Risk factors for melioidosis and bacteremic melioidosis

A case-control study was conducted in four hospitals in northeastern Thaila nd to identify risk factors for melioidosis and bacteremic melioidosis. Cas es were patients with culture-proven melioidosis, and there were two types of controls (those with infections, i.e., with community-acquired septicemi a caused by other bacteria, and those without infection, i.e., randomly sel ected patients admitted with noninfectious diseases to the same hospitals). Demographic data, clinical presentations, and suspected risk factors were analyzed. Diabetes mellitus, preexisting renal diseases, thalassemia, and o ccupational exposure, classified by the soil and water risk assessment, wer e confirmed to be significant risk factors for melioidosis and bacteremic m elioidosis. Only diabetes mellitus was a significant factor associated with bacteremic melioidosis, as compared with nonbacteremia. A significant inte raction was found between diabetes mellitus and occupational exposure. Thus , diabetic rice farmers would be the most appropriate population group for targeted control measures such as vaccination in the future.