Contributing factors to Melioidosis fatality in Buriram province

Abstract

 Melioidosis has been a national burden in Thailand. The contributing factors from previous literature were still inconclusive. The present study aimed to determine the case fatality of meloidosis and the contributing factors in Buriram province. The retrospective cohort study was implemented among melioidosis patients diagnosed with positive Burkholderia pseudomallei culture. The medical records were reviewed for data collection. The analyses of the contributed factors to meliodosis fatality were implemented in all cases and specifically among diabetes mellitus patients. The univariable results was shown as risk ratio, 95% confidence intervals and p-value. The significance factors were further analyzed by multiple logistic regression. The significance level was indicated as 0.05. The case fatality rate of melioidosis in this study was 36.4% (40/110). The results from multiple logistic regression revealed that chronic kidney disease (adjusted OR = 22.35, 95%CI: 1.98 - 251.22), more than one site of infection (adjusted OR = 19.79, 95%CI: 2.13 - 183.34), acute respiratory failure (adjusted OR = 4.905, 95%CI: 1.24 - 19.26), and septic shock (adjusted OR = 3.44, 95%CI: 1.07 - 11.05) associated with melioidosis fatality. Uncontrolled diabetes mellitus (adjusted OR = 7.40, 95%CI: 1.51 - 36.22) was associated with fatality among diabetes patients. The case fatality rate of melioiodosis in this study was high when compared to previous studies. The clinical characteristic and disease complication factors of the patients were mainly the contributing factor to melioidosis fatality. Health prevention programs and clinical practice guidelines should be developed and meliorated to mitigate the fatality rate among melioidosis patients.