title: The role and significance of sputum cultures in the diagnosis of melioidosis.
abstract: Pneumonia is a common manifestation of melioidosis, the disease caused by Burkholderia pseudomallei. In this study, we defined the prognostic significance of a positive sputum culture. A total of 712 patients presenting to Sappasithiprasong Hospital, Ubon Ratchathani, Thailand, with melioidosis between January 1992 and December 2002 had a sputum culture performed during admission, which was positive for B. pseudomallei in 444 patients (62%). The median duration of sputum positivity was 9 days (range, 1 to 49 days). Sputum cultures were negative in 32% of patients with radiologic changes suggestive of pulmonary involvement. Overall in-hospital mortality was 48%. A positive sputum culture was associated with mortality (adjusted OR 2.8, 95% CI: 1.9, 4.0; P < 0.001). This was independent of renal disease, a prior history of melioidosis, positive blood cultures, and other potential confounders. The presence of B. pseudomallei in the sputum of patients with melioidosis is associated with a poorer prognosis.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Diana
authors.initials: D
authors.lastname: Huis in 't Veld
authors.forename: Vanaporn
authors.initials: V
authors.lastname: Wuthiekanun
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.forename: Wirongrong
authors.initials: W
authors.lastname: Chierakul
authors.forename: Wipada
authors.initials: W
authors.lastname: Chaowagul
authors.forename: Annemarie E
authors.initials: AE
authors.lastname: Brouwer
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
authors.forename: Nicholas P J
authors.initials: NP
authors.lastname: Day
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
mesh_terms: D000328:Adult; D016957:Burkholderia pseudomallei / Q000302:isolation & purification* / Q000472:pathogenicity; D003470:Culture Media; D005260:Female; D006801:Humans; D008297:Male; D008554:Melioidosis / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D013183:Sputum / Q000382:microbiology*
chemical_list: D003470:Culture Media