A clinical study on clinical features,manifestations and drug resistance of melioidosis

Objectives: To explore the clinical features, manifestations and drug resistance of melioidosis.

Methods: The clinical data of 45 melioidosis patients treated by Affiliated Haikou Hospital of Xiangya Medical College, Central South University during January 2015 and January 2020 were studied. Informaiton collected included age, birthplace, area of residence, sex, ethnic group, clinical symptoms or signs, colony culture results, degree of drug resistance, treatment regimens and outcomes, department of initial diagnosis, and specimen type, thereby giving an analysis of the clinical features, manifestations, and treatment outcomes of the disease. Body fluids were obtained from all patients to analyze the drug resistance of the bacterium Burkholderia pseudomallei based on colony culture and susceptibility test results.

Results: In the 45 cases of melioidosis, the clinical manifestations predominantly included low fever (31.11%), pulmonary infection (22.22%); auxiliary examinations often suggested increases in C reactive protein (CRP) (73.33%), white blood cell count (#WBC) (68.89%) and procalcitonin (PCT) (66.67%); susceptibility test results showed that Burkholderia pseudomallei yielded high sensitive rate to antibacterials including trimethoprim–sulfamethoxazole (SXT) (88.89%),ceftazidime (CAZ)(93.33%), meropenem (MEM) (100.00%), imipenem (IPM)(100.00%); Of the 45 melioidosis patients, 23 were cured (51.11%), and 21 showed an improvement (33.33%) or remained stable (13.33%); A relatively high percentage of the patients experienced post-discharge recurrence/aggravation (recurrence within six months: 4.44%; recurrence within a year: 6.67%).

Conclusions: Low fever, pulmonary infection, and increases in serum inflammatory markers are major clinical features of melioidosis. Burkholderia pseudomallei presents high resistance rates to antibacterials such as GEN, FEP, AMP, and IPM.