The Predictive Factors Associated with In-Hospital Mortality of Melioidosis: A Cohort Study

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Epidemiology

Background:

• Melioidosis, caused by Burkholderia pseudomallei, is prevalent in tropical regions like Southeast Asia.
• Despite effective treatments, melioidosis carries a high mortality rate, particularly in cases of septic shock.
• Understanding prognostic factors is crucial for improving patient outcomes.

Purpose of the Study:

• To identify clinical characteristics, microbiological findings, and treatment outcomes in melioidosis patients.
• To determine factors associated with in-hospital mortality for better prognosis prediction.
• To guide future treatment strategies for melioidosis.

Main Methods:

• Retrospective cohort study of 262 hospitalized melioidosis patients (age > 15) at Surin Hospital, Thailand (April 2014 - March 2017).
• Inclusion criteria: positive B. pseudomallei culture.
• Logistic regression analysis to identify risk factors for in-hospital mortality.

Main Results:

• Out of 262 patients, 117 (44.7%) died. Mean age was 57.2 years; 73.7% were male.
• Common comorbidities: diabetes (46.9%), chronic kidney disease (13.4%), chronic liver disease (11.8%).
• Significant predictors of mortality: increased age (aOR 1.04), elevated respiration rate (aOR 1.18), abnormal chest X-ray (aOR 4.79), and decreased CO2 levels (aOR 0.92).

Conclusions:

• Age, respiration rate, abnormal chest X-ray findings, and CO2 levels are significant predictors of in-hospital mortality in melioidosis.
• Healthcare providers should closely monitor patients with these risk factors.
• Awareness of these factors can inform aggressive treatment and patient management strategies.