{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:52:38Z","timestamp":1784098358433,"version":"3.55.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Melioidosis is an infection caused by the bacterium <jats:italic>Burkholderia pseudomallei<\/jats:italic>. The most common presentation is bacteremia occurring in 38\u201373% of all patients, and the mortality rate ranges from 9% to 42%. Although there is abundant data representing risk factors for infection and patient outcomes, there is limited information regarding laboratory investigations associated with bacteremia and mortality. We assessed a range of baseline and diagnostic investigations and their association with patient outcomes in a retrospective cohort study in Townsville, Australia. 124 patients\u2019 medical and laboratory records were reviewed between January 1, 1997 and December 31, 2020. Twenty-seven patients died and 87 patients were bacteremic. The presence of lymphopenia (&lt; 1.5 \u00d7 10<jats:sup>9<\/jats:sup> cells\/L) was the highest risk for bacteremia (relative risk [RR] 2.2; 95% CI: 1.3\u20133.7, <jats:italic>P<\/jats:italic> &lt; 0.001). Factors associated with mortality included lymphopenia, (RR: 1.4; 95% CI: 1.2\u20131.6, <jats:italic>P<\/jats:italic>\u2009=\u20090.004); uremia (RR: 1.7; 95% CI: 1.1\u20132.5, <jats:italic>P<\/jats:italic>\u2009=\u20090.03); and an elevated international normalized ratio (RR: 1.5; 95% CI: 1.2\u20132.0, <jats:italic>P<\/jats:italic>\u2009=\u20090.006). Median incubation to positive blood culture result was 28 hours with 15\/82 (18%) positive in \u2264 24 hours. For serological testing during admission only 53\/121 (44%) were indirect hemagglutination assay positive, 67\/120 (56%) enzyme immunoassay IgG positive, and 23\/89 (26%) IgM positive. Simple baseline investigations at time of presentation may be used to stratify patients at high risk for both bacteremia and mortality. This information can be used as a decision aid for early intensive management.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0548","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T12:58:00Z","timestamp":1635771480000},"page":"54-59","source":"Crossref","is-referenced-by-count":14,"title":["Melioidosis: Laboratory Investigations and Association with Patient Outcomes"],"prefix":"10.4269","volume":"106","author":[{"given":"Ian","family":"Gassiep","sequence":"first","affiliation":[{"name":"1University of Queensland Centre for Clinical Research, Royal Brisbane and Woman\u2019s Hospital, Herston, Queensland, Australia;"},{"name":"2Department of Infectious Diseases, Mater Hospital Brisbane, South Brisbane, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibooshini","family":"Ganeshalingam","sequence":"additional","affiliation":[{"name":"3Department of Medicine, Townsville University Hospital, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Chatfield","sequence":"additional","affiliation":[{"name":"1University of Queensland Centre for Clinical Research, Royal Brisbane and Woman\u2019s Hospital, Herston, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick N. A.","family":"Harris","sequence":"additional","affiliation":[{"name":"1University of Queensland Centre for Clinical Research, Royal Brisbane and Woman\u2019s Hospital, Herston, Queensland, Australia;"},{"name":"4Pathology Queensland, Royal Brisbane and Women\u2019s Hospital, Herston, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Norton","sequence":"additional","affiliation":[{"name":"5Pathology Queensland, Townsville University Hospital, Townsville, Queensland, Australia;"},{"name":"6Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/1\/article-p54.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/1\/article-p54.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T12:08:43Z","timestamp":1641384523000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/1\/article-p54.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,5]]},"references-count":0,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0548","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,5]]}}}