A Simple Scoring System for Recurrent Melioidosis
Author Information
Author(s): Limmathurotsakul Direk, Chaowagul Wipada, Chantratita Narisara, Wuthiekanun Vanaporn, Biaklang Mayurachat, Tumapa Sarinna, White Nicholas J., Day Nicholas P. J., Peacock Sharon J.
Primary Institution: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
Hypothesis
Can a simple scoring system effectively differentiate between relapse and re-infection in patients with recurrent melioidosis?
Conclusion
A scoring index was developed that can help predict the cause of recurrent melioidosis, providing important information when bacterial genotyping is not available.
Supporting Evidence
- The scoring system correctly identified relapse in 85% of patients with a score of less than 5.
- A score of 5 or more correctly identified re-infection in 69% of patients.
- Independent predictors of relapse included shorter duration of oral treatment and time to recurrence.
Takeaway
Doctors created a simple way to tell if a patient with melioidosis is getting sick again from the same germs or from new germs, which helps them decide how to treat the patient.
Methodology
The study analyzed 2,804 patients with melioidosis, focusing on 141 with recurrent cases to develop a scoring system based on clinical predictors.
Potential Biases
Potential biases may arise from the reliance on clinical data without bacterial genotyping in many cases.
Limitations
The study was conducted in a single location, which may limit the generalizability of the findings.
Participant Demographics
The study included adult patients (≥15 years) with culture-confirmed recurrent melioidosis from northeast Thailand.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: 0.73–0.87
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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