Melioidosis in patients with suspected tuberculosis in Cambodia: a single-center cross-sectional study

• Published in: The international journal of tuberculosis and lung disease Vol. 22; no. 12; pp. 1481 - 1485
• Main Authors: Pho, Y., Nhem, S., Sok, C., By, B., Phann, D., Nob, H., Thann, S., Yin, S., Kim, C., Letchford, J., Fassier, T., Chan, S., West, T. E.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01-12-2018; International Union against Tuberculosis and Lung Disease (IUATLD)
• Subjects: Burkholderia; Cross-sectional studies; Culture; Diagnostics; Infection; Infections; Lung; Melioidosis; Patients; Risk analysis; Risk factors; Sputum; Tuberculosis; Cambodia
• DOI: 10.5588/ijtld.17.0294
• EISSN: 1815-7920
• ISSN: 1027-3719

SETTING: Melioidosis-Burkholderia pseudomallei infection-is increasingly recognized in Cambodia, a country with a high incidence of tuberculosis (TB). Melioidosis and TB can be clinically indistinguishable.OBJECTIVE: To quantify the proportion of patients with
clinically suspected TB who had melioidosis by testing sputum for B. pseudomallei.DESIGN: This was a prospective, 6-month cross-sectional single-center study at a Cambodian provincial referral hospital among patients with suspicion of TB who provided sputum specimens for testing.
TB was diagnosed using sputum Xpert® MTB/RIF molecular assay or culture; melioidosis was diagnosed using sputum culture for B. pseudomallei.RESULTS: Of 404 patients evaluated for possible TB, 52 (12.9%, 95%CI 9.8-16.5) had TB. Four patients (1.0%, 95%CI 0.3-2.5)
had melioidosis; none had concurrent TB or an existing medical risk factor for melioidosis, although two were farmers, an occupational risk factor.CONCLUSION: One per cent of patients being evaluated for TB at a Cambodian provincial referral hospital had culture-proven respiratory melioidosis,
a highly lethal infection. None had previously recognized medical conditions that would increase their risk of melioidosis. Testing for melioidosis should be considered in patients presenting with suspected TB in Cambodia.