Abstract
Introduction
Burkholderia pseudomallei (BP) is a gram-negative bacterium that is found primarily in soil and surface water. It causes melioidosis, a life-threatening infection that accounts for 165,000 global cases and 89,000 deaths annually, with a high prevalence in tropical regions, including Cambodia. Although the true burden of BP remains uncertain, it is clearly a significant cause of sepsis and community-acquired pneumonia in Cambodia. This study aimed to determine the prevalence and distribution of BP infections in patients at Takeo Provincial Referral Hospital in Cambodia from 2014 to 2018.
Methods
We used existing data from ACESO in collaboration with the NAMRU-2 and Takeo Provincial Referral Hospital (TPRH). They collected 521 eligible samples of patients seeking health care services at TPRH aged ≥18 years between 2014 and 2018. Blood samples were collected and tested for the pathogen Burkholderia at the Takeo provincial referral laboratory. STATA V 16 was used to analyze the data. We described the sociodemographic characteristics of patients in terms of frequency, percentage, mean (SD) and median (IQR). We also calculated the proportion of positive cases. The chi-square test was used to assess the associations between sociodemographic characteristics and BP positivity.
Results
Overall, there was a high proportion of patients from Takeo Province (75.8%), male patients (63.5%) and farmers (48.9%). The mean age of the patients was 50 years (SD = 16.7). The prevalence of BP among patients at TPRH was 8.5%. Males (9.7%), individuals aged 36–53 (11.9%), farmers (11.7%) and those with a high school education (15.9%). ICU admission (10.8%, p value = 0.017) and mortality (23.6%, p value < 0.001) were significantly associated with BP positivity. Effective antibiotics, including ceftazidime, imipenem and tetracycline, resulted in 100% sensitivity, while ciprofloxacin and gentamicin were resistant.
Conclusion
BP infections were identified in Takeo Provincial Referral Hospital, with a prevalence of 8.5%. Higher rates were found among males, patients reported as farmers, and older patients (aged 36–53 years). It commonly peaks during the wet season, which could be linked to the increase in exposure to contaminated soil and water in farming fields. These findings provide valuable insights into the patterns and burdens of melioidosis in Cambodia. The findings suggested the need for an increase in awareness, early detection, and proper clinical management to reduce morbidity and mortality.