Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent
Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent
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DOI：
10.3855/jidc.7612
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发表时间：
2017-01-01
影响因子：
1.9
通讯作者：
Harun, Azian
中科院分区：
文献类型：
--
作者：
Zueter, AbdelRahman Mohammad;Abumarzouq, Mahmoud;Harun, Azian
导言：累及骨骼、关节和软组织的类鼻疽病很少见，通常是由于疾病通过身体其他部位的感染而扩散；在较小程度上，它也可以被报告为类鼻疽病的主要表现。方法：对马来西亚塞恩斯医院2008-2014年间的骨科登记进行了回顾，随后对伯克霍尔德氏菌进行了分子分型。结果：在20例确诊病例中，19例患者被证实患有骨关节和/或软组织类鼻疽病。大多数患者是男性(84%)，16名患者有潜在的糖尿病，对疾病结果没有显著的估计风险。细菌基因型别与疾病的风险无关。细菌性感染患者的死亡是一个显著的结局(p=0.044)。结论：肺部或皮肤类鼻疽病患者需要仔细治疗和随访，以最大限度地减少继发性骨关节感染的机会。人类风险因素仍然是类鼻疽病的主要诱因。早期实验室和临床诊断和急性期治疗可以减少发病率和死亡率。
Introduction: Melioidosis involving bone, joints, and soft tissue is rare and reported usually following dissemination of disease from infection elsewhere in the body; to a lesser degree, it can also be reported as the primary manifestation of melioidosis.Methodology: The orthopedic registry at Hospital University Sains Malaysia from 2008 until 2014 was retrospectively reviewed and was followed by molecular typing of Burkholderia pseudomallei.Results: Out of 20 cases identified, 19 patients were confirmed to have osteoarticular and/or soft-tissue melioidosis. The majority of the patients were males (84%), and 16 patients had underlying diabetes mellitus with no significant estimated risk with the disease outcomes. Bacterial genotype was not associated with the disease as a risk. Death was a significant outcome in patients with bacteremic infections (p = 0.044).Conclusion: Patients with lung or skin melioidosis require careful treatment follow-up to minimize the chance for secondary osteoarticular infection. Human risk factors remain the leading predisposing factors for melioidosis. Early laboratory and clinical diagnosis and acute-phase treatment can decrease morbidity and mortality.