Clinical characteristics and outcome of severe melioidosis requiring intensive care.
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.
Chan
Kenneth P W
KP
Department of Respiratory and Critical Care Medicine, Singapore General Hospital. kpwchan@pacific.net.sg
Low
Jenny G H
JG
Raghuram
Jagadesan
J
Fook-Chong
Stephanie M C
SM
Kurup
Asok
A
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