Role and significance of quantitative urine cultures in diagnosis of melioidosis.
نویسندگان
چکیده
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 B. pseudomallei from a neat sample or pellet, (ii) positive result from a centrifuged pellet only (< 10(3) CFU/ml), (iii) detection of between 10(3) CFU/ml and 10(5) CFU/ml from a neat sample, or (iv) detection of > or = 10(5) CFU/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 10(3) CFU/ml and 10(5) CFU/ml and 71% for those with > or = 10(5) CFU/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.
منابع مشابه
Diagnosis Of Urinary Tract Infection Using Standard Urinalysis Or Hemocytometer Leukocyte Count
Background and Objective: This study was undertaken to assess the ability of standard urinalysis (UA) and hemocytometer white blood cell (WBC) counts for the diagnosis of urinary tract infection (UTI) in patients with urinary symptoms. Materials and Methods: A total of 600 patients with symptoms of urina...
متن کامل99mTc-MDP whole body bone scan in a case of acute disseminated melioidosis
Melioidosis is a potentially fatal infectious disease occurring predominantly in the tropics, caused by a Gram-negative, motile, rod shaped obligatory aerobic non-spore forming bacillus, Burkholderia pseudomallei. It can produce localised or disseminated disease largely affecting immunocompromised patients. It is a challenge to identify melioidosis early as this disease can manipulate host’s ce...
متن کاملCOMPARATIVE EVALUATION OF QUANTITATIVE PROTEIN MEASUREMENTS IN 8-12 AND 24 HOUR URINE SAMPLES FOR DIAGNOSIS OF PRE-ECLAMPSIA
ABSTRACT Background: In this study our purpose was to determine whether 8 and/or 12 hour urine total protein values correlate with the 24 hour value to confirm the diagnosis of pre-eclampsia. Methods: The study population included 70 inpatients with hypertensive disorders of pregnancy. Patient's urine was collected over 24 hours with the first 8 hours, next 4 hours, and remaining 12 hours in s...
متن کاملA comparison of lysis centrifugation, pour plate, and conventional blood culture methods in the diagnosis of septicaemic melioidosis.
AIMS To determine whether quantitative blood culture methods could improve the diagnosis of septicaemic melioidosis. METHODS A comparison of conventional broth based blood cultures, a pour plate method, and a commercial lysis centrifugation (Isolator 10) blood culture system was conducted in 71 Thai patients with severe melioidosis. The time to identification of B pseudomallei was recorded fo...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of clinical microbiology
دوره 43 5 شماره
صفحات -
تاریخ انتشار 2005