Dataset Information

Clinical Manifestations and Genomic Evaluation of Melioidosis Outbreak among Children after Sporting Event, Australia.

ABSTRACT: Melioidosis, caused by the environmental gram-negative bacterium Burkholderia pseudomallei, usually develops in adults with predisposing conditions and in Australia more commonly occurs during the monsoonal wet season. We report an outbreak of 7 cases of melioidosis in immunocompetent children in Australia. All the children had participated in a single-day sporting event during the dry season in a tropical region of Australia, and all had limited cutaneous disease. All case-patients had an adverse reaction to oral trimethoprim/sulfamethoxazole treatment, necessitating its discontinuation. We describe the clinical features, environmental sampling, genomic epidemiologic investigation, and public health response to the outbreak. Management of this outbreak shows the potential benefits of making melioidosis a notifiable disease. The approach used could also be used as a framework for similar outbreaks in the future.

SUBMITTER: Smith S

PROVIDER: S-EPMC10617349 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Clinical Manifestations and Genomic Evaluation of Melioidosis Outbreak among Children after Sporting Event, Australia.

Smith Simon S Marquardt Tonia T Jennison Amy V AV D'Addona Andrew A Stewart James J Yarwood Trent T Ho Jennifer J Binotto Enzo E Harris Julian J Fahmy Mark M Esmonde Juliet J Richardson Megan M Graham Rikki M A RMA Gair Richard R Ariotti Lawrence L Preston-Thomas Annie A Rubenach Sally S O'Sullivan Siobhan S Allen Darren D Ragh Thomas T Grayson Sachjuan S Manoy Sophie S Warner Jeffery M JM Meumann Ella M EM Robson Jennifer M JM Hanson Josh J

Emerging infectious diseases 20231101 11

Melioidosis, caused by the environmental gram-negative bacterium Burkholderia pseudomallei, usually develops in adults with predisposing conditions and in Australia more commonly occurs during the monsoonal wet season. We report an outbreak of 7 cases of melioidosis in immunocompetent children in Australia. All the children had participated in a single-day sporting event during the dry season in a tropical region of Australia, and all had limited cutaneous disease. All case-patients had an adver ...[more]

PMID: 37877500

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Project description:BackgroundAlthough there is a high incidence of hematogenous infections in melioidosis, a tropical infectious disease, there are few systematic analyses of hematogenous melioidosis in imaging articles. A comprehensive clinical and imaging evaluation of hematogenous melioidosis be conducted in order to achieve early diagnosis of the disease.Materials and methodsWe conducted an analysis of 111 cases of melioidosis diagnosed by bacteriological culture between August 2001 and September 2022. The analysis focused on observing the main manifestations of chest imaging and clinical data, including nodules, cavities, consolidation, ground glass opacity(GGO), pleural effusion, centrilobular nodules, and temperature, leucocyte count, diabetes, etc. Our study involved univariate and multivariate analyses to identify significant diagnostic variables and risk predictive factors.ResultsA total of 71.2% (79/111) of melioidosis cases were caused by hematogenous infection, and the most common organ involved was the lungs (88.5%, 100/113). The incidence of sepsis in patients with lung abnormalities was high (73%, 73/100), and the mortality rate of septic shock was 22% (22/100). Univariate analysis showed that the radiologic signs of blood culture-positive cases were more likely to have bilateral pulmonary and subpleural nodules (p = 0.003), bilateral GGO (p = 0.001), bilateral hydrothorax (p = 0.011). The multivariate analysis revealed a significant improvement in the area under the receiver operating characteristic curve (AUC) when comparing the model that included both clinical and radiologic variables to the model with clinical variables alone. The AUC increased from 0.818 to 0.932 (p = 0.012). The most important variables in the logistic regression with backward elimination were found to be nodule, GGO, and diabetes.ConclusionThe combination of CT features and clinical variables provided a valuable and timely warning for blood borne infectious melioidosis.

Dataset Information

Clinical Manifestations and Genomic Evaluation of Melioidosis Outbreak among Children after Sporting Event, Australia.

Publications

Clinical Manifestations and Genomic Evaluation of Melioidosis Outbreak among Children after Sporting Event, Australia.

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