Melioidosis in travelers : An analysis of Dutch melioidosis registry data 1985–2018

Autor: Emma Birnie, Jelmer Savelkoel, Frans Reubsaet, Joris J.T.H. Roelofs, Robin Soetekouw, Saskia Kolkman, Anne Lia Cremers, Martin P. Grobusch, Daan W. Notermans, W. Joost Wiersinga, Wouter Rozemeijer, Annemieke Rijkeboer, Maarten Scholing, Karin van Dijk, Ellen M. Mascini, Henk van der Veen, Wouter van den Bijllaardt, Maaike de Vries, Leonard C. Smeets, Alewijn Ott, Kees van Krimpen, Bjorn L. Herpers, G. Hanke Watttel-Louis, Karola Waar, Noortje L.Q. Schwandt, Ianthe Maat, Anthonius S.M. Dofferhoff, Joost N. Vermeulen, Mireille van Westreenen, Peter de Man, Regina W. Hofland, Joost van Gorp, Steven Thijsen, Lieven B. van der Velden, Cornelis M. Verduin
Přispěvatelé: Medical Microbiology & Infectious Diseases, Graduate School, AII - Infectious diseases, APH - Aging & Later Life, APH - Global Health, Center of Experimental and Molecular Medicine, Pathology, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, Radiology and Nuclear Medicine, Infectious diseases, Medical Microbiology and Infection Prevention, APH - Quality of Care
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Travel Medicine and Infectious Disease, 32. Elsevier USA
Travel Medicine and Infectious Disease, 32
Tropical medicine and infectious disease, 32:101461. Elsevier Inc.
Travel medicine and infectious disease, 32:101461. Elsevier USA
ISSN: 1477-8939
Popis: Background: Melioidosis, caused by the Gram-negative bacterium Burkholderia pseudomallei, is an opportunistic infection across the tropics. Here, we provide a systematic overview of imported human cases in a non-endemic country over a 25-year period. Methods: All 55 Dutch microbiology laboratories were contacted in order to identify all B. pseudomallei positive cultures from 1990 to 2018. A response rate of 100% was achieved. Additionally, a systematic literature search was performed, medical-charts reviewed, and tissue/autopsy specimens were re-assessed. Results: Thirty-three travelers with melioidosis were identified: 70% male with a median-age of 54 years. Risk factors were present in most patients (n = 23, 70%), most notably diabetes (n = 8, 24%) and cystic fibrosis (n = 3, 9%). Countries of acquisition included Thailand, Brazil, Indonesia, Panama, and The Gambia. Disease manifestations included pneumonia, intra-abdominal abscesses, otitis externa, genitourinary, skin-, CNS-, and thyroid gland infections. Twelve (36%) patients developed sepsis and/or septic shock. Repeat episodes of active infection were observed in five (15%) and mortality in four (12%) patients. Post-mortem analysis showed extensive metastatic (micro)abscesses amongst other sites in the adrenal gland and bone marrow. Conclusions: The number of imported melioidosis is likely to increase, given rising numbers of (immunocompromised) travelers, and increased vigilance of the condition. This first systematic retrospective surveillance study in a non-endemic melioidosis country shows that imported cases can serve as sentinels to provide information about disease activity in areas visited and inform pre-travel advice and post-travel clinical management.
Databáze: OpenAIRE