An observational study of sepsis in takeo province cambodia: An in-depth examination of pathogens causing severe infections

Michelle Rozo, Kevin L. Schully, Casandra Philipson, Amitha Fitkariwala, Dararith Nhim, Tin Som, Darith Sieng, Bora Huot, Sokha Dul, Michael J. Gregory, Vireak Heang, Andrew Vaughn, Te Vantha, Angela M. Prouty, Chien Chung Chao, Zhiwen Zhang, Tatyana Belinskaya, Logan J. Voegtly, Regina Z. Cer, Kimberly A. Bishop-LillyChris Duplessis, James V. Lawler, Danielle V. Clark

Research output: Contribution to journalArticle

Abstract

The world’s most consequential pathogens occur in regions with the fewest diagnostic resources, leaving the true burden of these diseases largely under-represented. During a prospective observational study of sepsis in Takeo Province Cambodia, we enrolled 200 patients over an 18-month period. By coupling traditional diagnostic methods such as cul-ture, serology, and PCR to Next Generation Sequencing (NGS) and advanced statistical analyses, we successfully identified a pathogenic cause in 46.5% of our cohort. In all, we detected 25 infectious agents in 93 patients, including severe threat pathogens such as Bur-kholderia pseudomallei and viral pathogens such as Dengue virus. Approximately half of our cohort remained undiagnosed; however, an independent panel of clinical adjudicators determined that 81% of those patients had infectious causes of their hospitalization, further underscoring the difficulty of diagnosing severe infections in resource-limited settings. We garnered greater insight as to the clinical features of severe infection in Cambodia through analysis of a robust set of clinical data.

Original languageEnglish (US)
Article numbere0008381
Pages (from-to)1-23
Number of pages23
JournalPLoS neglected tropical diseases
Volume14
Issue number8
DOIs
StatePublished - Aug 2020

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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