Raj Sruthi, Sistla Sujatha, Sadanandan Deepthy M, Kadhiravan Tamilarasu, Rameesh Basheer Mohamed Syed, Amalnath Deepak
Department of Microbiology, JIPMER, Puducherry, India.
Department of Biostatistics, JIPMER, Puducherry, India.
J Glob Infect Dis. 2023 May 31;15(2):72-78. doi: 10.4103/jgid.jgid_134_22. eCollection 2023 Apr-Jun.
Melioidosis is an under-recognized but important infection with high mortality and morbidity. It is endemic along the coastal regions of the Southern part of India. The present study focuses on the varied clinical manifestations, associated risk factors, and outcomes in patients from the Southeastern part of India.
Seventy patients from January 2018 to June 2021 from a Tertiary Care Hospital were included and prospectively followed up from 6 months to 3 years. Cox regression was performed to test for the association of various clinical and demographic factors with overall survival.
Diabetes and occupational exposure to soil and water (78.6%) followed by alcoholism (61.4%) were the most common risk factors for melioidosis. The most frequent presentation was sepsis (47.1%), followed by skin and soft tissue infection (32.9%) and pneumonia (25.7%). Mortality was 50%. Patients with sepsis had a 3.5-fold higher risk of mortality (adjusted hazard ratio = 3.50; = 0.01) while other risk factors were not significantly associated with mortality.
Lifestyle-dependent risk factors (diabetes, occupational exposure, and alcoholism) were most common among patients with melioidosis. Hospitalization among patients with sepsis is associated with high mortality despite the initiation of specific therapy.
类鼻疽是一种未得到充分认识但很重要的感染性疾病，死亡率和发病率都很高。它在印度南部沿海地区呈地方性流行。本研究聚焦于印度东南部患者的各种临床表现、相关危险因素及预后情况。
纳入了2018年1月至2021年6月期间来自一家三级护理医院的70例患者，并对其进行了为期6个月至3年的前瞻性随访。采用Cox回归分析来检验各种临床和人口统计学因素与总生存率之间的关联。
糖尿病以及职业性接触土壤和水（78.6%），其次是酗酒（61.4%），是类鼻疽最常见的危险因素。最常见的表现是败血症（47.1%），其次是皮肤和软组织感染（32.9%）以及肺炎（25.7%）。死亡率为50%。败血症患者的死亡风险高出3.5倍（调整后的风险比=3.50；P=0.01），而其他危险因素与死亡率无显著关联。
在类鼻疽患者中，与生活方式相关的危险因素（糖尿病、职业性接触和酗酒）最为常见。尽管开始了特异性治疗，但败血症患者住院期间的死亡率仍很高。
