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Sporadic and outbreak cases of melioidosis in southern Taiwan: clinical features and antimicrobial susceptibility.

机译：台湾南部零星和暴发性类疟疾病例：临床特征和抗菌药物敏感性。

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BACKGROUND: Melioidosis has been well known to be endemic in Thailand and Northern Australia, and was reported sporadically in Taiwan before 2005. METHODS: We retrospectively analyzed 58 patients with melioidosis in southern Taiwan from 2000 to 2005, including 40 clustered and 18 sporadic cases, for clinical characteristics and antimicrobial susceptibility. RESULTS: Fifty-one (88%) cases were found during the rainy season, and there was a significant correlation between the average monthly rainfalls and the case number (r = 0.37; p = 0.001). Diabetes mellitus was the most common underlying disease (35 cases, 60%). The majority (52 cases, 90%) had never traveled abroad before illness, indicating indigenous acquisition of Burkholderia pseudomallei. In comparison, clustered cases were older, less often had underlying diabetes mellitus and had a shorter duration of clinical symptoms before admission than sporadic cases. Acute form of melioidosis predominated, and shock at admission was independently associated with a grave prognosis. Overall, 22% of 58 patients died in hospitals. Ceftazidime, imipenem, meropenem, amoxicillin/clavulanic acid, co-trimoxazole, and doxycycline, as previously recommended, were the potentially therapeutic choices. The role of piperacillin/ tazobactam for melioidosis remains undefined. CONCLUSIONS: Melioidosis can occur sporadically or in a cluster in diabetic patients during rainy seasons in Taiwan.
机译：背景：拟南芥流行于泰国和澳大利亚北部，2005年之前在台湾零星报道。方法：我们回顾性分析了2000年至2005年台湾南部58例拟南芥病，包括40例成簇和18例散发病例，用于临床特征和抗菌药敏性。结果：在雨季发现了51例（88％）病例，平均月降雨量与病例数之间存在显着相关性（r = 0.37; p = 0.001）。糖尿病是最常见的基础疾病（35例，60％）。大多数（52例，90％）从未生过病，这表明土著人购买了假伯克霍尔德氏菌。相比之下，成簇的病例比散发的病例年龄更大，患基础糖尿病的频率更低，入院前临床症状的持续时间较短。急性类li虫病占主导地位，入院时的休克与严重的预后独立相关。总体而言，58位患者中有22％在医院死亡。如先前建议的那样，头孢他啶，亚胺培南，美罗培南，阿莫西林/克拉维酸，复方新诺明和多西环素是潜在的治疗选择。哌拉西林/他唑巴坦在类鼻oid病中的作用尚不清楚。结论：在台湾的雨季，糖尿病患者可能会偶发或成群地发生类鼻oid病。

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