Melioidosis Study in Yasothon Hospital

Abstract

Background: Melioidosis is a common disease in Thailand. Especially in the northeastern region, from the
surveillance report of melioidosis in Yasothon province, it was found that the morbidity rate was quite high.
There are times when patients receive appropriate antibiotic treatment but the treatment results still failed.
Objective: To study the factors related to birth failure of melioidosis treatment in Yasothon Hospital.
Methods: Retrospective analytical study was conducted. The group of the population is Data were collected
from inpatient medical records admitted in Yasothon Hospital. Who have been diagnosed with melioidosis with evidence of diagnosis from the detection of microbiological pathogens received in the ward General
Medicine and Internal Medicine Intensive Care Unit from October 1, 2021 to September 30, 2022, the data
will be analyzed statistically logistic regression to find such factors, set the statistical significance at 0.05.
Results: During the study period, one patient was diagnosed with melioidosis from the detection of
seropositive bacteria. There were 98 microbiological cases, 4 deaths. 2 cases died less than 48 hours after
treatment and were excluded from the study. There were 94 patients enrolled in the study, 64.89% of
males compared to the effective group. treatment failure with the group with good treatment results found
that Infectious pneumonia patients (59.52% and 9.6%) had septic shock at baseline (42.86% and 15.4%) and
receiving inappropriate antibiotics (11.9% and 0.0%) in the treatment group. Failure was significantly higher
than the well-treated group (p<0.001, p=0.004, p=0.017) and received significantly less ceftazidime than the
well-treated group. Statistically significant (76.19% and 92.3% p=0.033). There was no significant difference
between the patient's underlying disease or blood stream infection. Statistically significant results in
treatment failure were pneumonia, infection (Adjusted OR=23.99, 95%CI=5.96-96.48, p<0.001), bone and
joint infection (Adjusted OR=23.76, 95%CI=3.34-169.04, p=0.002), abdominal infection (Adjusted OR=14.05,
95%CI=2.19-89.96, p=0.005) and septic shock at baseline (Adjusted OR=8.38, 95%CI=2.04-34.40, p=0.003).
Conclusion: Melioidosis is a disease that infects many organs of the body. It is often found in patients with
diabetes. Chronic renal disease and liver disease the administration of antibiotics that are effective against
melioidosis reduces the mortality rate. Therefore, caring for patients with fever suspected to be caused by
infection especially in groups with such risk factors Melioidosis infection should be considered. In addition,
broad-spectrum antibiotics for melioidosis should also be considered.
Keywords: Risk factor, Melioidosis, Treatment failure, Systemic infections