Newly detected pediatric melioidosis cases in a single referral children’s hospital in Ho Chi Minh City indicate the probable under-recognition of melioidosis in South Vietnam

Abstract

Abstract Purpose.The epidemiology of melioidosis in Vietnam, a disease caused by the soil bacterium Burkholderia pseudomallei, remains unclear. This study aimed to detect pediatric melioidosis in South Vietnam and describe clinical features and the geographical distribution. Methods. We introduced a simple laboratory algorithm for detecting B. pseudomallei from clinical samples at Children’s Hospital 2 in Ho Chi Minh City in July 2015. B. pseudomallei culture isolates were confirmed by molecular methods. A retrospective observational study of children aged < 16 years with culture-confirmed melioidosis between July 2015 and August 2019 was undertaken. Results.Thirty-five pediatric cases of melioidosis were detected, with cases originating from 13 out of 32 provinces and cities in South Vietnam. The number of pediatric melioidosis cases detected from a certain region correlated with the overall number of inpatients originating from the respective geographical area. Suppurative parotitis (n = 15; 42.8 %) was the most common clinical presentation, followed by lung infection (n = 10; 28.6 %) and septicemia (n = 7; 20 %). Fourteen (40 %) children had disseminated disease, including all cases of lung infection. Four (11.4 %) deaths occurred in the disseminated disease group. Conclusions. We report here the first series of pediatric cases of melioidosis from Vietnam detected in a single big referral children’s hospital in Ho Chi Minh City. The patients’ origin indicates a wide distribution of melioidosis in South Vietnam. It seems probably that cases not only in children but also in adults remain grossly undiagnosed. Further awareness raising and laboratory capacity strengthening are needed in this part of the country.