FW: Our DORIM paper

[Narisara Chantratita]

Dear all,

 

Our DORIM paper "Characteristics and one year outcomes of melioidosis patients in Northeastern Thailand: A prospective, multicenter cohort study" has been published in the Lancet Regional Health – Southeast ASIA.

As this is a new journal in Lancet family, it is not on Pubmed now. Here is the open access link to the paper: https://www.sciencedirect.com/science/article/pii/S2772368222001354.

 

I hope the information is useful for you and melioidosis community. Please share our findings to your colleagues. The pdf file is also attached.

 

Best wishes,

Narisara Chantratita

 

 

Characteristics and one year outcomes of melioidosis patients in Northeastern Thailand: A prospective, multicenter cohort study

 

Summary

 

Background Melioidosis is a neglected tropical infection caused by the environmental saprophyte Burkholderia

pseudomallei.

 

Methods We conducted a prospective, observational study at nine hospitals in northeastern Thailand, a hyperendemic

melioidosis zone, to define current characteristics of melioidosis patients and quantify outcomes over one year.

 

Findings 2574 individuals hospitalised with culture-confirmed melioidosis were screened and 1352 patients were

analysed. The median age was 55 years, 975 (72%) were male and 951 (70%) had diabetes. 561 (42%) patients

presented with lung infection, 1042 (77%) were bacteraemic, 442 (33%) received vasopressors/inotropes and 547

(40%) received mechanical ventilation. 1307 (97%) received an intravenous antibiotic against B. pseudomallei. 335/

1354 (25%) patients died within one month and 448/1331 (34%) of patients died within one year. Most patients

had risk factors for melioidosis, but patients without identified risk factors did not have a reduced risk of death.

Of patients discharged alive, most received oral trimethoprim-sulfamethoxazole, which was associated with

decreased risk of post-discharge death; 235/970 (24%) were readmitted, and 874/1015 (86%) survived to one year.

Recurrent infection was detected in 17/1018 patients (2%). Patients with risk factors other than diabetes had

increased risk of death and increased risk of hospital readmission.

 

Interpretation In northeastern Thailand patients with melioidosis experience high rates of bacteraemia, organ failure

and death. Most patients discharged alive survive one year although all-cause readmission is common. Recurrent

disease is rare. Strategies that emphasize prevention, rapid diagnosis and intensification of early clinical

management are likely to have greatest impact in this and other resource-restricted regions.