Sporadic and Outbreak Cases of Melioidosis in Southern Taiwan: Clinical Features and Antimicrobial Susceptibility
- 14 October 2008
- journal article
- research article
- Published by Springer Science and Business Media LLC in Infection
- Vol. 37 (1), 9-15
- https://doi.org/10.1007/s15010-008-7324-8
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.Keywords
This publication has 25 references indexed in Scilit:
- Melioidosis Outbreak after Typhoon, Southern TaiwanEmerging Infectious Diseases, 2007
- Extreme weather events and environmental contamination are associated with case-clusters of melioidosis in the Northern Territory of AustraliaInternational Journal of Epidemiology, 2005
- Melioidosis: Epidemiology, Pathophysiology, and ManagementClinical Microbiology Reviews, 2005
- Antibiotic susceptibility of 65 isolates of Burkholderia pseudomallei and Burkholderia mallei to 35 antimicrobial agentsJournal of Antimicrobial Chemotherapy, 2004
- Melioidosis: An Emerging Infection in Taiwan?Emerging Infectious Diseases, 2001
- Melioidosis: An Emerging Infection in Taiwan?Emerging Infectious Diseases, 2001
- Endemic Melioidosis in Tropical Northern Australia: A 10‐Year Prospective Study and Review of the LiteratureClinical Infectious Diseases, 2000
- Comparison of Imipenem and Ceftazidime as Therapy for Severe MelioidosisClinical Infectious Diseases, 1999
- A Comparison of Chloramphenicol, Trimethoprim‐Sulfamethoxazole, and Doxycycline with Doxycycline Alone as Maintenance Therapy for MelioidosisClinical Infectious Diseases, 1999
- Susceptibility of Pseudomonas pseudomallei to some newer β-lactam antibiotics and antibiotic combinations using time-kill studiesJournal of Antimicrobial Chemotherapy, 1994