Repeat Blood Culture Positive for B. pseudomallei Indicates an Increased Risk of Death from Melioidosis
Limmathurotsakul D., Wuthiekanun V., Wongsuvan G., Pangmee S., Amornchai P., Teparrakkul P., Teerawattanasook N., Day NPJ., Peacock SJ.
Melioidosis, a bacterial infection caused by Burkholderia pseudomallei, 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 B. pseudomallei 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, P < 0.001 and adjusted odds ratio = 2.6, 95% confidence interval = 1.1–6.0, P = 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.