Volume 25, Number 2—February 2019
Dispatch
Clinical Manifestations, Antimicrobial Drug Susceptibility Patterns, and Outcomes in Melioidosis Cases, India
Maria Koshy, Manjeera Jagannati, Ravikar Ralph, Punitha Victor, Thambu David, Sowmya Sathyendra, Balaji Veeraraghavan, and George M. Varghese
Table 1
Patient characteristics and outcomes of patients with melioidosis, southern India, 2008–2014*
| Characteristic | All patients, N = 114 | Acute melioidosis, n = 41 | Chronic melioidosis, n = 73 |
|---|---|---|---|
| Age, y, mean + SD | 45.6 + 12.1 | 46 + 12.6 | 45.3 + 11.9 |
| Sex, no., M/F |
105/9 |
38/3 |
67/6 |
| Comorbid conditions, no. (%) | |||
| Diabetes mellitus | 93 (81.6) | 36 (87.8) | 57 (78.1) |
| Harmful ethanol use | 16 (14) | 10 (24.4) | 6 (8.5) |
| Chronic kidney disease | 4 (3.5) | 2 (4.9) | 2 (2.8) |
| Sickle cell disease | 3 (2.6) | 0 | 3 (4.2) |
| No risk factors |
15 (13.2) |
3 (7.3) |
12 (16.4) |
| Duration of symptoms, d, median (IQR) |
60 (30–90) |
20 (7–30) |
90 (60–210) |
| Clinical symptoms, no. (%) | |||
| Fever | 105 (97.2) | 41 (100) | 64 (95.5) |
| Cough | 17 (15.5) | 9 (21.9) | 8 (11.7) |
| Abdominal pain | 38 (34.8) | 10 (24.3) | 28 (41.1) |
| Joint pain | 27 (24.7) | 10 (24.3) | 17 (25) |
| Breathlessness |
16 (14.6) |
11 (26.8) |
5 (7.3) |
| Clinical signs, no. (%) | |||
| Tachypnea, reference >24/min | 24 (21.2) | 14 (34.1) | 10 (13.9) |
| Tachycardia, reference >100/min | 33 (29.2) | 20 (48.8) | 13 (18.1) |
| Hypotension, reference <90/60 mm Hg |
11 (9.7) |
6 (14.6) |
5 (6.9) |
| Laboratory parameters | |||
| Hemoglobin, g/dL, mean + SD | 10.2 + 2.3 | 11.3 + 2.5 | 9.6 + 2 |
| Lymphocyte count, × 109 cells/L, median (IQR) | 10.5 (7.7–15.4) | 14.6 (11.1–19.4) | 9 (6.8–12.2) |
| Platelet count, x 109/L, median (IQR) | 165 (107–272) | 177 (115–264) | 158 (102–280) |
| Total bilirubin, mg/dl, median (IQR) | 0.7 (0.5–1.4) | 1.2 (0.7–1.8) | 0.6 (0.4–0.9) |
| Total protein, g/dL, mean + SD | 7.2 + 1 | 6.7 + 0.8 | 7.5 + 1 |
| Albumin, g/dL, mean + SD | 2.9 + 0.8 | 2.6 + 0.7 | 3.1 + 0.7 |
| AST, IU/mL, median (IQR) | 42 (25–85) | 48 (26–128) | 36 (24–83) |
| ALT, IU/mL, median (IQR) | 29 (15–60) | 28 (13–99) | 30 (15–56) |
| ALP, IU/mL, median (IQR) | 148 (85–249) | 157 (102–239) | 137 (83–276) |
| Serum creatinine, mg/dL, median (IQR) | 1 (0.8–1.3) | 1.1 (0.8–1.3) | 1 (0.8–1.2) |
| Hemoglobin A1C, %, mean + SD | 9.7 + 2.6 | 11.1 + 2.9 | 8.9 + 2 |
| CRP, mg/L, mean + SD |
96.6 + 64.3 |
152.7 + 57.2 |
77.4 + 55.2 |
| Organ involvement | |||
| Lung | 28 (24.5) | 16 (39) | 12 (16.4) |
| Bacteremia | 63 (55.2) | 33 (80.4) | 30 (41) |
| Spleen | 49 (42.9) | 12 (29.2) | 37 (50.6) |
| Liver | 25 (21.9) | 9 (21.9) | 16 (21.9) |
| Genitourinary | 16 (14) | 2 (4.8) | 14 (19.1) |
| Septic arthritis | 22 (19.2) | 9 (21.9) | 13 (17.8) |
| Osteomyelitis | 12 (10.5) | 3 (7.3) | 9 (12.3) |
| Skin and subcutaneous tissue | 15 (13.1) | 7 (17) | 8 (10.9) |
| Parotid | 2 (1.7) | 2 (4.8) | 0 |
| Central nervous system |
3 (2.6) |
2 (4.8) |
1 (1.3) |
| Sequential organ failure assessment score, median (IQR) | 2 (1–4) | 3 (1–6) | 1 (0–3) |
| ICU admission, no. (%) | 25 (21.9) | 15 (36.6) | 10 (13.7) |
| Mechanical ventilation, no. (%) | 21 (18.4) | 13 (31.7) | 8 (11) |
| Duration of hospitalization, days, median (IQR) | 16.5 (9–24) | 18 (8.5–30.5) | 16 (10–21.5) |
| Case-fatality rate, no. (%) | 17 (14.9) | 7 (17.1) | 10 (13.7) |
*ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; ICU, intensive care unit; IQR, interquartile range.
Page created: January 18, 2019
Page updated: January 18, 2019
Page reviewed: January 18, 2019
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