A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis.
Melioidosis is an important cause of morbidity and mortality in East Asia. Recurrent melioidosis occurs in around 10% of patients following treatment either because of relapse with the same strain or re-infection with a new strain of Burkholderia pseudomallei. Distinguishing between the two is impor...
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ftdoajarticles:oai:doaj.org/article:adb872046b2f44328ff6a7c38d981bd5 2023-05-15T15:11:40+02:00 A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. Direk Limmathurotsakul Wipada Chaowagul Narisara Chantratita Vanaporn Wuthiekanun Mayurachat Biaklang Sarinna Tumapa Nicholas J White Nicholas P J Day Sharon J Peacock 2008-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000327 https://doaj.org/article/adb872046b2f44328ff6a7c38d981bd5 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2570249?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000327 https://doaj.org/article/adb872046b2f44328ff6a7c38d981bd5 PLoS Neglected Tropical Diseases, Vol 2, Iss 10, p e327 (2008) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2008 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000327 2022-12-31T04:15:03Z Melioidosis is an important cause of morbidity and mortality in East Asia. Recurrent melioidosis occurs in around 10% of patients following treatment either because of relapse with the same strain or re-infection with a new strain of Burkholderia pseudomallei. Distinguishing between the two is important but requires bacterial genotyping. The aim of this study was to develop a simple scoring system to distinguish re-infection from relapse.In a prospective study of 2,804 consecutive adult patients with melioidosis presenting to Sappasithiprasong Hospital, NE Thailand, between 1986 and 2005, there were 141 patients with recurrent melioidosis with paired strains available for genotyping. Of these, 92 patients had relapse and 49 patients had re-infection. Variables associated with relapse or re-infection were identified by multivariable logistic regression and used to develop a predictive model. Performance of the scoring system was quantified with respect to discrimination (area under receiver operating characteristic curves, AUC) and categorization (graphically). Bootstrap resampling was used to internally validate the predictors and adjust for over-optimism.Duration of oral antimicrobial treatment, interval between the primary episode and recurrence, season, and renal function at recurrence were independent predictors of relapse or re-infection. A score of < 5 correctly identified relapse in 76 of 89 patients (85%), whereas a score > or = 5 correctly identified re-infection in 36 of 52 patients (69%). The scoring index had good discriminative power, with a bootstrap bias-corrected AUC of 0.80 (95%CI: 0.73-0.87).A simple scoring index to predict the cause of recurrent melioidosis has been developed to provide important bedside information where rapid bacterial genotyping is unavailable. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 2 10 e327 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Direk Limmathurotsakul Wipada Chaowagul Narisara Chantratita Vanaporn Wuthiekanun Mayurachat Biaklang Sarinna Tumapa Nicholas J White Nicholas P J Day Sharon J Peacock A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Melioidosis is an important cause of morbidity and mortality in East Asia. Recurrent melioidosis occurs in around 10% of patients following treatment either because of relapse with the same strain or re-infection with a new strain of Burkholderia pseudomallei. Distinguishing between the two is important but requires bacterial genotyping. The aim of this study was to develop a simple scoring system to distinguish re-infection from relapse.In a prospective study of 2,804 consecutive adult patients with melioidosis presenting to Sappasithiprasong Hospital, NE Thailand, between 1986 and 2005, there were 141 patients with recurrent melioidosis with paired strains available for genotyping. Of these, 92 patients had relapse and 49 patients had re-infection. Variables associated with relapse or re-infection were identified by multivariable logistic regression and used to develop a predictive model. Performance of the scoring system was quantified with respect to discrimination (area under receiver operating characteristic curves, AUC) and categorization (graphically). Bootstrap resampling was used to internally validate the predictors and adjust for over-optimism.Duration of oral antimicrobial treatment, interval between the primary episode and recurrence, season, and renal function at recurrence were independent predictors of relapse or re-infection. A score of < 5 correctly identified relapse in 76 of 89 patients (85%), whereas a score > or = 5 correctly identified re-infection in 36 of 52 patients (69%). The scoring index had good discriminative power, with a bootstrap bias-corrected AUC of 0.80 (95%CI: 0.73-0.87).A simple scoring index to predict the cause of recurrent melioidosis has been developed to provide important bedside information where rapid bacterial genotyping is unavailable. |
format |
Article in Journal/Newspaper |
author |
Direk Limmathurotsakul Wipada Chaowagul Narisara Chantratita Vanaporn Wuthiekanun Mayurachat Biaklang Sarinna Tumapa Nicholas J White Nicholas P J Day Sharon J Peacock |
author_facet |
Direk Limmathurotsakul Wipada Chaowagul Narisara Chantratita Vanaporn Wuthiekanun Mayurachat Biaklang Sarinna Tumapa Nicholas J White Nicholas P J Day Sharon J Peacock |
author_sort |
Direk Limmathurotsakul |
title |
A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
title_short |
A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
title_full |
A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
title_fullStr |
A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
title_full_unstemmed |
A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
title_sort |
simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2008 |
url |
https://doi.org/10.1371/journal.pntd.0000327 https://doaj.org/article/adb872046b2f44328ff6a7c38d981bd5 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 2, Iss 10, p e327 (2008) |
op_relation |
http://europepmc.org/articles/PMC2570249?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000327 https://doaj.org/article/adb872046b2f44328ff6a7c38d981bd5 |
op_doi |
https://doi.org/10.1371/journal.pntd.0000327 |
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PLoS Neglected Tropical Diseases |
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2 |
container_issue |
10 |
container_start_page |
e327 |
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1766342495905513472 |