Title : Factors influencing outcomes in patients admitted with melioidosis-a single centre retrospective study

Abstract:

Introduction:

Melioidosis is largely under-reported in the Indian subcontinent, this region is believed to account for 44% of cases, with an estimated annual incidence of 52,500 cases per year in India. This retrospective study of 50 patients aimed at determining association between factors like diabetes mellitus, hypertension, existing heart disease, lung disease, liver disease, alcohol abuse, immunosuppression, symptoms at admission to the hospital, and time from symptom onset to isolation of the bacterium, on in-hospital mortality, development of acute kidney injury (AKI), need for renal replacement therapy (RRT), intensive care unit (ICU) stay and recurrence.

Objectives:

1. To study the risk factors influencing in-hospital mortality in patients admitted with melioidosis.
2. To study the association between risk factors identified and development of AKI, need for RRT, ICU stay and recurrence of the disease.

Materials and Methods:

Study setting: Teaching hospitals affiliated with Kasturba Medical College, Mangalore
Study design: Retrospective Cross Sectional Study
Inclusion Criteria: Patients admitted and diagnosed with Melioidosis, Age >18 years
Exclusion Criteria: Pre-existing kidney disease

Results:

Descriptive characteristics of the data collected is presented in Table 1. Preliminary data analysis showed that diabetes, hypertension, pre-existing heart disease, lung disease, liver disease, alcohol abuse, immunosuppression, symptom complex, time from symptom onset to isolation of organism, and development of AKI had no significant associations with in-hospital mortality. Hypertension, pre-existing heart disease, hyponatremia, and advanced age was noted to have statistically significant associations with development of AKI. Hypertension, pre-existing heart disease, and advanced age was noted have statistically significant associations with need for RRT. Pre-existing heart disease, and longer ICU stay had statistically significant associations with recurrence of the disease. Further analysis, with respect to geographic influences is ongoing.

Conclusion:

In patients with Melioidosis, hypertension, pre-existing cardiac disease, hyponatremia, and advanced age were noted to have significant association with development of AKI while pre-existing cardiac disease and longer ICU stay were associated with recurrence.

Keywords:

Melioidosis, Risk Factors, Acute Kidney Injury

Audience Take Away:

• This project highlights the specific comorbidities and conditions that lead to poor outcome, increased in-patient mortality and recurrence in patients with melioidosis.
• It highlights the importance of well controlled controlled Diabetes, Hypertension and other comorbidities in reducing in -patient mortality and improving outcome.
• Development of acute kidney injury in patients diagnosed with melioidosis.

Biography:

Ms. Samyuktha Srinivas is a final year medical student at Kasturba Medical College, Mangalore, affiliated with Manipal Academy of Higher Education. As a student, she has worked on research papers and case reports which have been presented at local and National conferences in India. She is a diligent and hardworking medical student with good clinical knowledge, a knack for research and eloquent presentation skills. She wishes to pursue a residency in Internal Medicine in the United States.