信报告不足。两个相邻的南部省份宋卡和博他仑被选为研究类鼻疽病的示范省份。2014年1月至2020年12月期间，这两个省份的四家三级护理医院的临床微生物实验室共诊断出473例经培养确诊的类鼻疽病患者。中位年龄为54岁（四分位距41.5 - 64岁），284例（60%）患者为50岁及以上成年人，337例（71.2%）为男性。我们回顾性分析了在宋卡那琳医院、合艾医院、宋卡省医院或博他仑省医院接受治疗的455例患者，其中181例（39.8%）患者死亡。从入院到死亡的中位持续时间为5天（四分位距2 - 17天）。在455例患者中，272例（57.5%）至少有一个临床危险因素，188例（39.8%）患有糖尿病。两种主要临床表现，菌血症和肺炎，分别发生在274例（58.1%）和166例（35.2%）患者中。在大多数情况下，395例本地患者中有298例（75%）与降雨有关。在研究的七年中，年平均发病率为每10万人2.87例（95%置信区间，2.10至3.64）。本研究证实泰国南部的这两个省份是类鼻疽病的流行地区；尽管发病率远低于东北部，但死亡率相当高。
