Patricia M. Tauran, Sri Wahyunie, Farahanna Saad, Andaru Dahesihdewi, Mahrany Graciella, Munawir Muhammad, Delly Chipta Lestari, Aryati Aryati, Ida Parwati, Tonny Loho, Dewi Indah Noviana Pratiwi, Vivi Keumala Mutiawati, Ricke Loesnihari, Dewi Anggraini, Siwipeni Irmawanti Rahayu, Wahyu Nawang Wulan, Ungke Antonjaya, David A.B. Dance, Bart J. Currie, Direk Limmathuthurotsakul, Mansyur Arif, Abu Tholib Aman, Ni Nyoman Sri Budayanti, Diah Iskandriati
A recent modeling study estimated that there could be as many as 20,000 human melioidosis cases per year in Indonesia, with around 10,000 potential deaths annually. Nonetheless, the true burden of melioidosis in Indonesia is still unknown. The Indonesia Melioidosis Network was formed during the first melioidosis workshop in 2017. Here, we reviewed 101 melioidosis cases (99 human and two animal cases) previously reported and described an additional 45 human melioidosis cases. All 146 culture-confirmed cases were found in Sumatra (n = 15), Java (n = 104), Kalimantan (n = 15), Sulawesi (n = 11) and Nusa Tenggara (n = 1). Misidentification of Burkholderia pseudomallei was not uncommon, and most cases were only recently identified. We also evaluated clinical manifestations and outcome of recent culture-confirmed cases between 2012 and 2017 (n = 42). Overall, 15 (36%) cases were children (age <15 years) and 27 (64%) were adults (age ≥15 years). The overall mortality was 43% (18/42). We conducted a survey and found that 57% (327/548) of healthcare workers had never heard of melioidosis. In conclusion, melioidosis is endemic throughout Indonesia and associated with high mortality. We propose that top priorities are increasing awareness of melioidosis amongst all healthcare workers, increasing the use of bacterial culture, and ensuring accurate identification of B. pseudomalleiand diagnosis of melioidosis. © 2018 by the authors.
Department of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin/Dr. Wahidin Sudirohusodo Hospital, Makassar, 90245, Indonesia; Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, 10560, Indonesia; Laboratory of Clinical Pathology, Abdul Wahab Sjahranie Hospital, Samarinda, 75123, Indonesia; Laboratory of Clinical Pathology, Tarakan Hospital, Jakarta, 10150, Indonesia; Department of Clinical Pathology, Faculty of Medicine, Universitas GadjahMada, Sardjito Hospital, Yogyakarta, 55281, Indonesia; Laboratory of Clinical Pathology, WZ Johannes Hospital, Kupang, 85112, Indonesia; Department of Microbiology, Faculty of Medicine, Universitas Hasanuddin/Hasanuddin University Hospital, Makassar, 90245, Indonesia; Department of Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, 10430, Indonesia; Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo Hospital, Surabaya, 60286, Indonesia; Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital, Bandung, 40161, Indonesia; Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, 10430, Indonesia; Department of Clinical Pathology, Faculty of Medicine, Universitas Lambung Mangkurat, Ulin Hospital, Banjarmasin, 70233, Indonesia; Laboratory of Clinical Pathology, Dr. Zainoel Abidin Hospital, Banda Aceh, 24415, Indonesia; Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik Hospital, North Sumatera, 20136, Indonesia; Laboratory of Microbiology, Eka Hospital, Pekanbaru, 28293, Indonesia; Department of Microbiology, Faculty of Medicine, Universitas Brawijaya/Saiful Anwar Hospital, Malang, 65112, Indonesia; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, OX3 7FZ, United Kingdom; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom; Tropical and Emerging Infectious Diseases Division, Menzies School of Health Research, Casuarina, 0811, NT, Australia; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand; Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta, 55281, Indonesia; Department of Microbiology, Faculty of Medicine, Universitas Udayana/Sanglah Hospital, Bali, 80113, Indonesia; Primate Research Center, Bogor Agricultural University, Bogor, 16151, Indonesia
