Publication: Role and significance of quantitative urine cultures in diagnosis of melioidosis
Issued Date
2005-05-01
Resource Type
ISSN
00951137
Other identifier(s)
2-s2.0-18544371367
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Clinical Microbiology. Vol.43, No.5 (2005), 2274-2276
Suggested Citation
Direk Limmathurotsakul, Vanaporn Wuthiekanun, Wirongrong Chierakul, Alien C. Cheng, Bina Maharjan, Wipada Chaowagul, Nicholas J. White, Nicholas P.J. Day, Sharon J. Peacock Role and significance of quantitative urine cultures in diagnosis of melioidosis. Journal of Clinical Microbiology. Vol.43, No.5 (2005), 2274-2276. doi:10.1128/JCM.43.5.2274-2276.2005 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/17004
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Role and significance of quantitative urine cultures in diagnosis of melioidosis
Abstract
Melioidosis is associated with significant mortality in countries in which it is endemic. Previous studies have demonstrated that quantitative Burkholderia pseudomallei counts in blood are predictive of mortality. Here we examine the relationship between outcomes and quantitative B. pseudomallei counts in urine. A total of 755 patients presenting to Sappasithiprasong Hospital, Ubon Ratchathani, northeast Thailand (in the northeast part of the country), with melioidosis between July 1993 and October 2003 had quantitative urine cultures performed within 72 h of admission. Urine culture results were divided into the following groups: (i) no growth of β. pseudomallei from a neat sample or pellet, (ii) positive result from a centrifuged pellet only (<103CFU/ml), (iii) detection of between 103CFU/ml and 105CFU/ml from a neat sample, or (iv) detection of >105CFU/ml from a neat sample. The overall in-hospital mortality rate was 45%. Patients with negative urine cultures had the lowest death rate (39%). Mortality rates rose with increasing B. pseudomallei counts in urine, from 58% for those with positive spun pellets only to 61% for those with between 103CFU/ml and 105CFU/ml and 71% for those with ≥105CFU/ml. This was independent of age, presence of bacteremia, known risk factors for melioidosis such as diabetes, and the prior administration of antibiotics. The presence of B. pseudomallei in urine during systemic infection is associated with a poor prognosis. Copyright © 2005, American Society for Microbiology. All Rights Reserved.