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Med J Malaysia ; 74(6): 472-476, 2019 12.
Article in English | MEDLINE | ID: mdl-31929471

ABSTRACT

INTRODUCTION: Melioidosis is caused by Burkholderia pseudomallei, a gram-negative aerobic bacillus, found in the soil and surface water. Treating melioidosis has been a challenge in district hospitals due to high usage of broad spectrum antibiotics and prolonged hospitalisation. This study is to review the patients' demography, clinical presentations and microbiological data. METHODS: A 5-year retrospective study was carried out on patients admitted with culture positive for melioidosis from year 2013 to 2017 in Hospital Teluk Intan, Perak. RESULTS: There were a total of 46 confirmed cases of melioidosis. Majority of the patients were working in the agricultural and farming (28.6%), and factories (25.7%). Thirty-one patients had diabetes mellitus (71.1%). Presentations of patients with melioidosis included pneumonia (54.3%), skin and soft tissue infection (19.6%), deep abscesses (15.2%) and bone and joint infections (13%). An average of 5.8 days was needed to confirm the diagnosis of melioidosis via positive culture. However, only 39.4% of these patients were started on ceftazidime or carbapenem as the empirical therapy. The intensive care unit (ICU) admission rate for melioidosis was 46% and the mortality rate was 52%. Our microbial cultures showed good sensitivity towards cotrimoxazole (97.1%), ceftazidime (100%) and carbapenem (100%). CONCLUSION: Melioidosis carries high mortality rate, especially with lung involvement and bacteremia. Physicians should have high clinical suspicion for melioidosis cases to give appropriate antimelioidosis therapy early.


Subject(s)
Bacteremia/drug therapy , Ceftazidime/therapeutic use , Hospitals, District/statistics & numerical data , Melioidosis/drug therapy , Adult , Anti-Bacterial Agents/therapeutic use , Bacteremia/epidemiology , Bacteremia/microbiology , Burkholderia pseudomallei/isolation & purification , Female , Follow-Up Studies , Hospitalization/trends , Humans , Incidence , Malaysia/epidemiology , Male , Melioidosis/epidemiology , Melioidosis/microbiology , Middle Aged , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome , Young Adult
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