Platelet Dynamics as Predictors of Clinical Outcomes in Melioidosis Patients – A Retrospective Study

Background: Burkholderia pseudomallei is the causative agent of melioidosis, a potentially fatal illness that is native to Northern Australia and Southeast Asia. Thrombocytopenia may indicate the severity of the disease and has been commonly seen in melioidosis. The predictive significance of platelet dynamics—trends in platelet count over time as indicators of clinical outcomes in melioidosis patients is investigated in this study. Methods: 35 adult patients with culture-confirmed melioidosis who were admitted between January 2019 and December 2023 were the subject of a retrospective investigation. Upon admission, platelet counts were taken, and they were tracked throughout the hospital stay. Clinical outcomes were used to categorise patients into survivors and non-survivors. The groups were compared in terms of platelet dynamics, such as nadir count, rate of change, and recovery tendencies. Results: Among the 35 patients (mean age 52.4 years; 68.6% male), 12 (34.3%) died during hospitalization. Thrombocytopenia (platelet count <150,000/μL) was observed in 80% of patients at some point during admission. Non-survivors exhibited significantly lower nadir platelet counts (mean 48,000/μL vs 132,000/μL, p < 0.01), and a delayed or absent platelet recovery trend. A declining platelet trajectory in the first 72 hours was significantly associated with mortality (p < 0.05). Multivariate analysis identified nadir platelet count and failure of platelet recovery by day 5 as independent predictors of mortality. Conclusion: Negative outcomes in melioidosis are significantly predicted by platelet dynamics, especially early thrombocytopenia and lack of count recovery. To direct early intervention measures, continuous platelet monitoring might be a useful, affordable prognostic tool.