Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia.
Department of Pathology, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.
PLoS Negl Trop Dis. 2023 Oct 16;17(10):e0011696. doi: 10.1371/journal.pntd.0011696. eCollection 2023 Oct.
Melioidosis is a deadly endemic disease in northern Australia and Southeast Asia, including Sabah, Malaysia, which is caused by the bacterium Burkholderia pseudomallei. It contributes to high fatality rates, mainly due to misdiagnosis leading to the wrong treatment being administered to the patients. Local epidemiology and data on clinical features could assist clinicians during diagnosis and treatment. However, these details are still scarce, particularly in Sabah.
A retrospective study of 246 culture-confirmed melioidosis cases in Queen Elizabeth Hospital, Sabah, Malaysia was performed between 2016 and 2018. The epidemiological data and clinical and laboratory findings were extracted and analysed.
The annual incidence of culture-confirmed melioidosis cases was estimated to be 4.97 per 100,000 people. The mean age of the patients was 50±15 years. Males and members of the Kadazan-Dusun ethnic group accounted for the majority of the melioidosis cases. The odds ratio analysis indicated that bacteraemic melioidosis in this region was significantly associated with fever (76%), and patients having at least one underlying illness (43%), including diabetes mellitus (32%). Sixty-eight patients (28%) succumbed to melioidosis. Contrary to what is known regarding factors that promote bacteraemic melioidosis, neither patients with fever nor patients with at least one comorbid disease, including diabetes mellitus, were significantly associated with death from melioidosis. There was no statistically significant difference between patients without comorbidities (24, 27%) and those with at least one comorbid disease (26, 25%), including diabetes mellitus (18, 23%). The odds ratios indicate that melioidosis mortality in this region is related to patients showing respiratory organ-associated symptoms (29%), bacteraemia (30%), and septic shock (47%). Burkholderia pseudomallei isolates in this study were highly susceptible to ceftazidime (100%), imipenem (100%), and trimethoprim-sulfamethoxazole (98%).
Information obtained from this study can be used by clinicians to recognise individuals with the highest risk of acquiring melioidosis, estimate an accurate prognosis, and provide effective treatment for melioidosis patients to reduce death from melioidosis.
类鼻疽病是一种致命的地方性疾病，发生在澳大利亚北部和东南亚地区，包括马来西亚沙巴州，由伯克霍尔德菌引起。它导致高死亡率，主要是由于误诊导致患者接受错误的治疗。当地流行病学和临床特征数据可以帮助临床医生进行诊断和治疗。然而，这些细节仍然很少，特别是在沙巴州。
对 2016 年至 2018 年间在马来西亚沙巴州伊丽莎白女王医院确诊的 246 例类鼻疽病进行回顾性研究。提取和分析流行病学数据以及临床和实验室发现。
每年确诊的类鼻疽病病例估计为每 10 万人 4.97 例。患者的平均年龄为 50±15 岁。男性和卡达山-杜顺族占大多数类鼻疽病病例。优势比分析表明，该地区的血源性类鼻疽病与发热（76%）显著相关，且至少有一种基础疾病（43%）的患者，包括糖尿病（32%）。68 例（28%）患者死于类鼻疽病。与已知促进血源性类鼻疽病的因素相反，发热患者和至少有一种合并症的患者，包括糖尿病，与类鼻疽病死亡无显著相关性。无合并症的患者（24%，27%）与至少有一种合并症的患者（26%，25%），包括糖尿病（18%，23%）之间无统计学差异。优势比表明，该地区类鼻疽病的死亡率与表现出呼吸道器官相关症状（29%）、菌血症（30%）和感染性休克（47%）的患者有关。本研究中的伯克霍尔德菌分离株对头孢他啶（100%）、亚胺培南（100%）和复方磺胺甲噁唑（98%）高度敏感。
从这项研究中获得的信息可以帮助临床医生识别感染类鼻疽病风险最高的个体，估计准确的预后，并为类鼻疽病患者提供有效的治疗，以降低类鼻疽病的死亡率。
