Infection

, 37:9

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

Authors

  • H.-I. Shih
    • Dept. of Internal MedicineNational Cheng Kung University Hospital, Dou-Liou Branch
  • Y.-C. Chuang
    • Dept. of Medical ResearchChi Mei Medical Center
  • B. M.-H. Cheung
    • Dept. of Internal MedicineTainan Municipal Hospital
  • J.-J. Yan
    • Dept. of PathologyNational Cheng Kung University Hospital
    • Dept. of MedicineNational Cheng Kung University, Medical College
  • C.-M. Chang
    • Dept. of Internal MedicineNational Cheng Kung University Hospital
    • Center for Infection ControlNational Cheng Kung University Hospital
  • K. Chang
    • Dept. of Internal MedicineTainan Municipal Hospital
    • Dept. of Internal MedicineKaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University
  • N.-Y. Lee
    • Dept. of Internal MedicineNational Cheng Kung University Hospital
    • Center for Infection ControlNational Cheng Kung University Hospital
  • H.-C. Lee
    • Dept. of MedicineNational Cheng Kung University, Medical College
    • Center for Infection ControlNational Cheng Kung University Hospital
  • C.-J. Wu
    • Dept. of Internal MedicineNational Cheng Kung University Hospital
    • Center for Infection ControlNational Cheng Kung University Hospital
  • P.-L. Chen
    • Dept. of Internal MedicineNational Cheng Kung University Hospital
    • Center for Infection ControlNational Cheng Kung University Hospital
  • C.-C. Lee
    • Dept. of Emergency MedicineNational Cheng Kung University Hospital
  • L.-R. Wang
    • Dept. of PathologyNational Cheng Kung University Hospital
    • Center for Infection ControlNational Cheng Kung University Hospital
  • N.-Y. Ko
    • Center for Infection ControlNational Cheng Kung University Hospital
    • Dept. of NursingNational Cheng Kung University, Medical College
    • Dept. of Internal MedicineNational Cheng Kung University Hospital, No. 138
    • Dept. of MedicineNational Cheng Kung University, Medical College
    • Center for Infection ControlNational Cheng Kung University Hospital
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