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Melioidosis: epidemiology and antibiogram of cases in Singapore
Abstract:
There has been an increased incidence of melioidosis in Singapore. The disease affects mainly males, older patients and a disproportionately higher number of Indians and Malays. Possible predisposing illness include diabetes mellitus. Most patients are bacteraemic. Mortality rate is 72% for bacteraemic patients, as compared to 32% for non-bacteraemic patients. Local strains of Pseudomonas pseudomallei have been consistently sensitive to ceftazidime, chloramphenicol and piperacillin, and nearly always sensitive to tetracycline.
Insights
Melioidosis incidence is rising in Singapore, primarily affecting older males, Indians, and Malays, often linked to diabetes. Bacteraemic patients face a significantly higher mortality risk.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Melioidosis, caused by Pseudomonas pseudomallei, presents a growing public health concern in Singapore.
- The disease disproportionately impacts specific demographic groups and is associated with underlying health conditions.
Purpose of the Study:
- To analyze the epidemiological trends and clinical characteristics of melioidosis cases in Singapore.
- To identify risk factors and patient demographics associated with increased melioidosis incidence and mortality.
- To evaluate the antibiotic susceptibility patterns of local Pseudomonas pseudomallei strains.
Main Methods:
- Retrospective analysis of melioidosis patient data in Singapore.
- Demographic and clinical data collection, including predisposing illnesses and disease outcomes.
- Antimicrobial susceptibility testing of isolated Pseudomonas pseudomallei strains.
Main Results:
- Increased incidence of melioidosis observed in Singapore.
- Predominant affectation in males, older individuals, Indians, and Malays, with diabetes mellitus as a common comorbidity.
- Higher mortality rates in bacteraemic patients (72%) compared to non-bacteraemic patients (32%).
- Local Pseudomonas pseudomallei strains show consistent sensitivity to ceftazidime, chloramphenicol, and piperacillin, and high sensitivity to tetracycline.
Conclusions:
- Melioidosis in Singapore exhibits distinct demographic and clinical patterns.
- Prompt diagnosis and treatment are crucial, especially for bacteraemic cases, given the high mortality.
- Antibiotic susceptibility data guides effective therapeutic strategies against local strains.