The Epidemiological, Clinical, and Microbiological Features of Patients with Burkholderia pseudomallei Bacteraemia—Implications for Clinical Management
Prinsloo, Carmen, Smith, Simon, Law, Matthew, and Hanson, Josh (2023) The Epidemiological, Clinical, and Microbiological Features of Patients with Burkholderia pseudomallei Bacteraemia—Implications for Clinical Management. Tropical Medicine and Infectious Disease, 8 (11). 481.
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Abstract
Patients with melioidosis are commonly bacteraemic. However, the epidemiological characteristics, the microbiological findings, and the clinical associations of Burkholderia pseudomallei bacteraemia are incompletely defined. All cases of culture-confirmed melioidosis at Cairns Hospital in tropical Australia between January 1998 and June 2023 were reviewed. The presence of bacteraemia was determined and correlated with patient characteristics and outcomes; 332/477 (70%) individuals in the cohort were bacteraemic. In multivariable analysis, immunosuppression (odds ratio (OR) (95% confidence interval (CI)): (2.76 (1.21–6.27), p = 0.02), a wet season presentation (2.27 (1.44–3.59), p < 0.0001) and male sex (1.69 (1.08–2.63), p = 0.02), increased the likelihood of bacteraemia. Patients with a skin or soft tissue infection (0.32 (0.19–0.57), p < 0.0001) or without predisposing factors for melioidosis (0.53 (0.30–0.93), p = 0.03) were less likely to be bacteraemic. Bacteraemia was associated with intensive care unit admission (OR (95%CI): 4.27 (2.35–7.76), p < 0.0001), and death (2.12 (1.04–4.33), p = 0.04). The median (interquartile range) time to blood culture positivity was 31 (26–39) hours. Patients with positive blood cultures within 24 h were more likely to die than patients whose blood culture flagged positive after this time (OR (95%CI): 11.05 (3.96–30.83), p < 0.0001). Bacteraemia portends a worse outcome in patients with melioidosis. Its presence or absence might be used to help predict outcomes in cases of melioidosis and to inform optimal clinical management.
| Item ID: | 81433 |
|---|---|
| Item Type: | Article (Research - C1) |
| ISSN: | 2414-6366 |
| Keywords: | antibiotic therapy, Australia, bacteraemia, Burkholderia pseudomallei, clinical management, critical care, indigenous health, melioidosis, sepsis, tropical medicine |
| Copyright Information: | © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
| Date Deposited: | 07 Mar 2024 04:31 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3207 Medical microbiology > 320701 Medical bacteriology @ 100% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100% |
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