Exploring patient characteristics and respiratory impacts of pulmonary melioidosis: A 5-year experience from endemic region of Thailand
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVE: Pulmonary melioidosis, caused by Burkholderia pseudomallei, emerges as the most prevalent and highly fatal manifestation of melioidosis. Despite being a global health concern, pulmonary melioidosis remains insufficiently studied and reported. RESEARCH QUESTION: Whether patients with pulmonary melioidosis have any potential characteristics or specific risk factors that are associated with their respiratory outcome's trajectory. METHODS: A 5-year retrospective cohort study was conducted. Electronic medical records of patients admitted for Burkholderia pseudomallei pneumonia between January 1, 2019 and December 31, 2023, at Chaophraya Abhaibhubejhr hospital, Prachinburi, Thailand were reviewed. RESULTS: Of 1,486 adults admitted with bacterial pneumonia, 36 patients (2.4%) were diagnosed with microbiologically confirmed pulmonary melioidosis. Thirty of 36 patients (83.3%) developed acute respiratory failure requiring mechanical ventilation within 24 hours after admission. Twenty-three of 36 (63.9%) met the 2024 global definition of acute respiratory distress syndrome (ARDS) with 78% being moderate-to-severe ARDS. Pulmonary melioidosis with ARDS was associated with excessive alcohol consumption (p = 0.013) and body mass index (BMI) < 20 Kg/m2 (odds ratio of 6, 95%CI 1.080-33.321, p = 0.041) when compared to non-ARDS. BMI < 20 Kg/m2 was also associated with ARDS development, independent of age (odds ratio of 29.27 (95%CI 1.849 - 463.678, p = 0.017). The overall mortality rate of pulmonary melioidosis was 55.6%, with no differences between patients with ARDS and non-ARDS (65.2% vs 38.5%, respectively; p = 0.169). CONCLUSION: ARDS frequently emerges in patients with pulmonary melioidosis requiring invasive mechanical ventilation and intensive care support. Excessive alcohol consumption and a low BMI status were associated with the development of ARDS in these patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".