Clinical Profile and Predictors of Mortality among Patients with Melioidosis

Sruthi Raj; Sujatha Sistla; Deepthy M Sadanandan; Tamilarasu Kadhiravan; Basheer Mohamed Syed Rameesh; Deepak Amalnath

doi:10.4103/jgid.jgid_134_22

Clinical Profile and Predictors of Mortality among Patients with Melioidosis

J Glob Infect Dis. 2023 May 31;15(2):72-78. doi: 10.4103/jgid.jgid_134_22. eCollection 2023 Apr-Jun.

Authors

Sruthi Raj¹, Sujatha Sistla¹, Deepthy M Sadanandan², Tamilarasu Kadhiravan³, Basheer Mohamed Syed Rameesh³, Deepak Amalnath³

Affiliations

¹ Department of Microbiology, JIPMER, Puducherry, India.
² Department of Biostatistics, JIPMER, Puducherry, India.
³ Department of Medicine, JIPMER, Puducherry, India.

Abstract

Introduction: Melioidosis is an under-recognized but important infection with high mortality and morbidity. It is endemic along the coastal regions of the Southern part of India. The present study focuses on the varied clinical manifestations, associated risk factors, and outcomes in patients from the Southeastern part of India.

Methods: Seventy patients from January 2018 to June 2021 from a Tertiary Care Hospital were included and prospectively followed up from 6 months to 3 years. Cox regression was performed to test for the association of various clinical and demographic factors with overall survival.

Results: Diabetes and occupational exposure to soil and water (78.6%) followed by alcoholism (61.4%) were the most common risk factors for melioidosis. The most frequent presentation was sepsis (47.1%), followed by skin and soft tissue infection (32.9%) and pneumonia (25.7%). Mortality was 50%. Patients with sepsis had a 3.5-fold higher risk of mortality (adjusted hazard ratio = 3.50; P = 0.01) while other risk factors were not significantly associated with mortality.

Conclusion: Lifestyle-dependent risk factors (diabetes, occupational exposure, and alcoholism) were most common among patients with melioidosis. Hospitalization among patients with sepsis is associated with high mortality despite the initiation of specific therapy.

Keywords: Burkholderia pseudomallei; melioidosis; mortality; risk factors; treatment.