This is a prospective observational study to evaluate clinical characteristics, current practice and outcomes of adult patients (age ≥18 years) with suspected or confirmed melioidosis.
This is a prospective observational study to evaluate clinical characteristics, current practice and outcomes of adult patients (age ≥18 years) with suspected or confirmed melioidosis. Determination of microbiologically confirmed acute melioidosis among patients presenting with suspected melioidosis, and determination of clinical outcomes of interest (including all-cause mortality, characterization of organ involvement or organ failure, resolution of sepsis, improvement of renal function, rates of suspected vs. microbiologically confirmed melioidosis, and rates of melioidosis involvement of different organ systems) will be performed. Defining clinical and microbiological outcomes in a standardized manner will enable characterization and selection of the relevant outcome measures to be utilized in future clinical studies of IV epetraborole in acute melioidosis. Patients will be identified through daily, active surveillance of hospital admissions at the investigative sites and review of microbiology laboratory culture results. Data will be extracted from hospital and outpatient medical charts. These data will refine the expected treatment effect of standard-of-care antimicrobial therapy and the consequent statistical power calculations needed for sample size and outcome measure design elements of future clinical trials of IV epetraborole adjunctive therapy in hospitalized patients with suspected acute melioidosis. Participation in the study requires written informed consent from the patient or from their next-of-kin (if needed) at the time of screening. On day 28 (+7) and day 90 (+7) after enrolment the study team will contact the participant by phone interview with standardized script if the participant is discharged alive prior to the day 28 or day 90. There will be no clinical specimens collected as part of the study protocol, as this study aims to observe clinical characteristics and outcomes among patients with confirmed and suspected acute melioidosis in current clinical practice.
Study Type
OBSERVATIONAL
Enrollment
200
None, this is a non-interventional trial
Mahosot Hospital
Vientiane, Laos
Srinagarind Hospital
Khon Kaen, Thailand
Sunpasitthiprasong Hospital
Ubon Ratchathani, Thailand
Data Collection of patients in Thailand with "suspected melioidosis"
Describe, prospective data collection, the presenting clinical characteristics of patients hospitalized in Thailand with "suspected melioidosis" to understand the presentation of this disease in a contemporaneous, rigorously studied cohort.
Time frame: 2 years
Data Collection of patients in Thailand with "microbiologically confirmed melioidosis ".
Describe, prospective data collection, the presenting clinical characteristics of patients hospitalized in Thailand with "microbiologically confirmed melioidosis " to understand the presentation of this disease in a contemporaneous, rigorously studied cohort.
Time frame: 2 years
Data Collection of patients in Laos with "suspected melioidosis"
Describe, prospective data collection, the presenting clinical characteristics of patients hospitalized in Laos with "suspected melioidosis" to understand the presentation of this disease in a contemporaneous, rigorously studied cohort.
Time frame: 2 years
Data Collection of patients in Laos with "microbiologically confirmed melioidosis ".
Describe, prospective data collection, the presenting clinical characteristics of patients hospitalized in Laos with "microbiologically confirmed melioidosis " to understand the presentation of this disease in a contemporaneous, rigorously studied cohort.
Time frame: 2 years
Use ± Immunofluorescence Microscopy (IFM) to Determine the percentage of "suspected melioidosis patients" with microbiologically confirmed disease
Use ± IFM to determine the percentage of "suspected melioidosis patients" with microbiologically confirmed disease
Time frame: 2 Years
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Use ± Polymerase Chain Reaction (PCR) to Determine the percentage of "suspected melioidosis patients" with microbiologically confirmed disease
Use ± PCR to determine the percentage of "suspected melioidosis patients" with microbiologically confirmed disease
Time frame: 2 Years
Determine the rates of Burkholderia pseudomallei eradication in patients with microbiologically confirmed acute melioidosis
Determine microbiological eradication patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Determine frequency of specific involvement of organ systems involvement in patients with microbiologically confirmed acute melioidosis
Determine the frequency of specific organ system involvement in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Measure rate to resolution of bacteremia conversion to negative cultures
Microbiological outcomes in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Measure time to resolution of bacteremia conversion to negative cultures
Microbiological outcomes in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Frequency of Liver involvement in patients with microbiologically confirmed acute melioidosis (as diagnosed per standard of care)
Frequency of involvement of organ systems in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Frequency of Skin involvement in patients with microbiologically confirmed acute melioidosis (as diagnosed per standard of care)
Frequency of involvement of organ systems in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Frequency of Lung involvement in patients with microbiologically confirmed acute melioidosis (as diagnosed per standard of care)
Frequency of involvement of organ systems in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Frequency of Spleen involvement in patients with microbiologically confirmed acute melioidosis (as diagnosed per standard of care)
Frequency of involvement of organ systems in patients with microbiologically confirmed acute melioidosis
Time frame: 28 days after enrollment
Time to resolution of sepsis
Time in days to resolution of sepsis in patients with microbiologically confirmed acute melioidosis who receive antimicrobial therapy directed against B. pseudomallei
Time frame: enrollment through day 90
Time to resolution of fever
Time in days to resolution of fever in patients with microbiologically confirmed acute melioidosis who receive antimicrobial therapy directed against B. pseudomallei
Time frame: enrollment through day 90
Time to resolution of hypotension
Time in days to resolution of hypotension in patients with microbiologically confirmed acute melioidosis who receive antimicrobial therapy directed against B. pseudomallei
Time frame: enrollment through day 90
Determine clinical cure rates among patients with of microbiologically confirmed acute melioidosis who are treated with ceftazidime
Percentage of each clinical outcome of microbiologically confirmed acute melioidosis by antimicrobial treatment regimen
Time frame: enrollment through day 90
Determine clinical cure rates among patients with microbiologically confirmed acute melioidosis who are treated with meropenem
Percentage of each clinical outcome of microbiologically confirmed acute melioidosis by antimicrobial treatment regimen
Time frame: enrollment through day 90
Determine clinical cure rates among patients with suspected melioidosis who are treated with an appropriate antibiotic in the subset of patients with no other microbiologically confirmed diagnosis
Percentage of each clinical outcome of "suspected melioidosis patients" to an appropriate antibiotic (ceftazidime or meropenem) in the subset of patients with no other microbiologically confirmed diagnosis (monomicrobial acute melioidosis)
Time frame: enrollment through day 90
Antimicrobial durations of treatment of microbiologically confirmed acute melioidosis
Antimicrobial durations of treatment of microbiologically confirmed acute melioidosis (including parenteral therapy during the initial phase of treatment and oral therapy during the eradication phase)
Time frame: enrollment through day 90