Clinical characteristics and outcome of severe melioidosis requiring intensive care.

Abstract:

STUDY OBJECTIVE:To describe the clinical characteristics and outcome of patients with severe melioidosis requiring intensive care. DESIGN:Retrospective chart review. SETTING:Two ICUs from a tertiary-care teaching hospital. PATIENTS:Twenty-seven adult ICU patients with microbiologically documented melioidosis. INTERVENTIONS:None. MEASUREMENTS AND RESULTS:The median age was 59 years with a male preponderance (26:1). Twenty patients (74%) had medical comorbidities, with diabetes mellitus being the most common (59.3%). Almost all patients (96.3%) were bacteremic. Twenty patients (74.1%) presented with pneumonia. Twenty patients (74.1%) were in septic shock, and 16 patients (59.3%) had ARDS. Twelve patients (44.4%) required hemodialysis. The patients had a median of three organ dysfunctions, and the median APACHE (acute physiology and chronic health evaluation) II score was 27. The overall mortality was 48.1%. Mortality among patients with septic shock was 60%. The median ICU length of stay for survivors and nonsurvivors was 11 days and 2 days, respectively. Multivariate analysis revealed that the number of organ dysfunctions is an independent predictor of mortality (odds ratio, 8.2; 95% confidence interval, 1.3 to 51.4). CONCLUSIONS:The outcome of severe melioidosis requiring intensive care is poor, with death being predicted by the number of organ dysfunctions.

journal_name

Chest

journal_title

Chest

authors

Chan KP,Low JG,Raghuram J,Fook-Chong SM,Kurup A

doi

10.1378/chest.128.5.3674

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

3674-8

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)52948-6

journal_volume

128

pub_type

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