Rapid diagnostics for melioidosis: a comparative study of a novel lateral flow antigen detection assay

Robertson, Gemma; Sorenson, Alanna E.; Govan, Brenda; Ketheesan, Natkunam; Houghton, Raymond L.; Chen, Hongjing; AuCoin, David P.; Dillon, Michael J.; Norton, Robert

doi:10.1099/jmm.0.000098

Cited by 40 publications

(42 citation statements)

References 16 publications

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“…A lateral flow antigen detection assay has been developed as a rapid diagnostic tool, which is proving to be useful as an adjunct to the diagnosis of melioidosis, however, it is not yet routinely available [ 68 ]. Polymerase chain reaction is available in some areas to confirm bacterial isolates from clinical specimens, but is not sensitive or specific enough for routine use directly on clinical samples [ 69 , 70 , 71 ].…”

Section: Diagnosismentioning

confidence: 99%

Melioidosis: An Australian Perspective

2018

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Burkholderia pseudomallei is endemic in northern Australia, with cases of melioidosis most commonly occurring during the wet season in individuals with diabetes, hazardous alcohol use, and chronic kidney disease. Pneumonia is the most common presentation and the majority of patients are bacteraemic—however, infection may involve almost any organ, with the skin and soft tissues, genitourinary system, visceral organs, and bone and joints affected most commonly. Central nervous system involvement is rarer, but has a high attributable mortality. Increased awareness of the disease amongst healthcare providers, ready access to appropriate antibiotic therapy and high-quality intensive care services has resulted in a sharp decline in the case fatality rate over the last 20 years. Further improvement in clinical outcomes will require a greater understanding of the disease′s pathophysiology, its optimal management, and more effective strategies for its prevention.

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Section: Diagnosismentioning

confidence: 99%

Melioidosis: An Australian Perspective

2018

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“…Attempts to detect B. pseudomallei directly in blood by IFA or latex agglutination were unsuccessful; however, these methods were useful if the bacteria in hemoculture were enriched by incubation for 1 or 2 days ( 20 , 21 ). A lateral flow immunoassay (LFI) for the detection of the B. pseudomallei 6-deoxyheptan capsular polysaccharide (CPS) antigen has been developed and shown to be highly specific but had low sensitivity (40%) when used with whole-blood specimens ( 22 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

Development of Rapid Enzyme-Linked Immunosorbent Assays for Detection of Antibodies to Burkholderia pseudomallei

et al. 2016

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Burkholderia pseudomallei, the causative agent of melioidosis, is an environmental bacillus found in northeast Thailand. The mortality rate of melioidosis is ∼40%. An indirect hemagglutination assay (IHA) is used as a reference serodiagnostic test; however, it has low specificity in areas where the background seropositivity of healthy people is high. To improve assay specificity and reduce the time for diagnosis, four rapid enzyme-linked immunosorbent assays (ELISAs) were developed using two purified polysaccharide antigens (O-polysaccharide [OPS] and 6-deoxyheptan capsular polysaccharide [CPS]) and two crude antigens (whole-cell [WC] antigen and culture filtrate [CF] antigen) of B. pseudomallei. The ELISAs were evaluated using serum samples from 141 culture-confirmed melioidosis patients from Thailand along with 188 healthy donors from Thailand and 90 healthy donors from the United States as controls. The areas under receiver operator characteristic curves (AUROCC) using Thai controls were high for the OPS-ELISA (0.91), CF-ELISA (0.91), and WC-ELISA (0.90), while those of CPS-ELISA (0.84) and IHA (0.72) were lower. AUROCC values using U.S. controls were comparable to those of the Thai controls for all ELISAs except IHA (0.93). Using a cutoff optical density (OD) of 0.87, the OPS-ELISA had a sensitivity of 71.6% and a specificity of 95.7% for Thai controls; for U.S. controls, specificity was 96.7%. An additional 120 serum samples from tuberculosis, scrub typhus, or leptospirosis patients were evaluated in all ELISAs and resulted in comparable or higher specificities than using Thai healthy donors. Our findings suggest that antigen-specific ELISAs, particularly the OPS-ELISA, may be useful for serodiagnosis of melioidosis in areas where it is endemic and nonendemic.

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“…Hence, a rapid and accurate point of care diagnostic assay is a prime requisite. The advent of AMD LFA has brought a new avenue for early detection of B. pseudomallei antigen directly from the patient’s sample 14. The test can be helpful for presumptive diagnosis of the disease and institution of an early specific therapy.…”

Section: Discussionmentioning

confidence: 99%

Melioidosis: the great mimicker presenting as spondylodiscitis

et al. 2018

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Melioidosis, a syndrome with protean clinical manifestations, is caused by Gram-negative soil saprophyte Among its diverse clinical presentations, the involvement of spine is a rare phenomenon and can mimic tuberculosis on presentation. A 65-year-old female with a known case of diabetes presented with fever with lower back pain. Blood culture grew, and as per sensitivity report, clindamycin and cefazolin were started. X-ray and MRI lumbosacral spine showed spondylodiscitis (likely Koch's). Decompression and biopsy were done, and a sample was sent for microbiological investigations that showed no growth of any significant pathogen; furthermore, all tests for tuberculosis diagnosis also remained negative. Active Melioidosis Detect Lateral Flow Assay was used on the tissue sample, which was positive for Capsular Polysaccharide (CPS) antigen; the case was confirmed by typethree secretion system 1 PCR for melioidosis. Antibiotics were changed to parenteral ceftazidime for 2 weeks followed by oral cotrimoxazole. A dedicated team of microbiologists and physicians is required to identify and treat the disease.

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Rapid diagnostics for melioidosis: a comparative study of a novel lateral flow antigen detection assay

Cited by 40 publications

References 16 publications

Melioidosis: An Australian Perspective

Melioidosis: An Australian Perspective

Development of Rapid Enzyme-Linked Immunosorbent Assays for Detection of Antibodies to Burkholderia pseudomallei

Melioidosis: the great mimicker presenting as spondylodiscitis

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