Melioidosis in Pahang, Malaysia

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Epidemiology

Background:

• Melioidosis is a significant infectious disease in Southeast Asia, particularly in Malaysia.
• Risk factors and clinical presentations of melioidosis can vary geographically.
• Understanding local epidemiology is crucial for effective disease management.

Purpose of the Study:

• To describe the clinical characteristics, treatment, and outcomes of melioidosis patients in Pahang, Malaysia.
• To identify risk factors associated with mortality and relapse in melioidosis.
• To evaluate the appropriateness of empirical antibiotic therapy.

Main Methods:

• Retrospective review of 135 melioidosis cases in Pahang from January 2000 to June 2003.
• Analysis of patient demographics, clinical presentations, treatment regimens, and outcomes (mortality, relapse).
• Statistical analysis to determine factors influencing mortality.

Main Results:

• The study population comprised mostly Malay males (83% Malay, 78.5% male), with a median age of 51 years.
• Diabetes mellitus was highly prevalent (74%). Common presentations included pneumonia (40.7%), sepsis (19.3%), and multiple organ involvement (15.6%).
• High overall mortality (54%), with 65% of deaths occurring within 48 hours of admission. Pneumonia, sepsis, and multiple organ involvement were associated with higher mortality. Relapse rate was 19.2%.

Conclusions:

• Melioidosis in Pahang presents with high mortality, particularly in patients with pneumonia, sepsis, or multiple organ involvement.
• Inadequate empirical antibiotic treatment was observed in a majority of cases (67.3%).
• Urgent and appropriate antibiotic therapy is critical for improving survival rates in melioidosis patients.