Recurrent Melioidosis in Taiwan, 2004-2012

Chia-Lin Chen, Yu-Mei Liu, Jung-Jung Mu

2014 Vol.30 NO.18

Correspondence Author: Chia-Lin Chen,Yu-Mei Liu, Jung-Jung Mu

  • Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


       Melioidosis is a zoonosis caused by Burkholderia pseudomallei and endemic in Southeast Asia and Northern Australia. Taiwan Centers for Disease Control started the surveillance for melioidosis since 2000, and 363 cases were identified from 2004 to 2013. Despite the standard antimicrobial treatment, recurrent infection occurs. It is the most important complication in survivors, with more than 6% of patients affected who survived the primary episode. Recurrence can be classified into relapse and reinfection by comparing the bacterial genotype of strain pairs isolated during primary and recurrent episodes. In this study, we determined all 20 recurrent cases from 2004 to 2012 in Taiwan as relapse, but not reinfection, by pulsed-field gel electrophoresis. Through analyzing the patient’s background and clinical parameters in relapse cases, alcoholism came out as a risk factor for relapse. Furthermore, according to published studies, the protocol of antimicrobial treatment is an important determinant for relapse. In summary, in order to reduce the relapse rate of melioidosis, standard courses of antibiotic treatment are critical, and the instructions should be reinforced to alcoholic melioidosis patients.

Keywords:melioidosis, recurrence, pulsed-field gel electrophoresis