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.
Characteristics and one year outcomes of melioidosis patients in Northeastern Thailand: A prospective, multicenter cohort study
Background Melioidosis is a neglected tropical infection caused by the environmental saprophyte Burkholderia
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.