Investigation of Melioidosis Using Blood Culture and Indirect Hemagglutination Assay Serology among Patients with Fever, Northern Tanzania

Maze, Michael J.; Elrod, Mindy G.; Biggs, Holly M.; Bonnewell, John; Carugati, Manuela; Hoffmaster, Alex R.; Lwezaula, Bingileki F.; Madut, Deng B.; Maro, Venance P.; Mmbaga, Blandina T.; Morrissey, Anne B.; Saganda, Wilbrod; Sakasaka, Philoteus; Rubach, Matthew P.; Crump, John A.

doi:10.4269/ajtmh.20-0160

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…Currently, melioidosis is diagnosed by a culture technique, which could be performed either by culturing the specimens (e.g., blood, urine, pus) directly on selective media such as Ashdown's agar or by growing bacteria using a hemoculture bottle followed by identification with selective media or other techniques [10,35,36]. Thus, we first tested the selected LFIAs with a normal serum.…”

Section: Discussionmentioning

confidence: 99%

Development of an Antigen Capture Lateral Flow Immunoassay for the Detection of Burkholderia pseudomallei

Nualnoi,

Wongwitwichot,

Kaewmanee

et al. 2024

Diagnostics

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Early diagnosis is essential for the successful management of Burkholderia pseudomallei infection, but it cannot be achieved by the current gold standard culture technique. Therefore, this study aimed to develop a lateral flow immunoassay (LFIA) targeting B. pseudomallei capsular polysaccharide. The development was performed by varying nitrocellulose membrane reaction pads and chase buffers. The prototype LFIA is composed of Unisart CN95 and chase buffer containing tris-base, casein, and Surfactant 10G. The assay showed no cross-reactivity with E. coli, S. aureus, P. aeruginosa, and P. acne. The limit of detections (LODs) of the prototype LFIA was 107 and 106 CFU/mL B. pseudomallei in hemoculture medium and artificial urine, respectively. These LODs suggest that this prototype can detect melioidosis from positive hemoculture bottles but not straight from urine. Additionally, these LODs are still inferior compared to Active Melioidosis Detect (AMDTM). Overall, this prototype holds the potential to be used clinically with hemoculture bottles. However, further improvements should be considered, especially for use with urine samples.

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Section: Discussionmentioning

confidence: 99%

Development of an Antigen Capture Lateral Flow Immunoassay for the Detection of Burkholderia pseudomallei

Nualnoi,

Wongwitwichot,

Kaewmanee

et al. 2024

Diagnostics

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show abstract

“…37 Estimated sensitivity of blood culture for melioidosis is approximately 60%. 38 A direct polymerase chain reaction (PCR), even though a quicker diagnostic method, has not been sufficiently specific or sensitive especially when performed in blood. 4,39 Indirect hemagglutination assay (IHA) is the serological test mainly used for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Double-trouble: A rare case of co-infection with melioidosis and leptospirosis from Sri Lanka

Gunasena

Silva

2023

Trop Doct

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Melioidosis and leptospirosis are two emerging tropical infections that share somewhat similar clinical manifestations but require different methods of management. A 59-year-old farmer presented to a tertiary care hospital with an acute febrile illness associated with arthralgia, myalgia and jaundice, complicated by oliguric acute kidney injury and pulmonary haemorrhage. Treatment was initiated for complicated leptospirosis but with poor response. Blood culture was positive for Burkholderia pseudomallei and microscopic agglutination test (MAT) for leptospirosis was positive at the highest titres of 1:2560, confirming a co-infection of leptospirosis and melioidosis. The patient made a complete recovery with therapeutic plasma exchange (TPE), intermittent haemodialysis and intravenous (IV) antibiotics. Similar environmental conditions harbour melioidosis and leptospirosis, making co-infection a very real possibility. Co-infection should be suspected in patients from endemic areas with water and soil exposure. Using two antibiotics to cover both pathogens effectively is prudent. IV penicillin with IV ceftazidime is one such effective combination.

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“…A study implemented in Tanzania examined the relationship between bacterial culture proven cases and reciprocal antibody titer of IHA. It recommended that the appropriate cut-off point for IHA was 1:40 30 .…”

Section: Discussionmentioning

confidence: 99%

Clinical information associated with bacterial culture proven Burkholderia pseudomallei among melioiodosis patients in Buriram province

Darasawang¹

2023

J Public Hlth Dev

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Indirect hemagglutination assay (IHA) is a general rapid diagnosis procedure in melioidosis patients combined with clinical information. The Burkholderia pseudomallei culture technique requires prolonged time before getting culture results. Related factors of bacterial culture proven melioidosis and the appropriate cut-off point for IHA are unfashionable and need to be updated. A cross-sectional study was conducted among melioidosis patients using data reported in the medical records. Univariable analysis was performed by Chi-square test and Student T-test as appropriate. Multivariable logistic regression was finally used to identify the contributing factors to bacterial culture proven cases. The results were shown as adjusted odds ratio (AdjOR) and 95%CI. Validity domains, sensitivity, specificity, predictive values, and likelihood ratios at each cut-off point for IHA were demonstrated. The results revealed that after adjustment for abdominal pain symptoms, diabetes mellitus (DM)(p-value < 0.001) and dyspnea symptoms (p-value = 0.025) were the associated factors of bacterial culture proven cases. The IHA titer > 1: 10240 provided the highest positive and negative predictive values, 30% and 69% respectively. Both positive and negative likelihood ratios of this cut-off point were also accounted for as 0.95 and 1.003, respectively. Health personnel should perform melioidosis diagnosis by the use of clinical information and an appropriate cut-off point for IHA, especially in diabetic patients who have dyspnea.

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Investigation of Melioidosis Using Blood Culture and Indirect Hemagglutination Assay Serology among Patients with Fever, Northern Tanzania

Abstract: Prediction models indicate that melioidosis may be common in parts of East Africa, but there are few empiric data. We evaluated the prevalence of melioidosis among patients presenting with fever to hospitals in Tanzania. Patients with fever were enrolled at two referral hospitals in

Cited by 4 publications

References 28 publications

Development of an Antigen Capture Lateral Flow Immunoassay for the Detection of Burkholderia pseudomallei

Development of an Antigen Capture Lateral Flow Immunoassay for the Detection of Burkholderia pseudomallei

Double-trouble: A rare case of co-infection with melioidosis and leptospirosis from Sri Lanka

Clinical information associated with bacterial culture proven Burkholderia pseudomallei among melioiodosis patients in Buriram province

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