BACKGROUND: Melioidosis has been well known to be endemic in Thailand and Northern Australia, and was reported sporadically in Taiwan before 2005. METHODS: We retrospectively analyzed 58 patients with melioidosis in southern Taiwan from 2000 to 2005, including 40 clustered and 18 sporadic cases, for clinical characteristics and antimicrobial susceptibility. RESULTS: Fifty-one (88%) cases were found during the rainy season, and there was a significant correlation between the average monthly rainfalls and the case number (r = 0.37; p = 0.001). Diabetes mellitus was the most common underlying disease (35 cases, 60%). The majority (52 cases, 90%) had never traveled abroad before illness, indicating indigenous acquisition of Burkholderia pseudomallei. In comparison, clustered cases were older, less often had underlying diabetes mellitus and had a shorter duration of clinical symptoms before admission than sporadic cases. Acute form of melioidosis predominated, and shock at admission was independently associated with a grave prognosis. Overall, 22% of 58 patients died in hospitals. Ceftazidime, imipenem, meropenem, amoxicillin/clavulanic acid, co-trimoxazole, and doxycycline, as previously recommended, were the potentially therapeutic choices. The role of piperacillin/ tazobactam for melioidosis remains undefined. CONCLUSIONS: Melioidosis can occur sporadically or in a cluster in diabetic patients during rainy seasons in Taiwan.
BACKGROUND:Melioidosis has been well known to be endemic in Thailand and Northern Australia, and was reported sporadically in Taiwan before 2005. METHODS: We retrospectively analyzed 58 patients with melioidosis in southern Taiwan from 2000 to 2005, including 40 clustered and 18 sporadic cases, for clinical characteristics and antimicrobial susceptibility. RESULTS: Fifty-one (88%) cases were found during the rainy season, and there was a significant correlation between the average monthly rainfalls and the case number (r = 0.37; p = 0.001). Diabetes mellitus was the most common underlying disease (35 cases, 60%). The majority (52 cases, 90%) had never traveled abroad before illness, indicating indigenous acquisition of Burkholderia pseudomallei. In comparison, clustered cases were older, less often had underlying diabetes mellitus and had a shorter duration of clinical symptoms before admission than sporadic cases. Acute form of melioidosis predominated, and shock at admission was independently associated with a grave prognosis. Overall, 22% of 58 patients died in hospitals. Ceftazidime, imipenem, meropenem, amoxicillin/clavulanic acid, co-trimoxazole, and doxycycline, as previously recommended, were the potentially therapeutic choices. The role of piperacillin/ tazobactam for melioidosis remains undefined. CONCLUSIONS:Melioidosis can occur sporadically or in a cluster in diabeticpatients during rainy seasons in Taiwan.
Authors: B J Currie; D A Fisher; D M Howard; J N Burrow; D Lo; S Selva-Nayagam; N M Anstey; S E Huffam; P L Snelling; P J Marks; D P Stephens; G D Lum; S P Jacups; V L Krause Journal: Clin Infect Dis Date: 2000-10-25 Impact factor: 9.079
Authors: A J Simpson; Y Suputtamongkol; M D Smith; B J Angus; A Rajanuwong; V Wuthiekanun; P A Howe; A L Walsh; W Chaowagul; N J White Journal: Clin Infect Dis Date: 1999-08 Impact factor: 9.079
Authors: S S Lee; Y C Liu; Y S Chen; S R Wann; J H Wang; M Y Yen; J H Wang; H H Lin; W K Huang; D L Cheng Journal: J Formos Med Assoc Date: 1996-07 Impact factor: 3.282