Characteristics,clinical outcomes and factors influencing mortality of patients with melioidosis in southern Thailand:a 10-year retrospective study

Objective:To study characteristics,clinical outcomes and factors influencing mortality of patients afflicted with melioidosis.Methods:A total of 134 patients were retrospectively analyzed with a microbiologically-confirmed diagnosis of melioidosis,during the period from January 2002 to June 2011 at Songklanagarind Hospital,a tertiary care hospital in southern Thailand.Results:The prevalence of melioidosis among admitted patients was 36.8 per100000 in patients.The median age was 49 years and they were predominantly male.The most common underlying disease was diabetes mellitus(47.01%).The majority of cases(50%)had localized infection.The rates of multifocal,bacteremic,and disseminated infections were12.7%.23.1%.and 14.2%.respectively.The lungs were the most common organ afflicted,resulting in infection(24.63%).Splenic abscess as well as liver abscess accounted for 20.90%and 19.40%.respectively.A total of one eighth of the patients had septic shock at presentation.The overall mortality rate was 8.96%.The factors influencing mortality were pneumonia,septic shock,a positive blood culture for Burkholderia pseudomallei.superimposing with nosocomial infection and inappropriate antibiotic administration.Conclusions:Melioidosis is not uncommon in southern Thailand.The mortality of patients with pneumonia,bacteremia and septic shock is relatively high.Appropriate antibiotics,initially,will improve outcomes.