Sporadic and outbreak cases of melioidosis in Southern Taiwan: Clinical features and antimicrobial susceptibility

Hsin-I Shih, Y. C. Chuang, B. M.H. Cheung, J. J. Yan, Chia-Ming Chang, K. Chang, Nan-Yao Lee, H. C. Lee, C. J. Wu, Po-Lin Chen, C. C. Lee, L. R. Wang, Nai-Ying Ko, Wen-Chien Ko

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15 Citations (Scopus)

Abstract

Background: : Melioidosis has been well known to be endemic in Thailand and Northern Australia, and was reported sporadically in Taiwan before 2005. Methods: : We retrospectively analyzed 58 patients with melioidosis in southern Taiwan from 2000 to 2005, including 40 clustered and 18 sporadic cases, for clinical characteristics and antimicrobial susceptibility. Results: : Fifty-one (88%) cases were found during the rainy season, and there was a significant correlation between the average monthly rainfalls and the case number (r = 0.37; p = 0.001). Diabetes mellitus was the most common underlying disease (35 cases, 60%). The majority (52 cases, 90%) had never traveled abroad before illness, indicating indigenous acquisition of Burkholderia pseudomallei. In comparison, clustered cases were older, less often had underlying diabetes mellitus and had a shorter duration of clinical symptoms before admission than sporadic cases. Acute form of melioidosis predominated, and shock at admission was independently associated with a grave prognosis. Overall, 22% of 58 patients died in hospitals. Ceftazidime, imipenem, meropenem, amoxicillin/clavulanic acid, co-trimoxazole, and doxycycline, as previously recommended, were the potentially therapeutic choices. The role of piperacillin/ tazobactam for melioidosis remains undefined. Conclusions: : Melioidosis can occur sporadically or in a cluster in diabetic patients during rainy seasons in Taiwan.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalInfection
Volume37
Issue number1
DOIs
Publication statusPublished - 2009 Feb 1

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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