Enhanced melioidosis surveillance in patients attending four tertiary hospitals in Yangon, Myanmar

Mo Mo Win, Kyi Kyi Nyein Win, Thin Thin Wah, Su Nyein Aye, Tin Tin Htwe, Khwar Nyo Zin, Myint Thazin Aung, Wah Wah Aung, Elizabeth A. Ashley, Frank Smithuis, Vanessa Rigas, Bart J. Currie, Mark Mayo, Jessica R. Webb, Clare L. Ling, Zaw Than Htun, David A.B. Dance

Research output: Contribution to journalArticlepeer-review

Abstract

In order to investigate the current epidemiology of melioidosis in Yangon, Myanmar, between June 2017 and May 2019 we conducted enhanced surveillance for melioidosis in four tertiary hospitals in Yangon, where the disease was first discovered in 1911. Oxidase-positive Gram negative rods were obtained from the microbiology laboratories and further analyzed at the Department of Medical Research. Analysis included culture on Ashdown agar, the three disc sensitivity test (gentamicin, colistin and co-amoxiclav), latex agglutination, API 20 NE, antibiotic susceptibility testing, and a subset underwent molecular confirmation with a Burkholderia pseudomallei-specific assay. Twenty one of 364 isolates (5.7%) were confirmed as B. pseudomallei and were mostly susceptible to the antibiotics used in standard therapy for melioidosis. Ten patients were from Yangon Region, nine were from Ayeyarwaddy region, and one each was from Kayin and Rakhine States. A history of soil contact was given by seven patients, five had diabetes mellitus and one had renal insufficiency. The patients presented with septicaemia (twelve cases), pneumonia (three cases), urinary tract infection (two cases) and wound infection (four cases). Eighteen patients survived to hospital discharge. This study highlights the likelihood that melioidosis may be far more common, but underdiagnosed, in more rural parts of Myanmar as in other countries in SE Asia.

Original languageEnglish
Article numberE154
Number of pages6
JournalEpidemiology and Infection
Volume149
Early online dateJun 2021
DOIs
Publication statusE-pub ahead of print - Jun 2021

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