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Published on: February 24, 2023
Clinical Profile and Predictors of Mortality among Patients with Melioidosis
Sruthi Raj1, Sujatha Sistla1, Deepthy M Sadanandan2
1Department of Microbiology, JIPMER, Puducherry, India.
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.
Insights
Melioidosis, a serious infection in Southern India, is often linked to diabetes and occupational exposure. Sepsis presentation significantly increases mortality risk, highlighting the need for early intervention.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Epidemiology
Background:
- Melioidosis is a significant cause of mortality and morbidity, particularly in coastal Southern India.
- This study investigates melioidosis in Southeastern India, focusing on clinical features, risk factors, and outcomes.
Purpose of the Study:
- To analyze the diverse clinical presentations of melioidosis.
- To identify associated risk factors and patient outcomes.
- To understand the impact of sepsis on melioidosis mortality.
Main Methods:
- Prospective study of 70 patients from January 2018 to June 2021.
- Follow-up duration ranged from 6 months to 3 years.
- Cox regression analysis was used to assess factors associated with survival.
Main Results:
- Diabetes and occupational exposure (78.6%) and alcoholism (61.4%) were primary risk factors.
- Sepsis (47.1%) was the most common presentation, followed by skin infections (32.9%) and pneumonia (25.7%).
- Overall mortality was 50%; sepsis increased mortality risk 3.5-fold (AHR=3.50, P=0.01).
Conclusions:
- Lifestyle-related factors like diabetes, occupational exposure, and alcoholism are key risk factors for melioidosis.
- Sepsis in melioidosis patients is linked to high mortality, even with treatment.
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