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Pulmonary melioidosis in Cambodia: A prospective study

Authors :
Te Vantha
Angebault Cécile
Overtoom Rob
Goyet Sophie
Buchy Philippe
Hem Sopheak
Borand Laurence
Beauté Julien
Rammaert Blandine
Try Patrich
Mayaud Charles
Vong Sirenda
Guillard Bertrand
Source :
BMC Infectious Diseases, Vol 11, Iss 1, p 126 (2011)
Publication Year :
2011
Publisher :
BMC, 2011.

Abstract

Abstract Background Melioidosis is a disease caused by Burkholderia pseudomallei and considered endemic in South-East Asia but remains poorly documented in Cambodia. We report the first series of hospitalized pulmonary melioidosis cases identified in Cambodia describing clinical characteristics and outcomes. Methods We characterized cases of acute lower respiratory infections (ALRI) that were identified through surveillance in two provincial hospitals. Severity was defined by systolic blood pressure, cardiac frequency, respiratory rate, oxygen saturation and body temperature. B. pseudomallei was detected in sputum or blood cultures and confirmed by API20NE gallery. We followed up these cases between 6 months and 2 years after hospital discharge to assess the cost-of-illness and long-term outcome. Results During April 2007 - January 2010, 39 ALRI cases had melioidosis, of which three aged ≤2 years; the median age was 46 years and 56.4% were males. A close contact with soil and water was identified in 30 patients (76.9%). Pneumonia was the main radiological feature (82.3%). Eleven patients were severe cases. Twenty-four (61.5%) patients died including 13 who died within 61 days after discharge. Of the deceased, 23 did not receive any antibiotics effective against B. pseudomallei. Effective drugs that were available did not include ceftazidime. Mean total illness-related costs was of US$65 (range $25-$5000). Almost two-thirds (61.5%) incurred debt and 28.2% sold land or other belongings to pay illness-related costs. Conclusions The observed high fatality rate is likely explained by the lack or limited access to efficient antibiotics and under-recognition of the disease among clinicians, which led to inappropriate therapy.

Details

Language :
English
ISSN :
14712334
Volume :
11
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Infectious Diseases
Publication Type :
Academic Journal
Accession number :
edsdoj.f924a6e54d444f129aa09fe5506cf31f
Document Type :
article
Full Text :
https://doi.org/10.1186/1471-2334-11-126