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Thalassemia Major Is a Major Risk Factor for Pediatric Melioidosis in Kota Kinabalu, Sabah, Malaysia

Fong, Siew M., Wong, Ke J., Fukushima, Masako and Yeo, Tsin W. (2015). Thalassemia Major Is a Major Risk Factor for Pediatric Melioidosis in Kota Kinabalu, Sabah, Malaysia. Clinical Infectious Diseases,60(12):1802-1807.

Document type: Journal Article
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IRMA ID 10444xPUB70
Title Thalassemia Major Is a Major Risk Factor for Pediatric Melioidosis in Kota Kinabalu, Sabah, Malaysia
Author Fong, Siew M.
Wong, Ke J.
Fukushima, Masako
Yeo, Tsin W.
Journal Name Clinical Infectious Diseases
Publication Date 2015
Volume Number 60
Issue Number 12
ISSN 1058-4838   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84958699033
Start Page 1802
End Page 1807
Total Pages 6
Place of Publication United States
Publisher Oxford University Press
Field of Research MEDICAL AND HEALTH SCIENCES
HERDC Category C1 - Journal Article (DIISR)
Abstract Background. Melioidosis is an important cause of community-acquired infection in Southeast Asia and northern Australia. Studies from endemic countries have demonstrated differences in the epidemiology and clinical features among children diagnosed with melioidosis. This suggests that local data are needed to determine the risk factors and outcome in specific areas.

Methods. This was a retrospective study of all children admitted to Likas Women's and Children Hospital, Kota Kinabalu, Sabah, Malaysia, with a blood or clinical sample positive for Burkholderia pseudomallei from 2001 to 2012.

Results. Of 28 children with confirmed melioidosis, 27 records were reviewed including 11 (41%) children with thalassemia major. Twenty of the children had bacteremia, and 16 (59%) had a fatal outcome. Six children had chronic disease, and none died. Empiric use of antibiotics not specific for B. pseudomallei was associated with increased risk of death (P < .001). The annual incidence of melioidosis in children with thalassemia major from 2001 to 2010 was 140 per 100 000/year vs 0.33 per 100 000/year for other children (P < .001). After institution of iron chelation therapy in 2010, no child with thalassemia major was diagnosed with melioidosis in 2011 or 2012.

Conclusions.
 Pediatric melioidosis in Sabah is associated with a high proportion of bacteremia and death. Thalassemia major was a major risk factor for melioidosis among children from 2001 to 2010, but infections decreased markedly from 2011 to 2012 after universal availability of iron chelation therapy. Inappropriate empiric therapy was associated with an increased risk of death.
Keywords melioidosis
Burkholderia pseudomallei
thalassemia major
pediatric
iron
DOI http://dx.doi.org/10.1093/cid/civ189   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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