title: Clinical characteristics and outcome of severe melioidosis requiring intensive care.
abstract: OBJECTIVE
  To describe the clinical characteristics and outcome of patients with severe melioidosis requiring intensive care.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Two ICUs from a tertiary-care teaching hospital.
  
  
  METHODS
  Twenty-seven adult ICU patients with microbiologically documented melioidosis.
  
  
  METHODS
  None.
  
  
  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.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Singapore General Hospital. kpwchan@pacific.net.sg
authors.forename: Kenneth P W
authors.initials: KP
authors.lastname: Chan
authors.forename: Jenny G H
authors.initials: JG
authors.lastname: Low
authors.forename: Jagadesan
authors.initials: J
authors.lastname: Raghuram
authors.forename: Stephanie M C
authors.initials: SM
authors.lastname: Fook-Chong
authors.forename: Asok
authors.initials: A
authors.lastname: Kurup
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003422:Critical Care; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008554:Melioidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000401:mortality; D016019:Survival Analysis