Volume 84, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Melioidosis, a bacterial infection caused by , is notoriously difficult to cure despite appropriate antimicrobial therapy and has a mortality rate of up to 40%. We demonstrate that a blood culture positive for taken at the end of the first and/or second week after hospitalization for melioidosis is a strong prognostic factor for death (adjusted odds ratio = 4.2, 95% confidence interval = 2.1–8.7, < 0.001 and adjusted odds ratio = 2.6, 95% confidence interval = 1.1–6.0, = 0.03, respectively). However, repeat cultures of respiratory secretions, urine, throat swabs, or pus/surface swabs provide no prognostic information. This finding highlights the need for follow-up blood cultures in patients with melioidosis.


Article metrics loading...

Loading full text...

Full text loading...



  1. Limmathurotsakul D, Wongratanacheewin S, Teerawattanasook N, Wongsuvan G, Chaisuksant S, Chetchotisakd P, Chaowagul W, Day NP, Peacock SJ, , 2010. Increasing incidence of human melioidosis in northeast Thailand. Am J Trop Med Hyg 82: 11131117.[Crossref]
  2. Currie BJ, Fisher DA, Howard DM, Burrow JN, Selvanayagam S, Snelling PL, Anstey NM, Mayo MJ, , 2000. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop 74: 121127.[Crossref]
  3. Limmathurotsakul D, Wuthiekanun V, Chierakul W, Cheng AC, Maharjan B, Chaowagul W, White NJ, Day NP, Peacock SJ, , 2005. Role and significance of quantitative urine cultures in diagnosis of melioidosis. J Clin Microbiol 43: 22742276.[Crossref]
  4. Walsh AL, Smith MD, Wuthiekanun V, Suputtamongkol Y, Chaowagul W, Dance DA, Angus B, White NJ, , 1995. Prognostic significance of quantitative bacteremia in septicemic melioidosis. Clin Infect Dis 21: 14981500.[Crossref]
  5. Walsh AL, Wuthiekanun V, , 1996. The laboratory diagnosis of melioidosis. Br J Biomed Sci 53: 249253.
  6. Chaowagul W, Chierakul W, Simpson AJ, Short JM, Stepniewska K, Maharjan B, Rajchanuvong A, Busarawong D, Limmathurotsakul D, Cheng AC, Wuthiekanun V, Newton PN, White NJ, Day NP, Peacock SJ, , 2005. Open-label randomized trial of oral trimethoprim-sulfamethoxazole, doxycycline, and chloramphenicol compared with trimethoprim-sulfamethoxazole and doxycycline for maintenance therapy of melioidosis. Antimicrob Agents Chemother 49: 40204025.[Crossref]
  7. Chaowagul W, Simpson AJ, Suputtamongkol Y, Smith MD, Angus BJ, White NJ, , 1999. A comparison of chloramphenicol, trimethoprim-sulfamethoxazole, and doxycycline with doxycycline alone as maintenance therapy for melioidosis. Clin Infect Dis 29: 375380.[Crossref]
  8. Cheng AC, Limmathurotsakul D, Chierakul W, Getchalarat N, Wuthiekanun V, Stephens DP, Day NP, White NJ, Chaowagul W, Currie BJ, Peacock SJ, , 2007. A randomized controlled trial of granulocyte colony-stimulating factor for the treatment of severe sepsis due to melioidosis in Thailand. Clin Infect Dis 45: 308314.[Crossref]
  9. Chierakul W, Anunnatsiri S, Short JM, Maharjan B, Mootsikapun P, Simpson AJ, Limmathurotsakul D, Cheng AC, Stepniewska K, Newton PN, Chaowagul W, White NJ, Peacock SJ, Day NP, Chetchotisakd P, , 2005. Two randomized controlled trials of ceftazidime alone versus ceftazidime in combination with trimethoprim-sulfamethoxazole for the treatment of severe melioidosis. Clin Infect Dis 41: 11051113.[Crossref]
  10. Wuthiekanun V, Limmathurotsakul D, Wongsuvan G, Chierakul W, Teerawattanasook N, Teparrukkul P, Day NP, Peacock SJ, , 2007. Quantitation of B. pseudomallei in clinical samples. Am J Trop Med Hyg 77: 812813.
  11. Fowler VG, Jr Olsen MK, Corey GR, Woods CW, Cabell CH, Reller LB, Cheng AC, Dudley T, Oddone EZ, , 2003. Clinical identifiers of complicated Staphylococcus aureus bacteremia. Arch Intern Med 163: 20662072.[Crossref]
  12. Baughman RP, Kerr MA, , 2003. Ventilator-associated pneumonia patients who do not reduce bacteria from the lungs have a worse prognosis. J Intensive Care Med 18: 269274.[Crossref]
  13. Simpson AJ, Suputtamongkol Y, Smith MD, Angus BJ, Rajanuwong A, Wuthiekanun V, Howe PA, Walsh AL, Chaowagul W, White NJ, , 1999. Comparison of imipenem and ceftazidime as therapy for severe melioidosis. Clin Infect Dis 29: 381387.[Crossref]
  14. Suputtamongkol Y, Rajchanuwong A, Chaowagul W, Dance DA, Smith MD, Wuthiekanun V, Walsh AL, Pukrittayakamee S, White NJ, , 1994. Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. Clin Infect Dis 19: 846853.[Crossref]

Data & Media loading...

  • Received : 31 Oct 2010
  • Accepted : 06 Feb 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error