Clinical and Laboratory Characteristics of Dengue Patients with Bacteria Co-infection in Hospital Serdang in 2016

Lo, Janet Lo Zhen Lin (2020) Clinical and Laboratory Characteristics of Dengue Patients with Bacteria Co-infection in Hospital Serdang in 2016. [Project Paper] (Submitted)

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Abstract

Dengue is one of the most common human arboviral diseases in tropical and sub-tropical countries globally. The clinical course of dengue fever can be affected by bacterial co-infection, resulting in atypical dengue manifestations. Furthermore, the clinical presentations of dengue and some bacterial infections are overlapping. As a result, bacteria co-infections can be easily overlooked among dengue cases. Objectives: The aim of this study is to analyze and differentiate the clinical and laboratory parameters between dengue and dengue bacterial co-infection. The clinical and laboratory parameters will be also identified and compared between leptospiral co-infection and other bacterial-coinfected dengue patients. Hypothesis: There is a significant difference in the clinical and laboratory parameters between dengue and dengue bacterial co-infection group. There are also significant differences in the clinical and laboratory parameters between leptospiral-coinfected and other bacterial-coinfected dengue patients. Methodology: This is a retrospective study conducted in Hospital Serdang that only involves data collection. All the data were retrieved from the hospital database. Statistical analysis was performed by using the SPSS software. Categorical data, continuous parametric data and non-parametric data were analyzed by using Chi-square test, Student’s t-test and Mann-Whitney U test respectively. Binary logistic regression analysis was further carried out to identify clinical predictors of dengue with bacteria co-infection and leptospiral co-infection. A p-value of less than 0.05 (p < 0.05) is considered as statistically significant. Results: The total sample size of dengue patients is 1,730. There are 72 and 26 cases of dengue with bacteria co-infection and dengue with leptospiral-coinfection respectively. The presence of warning signs, severe dengue, severe leakage and prolonged fever are less likely to be associated with dengue bacteria coinfection (OR < 1). Elevated creatine kinase (CK) levels may be predictive factors of dengue with bacteria co-infection. High C-reactive protein (CRP) level is less likely to be associated with leptospiral co-infection. Discussion: Bacteria co-infected dengue patients are prone to be critically ill with compensated shock and warning sign of haemoconcentration. Some studies observed prolonged fever in Salmonella co-infection and elevated CRP levels in leptospirosis co-infection but these contradicted our results. Studies reported high CK level detected in dengue with Staphylococcus aureus pneumonia co-infection. Conclusion: Discrimination between dengue and dengue with bacteria co-infection a crucial for accurate diagnosis and empirical antibiotics prescription.

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Ms. Nor Safa'aton Saidin
Date Deposited:	23 Aug 2023 00:33
Last Modified:	23 Aug 2023 00:33
URI:	http://psaspb.upm.edu.my/id/eprint/1331

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