ArticlePLoS neglected tropical diseases2008
A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis.
Article in PLoS neglected tropical diseases, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 32 citations in OpenAlex.
- A Comparison Between 12 Versus 20 Weeks of Trimethoprim-sulfamethoxazole as Oral Eradication Treatment for Melioidosis: An Open-label, Pragmatic, Multicenter, Non-inferiority, Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Comparative genomic analysis of paired clinical isolates from a patient with recurrent melioidosis reveals a low within-host mutation rate.Journal of medical microbiology · 2025Article
- d-Methionine-induced DNases disperse establishedBiofilm · 2024Article
- A molecular epidemiological analysis of Burkholderia pseudomallei in southern Thailand.PLoS neglected tropical diseases · 2024Article
- Epidemiology and genetic diversity of Burkholderia pseudomallei from Riau Province, Indonesia.PLoS neglected tropical diseases · 2024Article
- Marmosets as models of infectious diseases.Frontiers in cellular and infection microbiology · 2024Review
- Characteristics and One Year Outcomes of Melioidosis Patients in Northeastern Thailand: A Prospective, Multicenter Cohort Study.The Lancet regional health. Southeast Asia · 2023Article
- DNase I and chitosan enhance efficacy of ceftazidime to eradicate Burkholderia pseudomallei biofilm cells.Scientific reports · 2023Article
- Efficacy of Co-Trimoxazole against Experimental Melioidosis Acquired by Different Routes of Infection.Antimicrobial agents and chemotherapy · 2022Article
- Hijacking of the Host's Immune Surveillance Radars byFrontiers in immunology · 2021Review
- Human Melioidosis.Clinical microbiology reviews · 2020Review
- The Impact of Age and Sex on Mouse Models of Melioidosis.Pathogens (Basel, Switzerland) · 2020Article
- What Can Go Wrong When Applying Immune Modulation Therapies to Target Persistent Bacterial Infections.Journal of cellular immunology · 2020Article
- A MarR family transcriptional regulator and subinhibitory antibiotics regulate type VI secretion gene clusters in Burkholderia pseudomallei.Microbiology (Reading, England) · 2018Article
- Melioidosis.Nature reviews. Disease primers · 2018Review
- Role of Burkholderia pseudomallei biofilm formation and lipopolysaccharide in relapse of melioidosis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2014Article
- Recurrent melioidosis in the Darwin Prospective Melioidosis Study: improving therapies mean that relapse cases are now rare.Journal of clinical microbiology · 2014Article
- Within-host evolution of Burkholderia pseudomallei over a twelve-year chronic carriage infection.mBio · 2013Article
- Melioidosis with a Pericardial Effusion, which Relapsed as a Chest Wall Abscess: A Rare Presentation.Journal of clinical and diagnostic research : JCDR · 2013Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMelioidosis 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.
methodsIn 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.
findingsDuration 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).
conclusionsA simple scoring index to predict the cause of recurrent melioidosis has been developed to provide important bedside information where rapid bacterial genotyping is unavailable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.