Infection

, 37:9

Sporadic and Outbreak Cases of Melioidosis in Southern Taiwan: Clinical Features and Antimicrobial Susceptibility

  • H.-I. Shih
  • Y.-C. Chuang
  • B. M.-H. Cheung
  • J.-J. Yan
  • C.-M. Chang
  • K. Chang
  • N.-Y. Lee
  • H.-C. Lee
  • C.-J. Wu
  • P.-L. Chen
  • C.-C. Lee
  • L.-R. Wang
  • N.-Y. Ko
  • W.-C. Ko
Clinical and Epidemiological Study

DOI: 10.1007/s15010-008-7324-8

Cite this article as:
Shih, H., Chuang, Y., Cheung, B.M. et al. Infection (2009) 37: 9. doi:10.1007/s15010-008-7324-8

Abstract

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.

Copyright information

© Springer 2008

Authors and Affiliations

  • H.-I. Shih
    • 2
  • Y.-C. Chuang
    • 3
  • B. M.-H. Cheung
    • 4
  • J.-J. Yan
    • 5
    • 6
  • C.-M. Chang
    • 7
    • 8
  • K. Chang
    • 4
    • 11
  • N.-Y. Lee
    • 7
    • 8
  • H.-C. Lee
    • 6
    • 8
  • C.-J. Wu
    • 7
    • 8
  • P.-L. Chen
    • 7
    • 8
  • C.-C. Lee
    • 9
  • L.-R. Wang
    • 5
    • 8
  • N.-Y. Ko
    • 8
    • 10
  • W.-C. Ko
    • 1
    • 6
    • 8
  1. 1.Dept. of Internal MedicineNational Cheng Kung University Hospital, No. 138TainanTaiwan
  2. 2.Dept. of Internal MedicineNational Cheng Kung University Hospital, Dou-Liou BranchYunlinTaiwan
  3. 3.Dept. of Medical ResearchChi Mei Medical CenterTainanTaiwan
  4. 4.Dept. of Internal MedicineTainan Municipal HospitalTainanTaiwan
  5. 5.Dept. of PathologyNational Cheng Kung University HospitalTainanTaiwan
  6. 6.Dept. of MedicineNational Cheng Kung University, Medical CollegeTainanTaiwan
  7. 7.Dept. of Internal MedicineNational Cheng Kung University HospitalTainanTaiwan
  8. 8.Center for Infection ControlNational Cheng Kung University HospitalTainanTaiwan
  9. 9.Dept. of Emergency MedicineNational Cheng Kung University HospitalTainanTaiwan
  10. 10.Dept. of NursingNational Cheng Kung University, Medical CollegeTainanTaiwan
  11. 11.Dept. of Internal MedicineKaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical UniversityKaohsiungTaiwan