Open AccessAn Observational Study of Sepsis in Takeo Province Cambodia: An in-depth examination of pathogens causing severe infections
Author(s) -
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,
Vantha Te,
Angela M. Prouty,
ChienChung Chao,
Zhiwen Zhang,
Tatyana Belinskaya,
Logan J. Voegtly,
Regina Z. Cer,
Kimberly A. BishopLilly,
Chris Duplessis,
James V. Lawler,
Danielle V. Clark
Publication year - 2020
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0008381
Subject(s) - medicine , observational study , dengue fever , cohort , serology , cohort study , intensive care medicine , sepsis , pediatrics , immunology , antibody
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 culture, 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 Burkholderia 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.