Volume 74, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Melioidosis is caused by the saprophytic organism . The use of the indirect hemagglutination assay (IHA) has found widespread use in areas endemic for this disease. Using this assay, we explored the serologic profile of 275 patients with culture-confirmed melioidosis in the Northern Territory of Australia. Based on a threshold titer of 1:40, the sensitivity of the IHA on admission was 56%. Female patients, those with positive blood cultures, and those with pneumonia independently predicted a negative IHA result. Most patients (68%) with negative admission IHA titers subsequently seroconverted. Most patients (92%) with positive admission IHA titers had persistently positive IHA titers. Relapses were not observed in 36 patients who had a negative IHA at least 1 month after admission, irrespective of initial admission IHA. The IHA has limited utility as a diagnostic test for acute disease, and most patients subsequently have persistently positive titers after recovery from illness.


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  1. White NJ, 2003. Melioidosis. Lancet 361 : 1715–1722.
  2. Currie BJ, Fisher DA, Howard DM, Burrow JN, Selvanayagam S, Snelling PL, Anstey NM, Mayo MJ, 2000. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop 74 : 121–127.
  3. Suputtamongkol Y, Hall AJ, Dance DA, Chaowagul W, Rajchanuvong A, Smith MD, White NJ, 1994. The epidemiology of melioidosis in Ubon Ratchatani, northeast Thailand. Int J Epidemiol 23 : 1082–1090.
  4. Currie BJ, Fisher DA, Howard DM, Burrow JN, Lo D, Selva-Nayagam S, Anstey NM, Huffam SE, Snelling PL, Marks PJ, Stephens DP, Lum GD, Jacups SP, Krause VL, 2000. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 31 : 981–986.
  5. Ashdown LR, Guard RW, 1984. The prevalence of human melioidosis in northern Queensland. Am J Trop Med Hyg 33 : 474–478.
  6. Kanaphun P, Thirawattanasuk N, Suputtamongkol Y, Naigowit P, Dance DA, Smith MD, White NJ, 1993. Serology and carriage of Pseudomonas pseudomallei: a prospective study in 1000 hospitalized children in northeast Thailand. J Infect Dis 167 : 230–233.
  7. O’Brien M, Freeman K, Lum G, Cheng AC, Jacups SP, Currie BJ, 2004. Further evaluation of a rapid diagnostic test for melioidosis in an area of endemicity. J Clin Microbiol 42 : 2239–2240.
  8. Charuchaimontri C, Suputtamongkol Y, Nilakul C, Chaowagul W, Chetchotisakd P, Lertpatanasuwun N, Intaranongpai S, Brett PJ, Woods DE, 1999. Antilipopolysaccharide II: an antibody protective against fatal melioidosis. Clin Infect Dis 29 : 813–818.
  9. Jones SM, Ellis JF, Russell P, Griffin KF, Oyston PC, 2002. Passive protection against Burkholderia pseudomallei infection in mice by monoclonal antibodies against capsular polysaccharide, lipopolysaccharide or proteins. J Med Microbiol 51 : 1055–1062.
  10. Ketheesan N, Barnes JL, Ulett GC, van Gessel HJ, Norton RE, Hirst RG, LaBrooy JT, 2002. Demonstration of a cell-mediated immune response in melioidosis. J Infect Dis 186 : 286–289.
  11. Dharakul T, Songsivilai S, Anuntagool N, Chaowagul W, Wongbunnate S, Intachote P, Sirisinha S, 1997. Diagnostic value of an antibody enzyme-linked immunosorbent assay using affinity-purified antigen in an area endemic for melioidosis. Am J Trop Med Hyg 56 : 418–423.
  12. Appassakij H, Silpapojakul KR, Wansit R, Pornpatkul M, 1990. Diagnostic value of the indirect hemagglutination test for melioidosis in an endemic area. Am J Trop Med Hyg 42 : 248–253.
  13. Sermswan RW, Wongratanacheewin S, Anuntagool N, Sirisinha S, 2000. Comparison of the polymerase chain reaction and serologic tests for diagnosis of septicemic melioidosis. Am J Trop Med Hyg 63 : 146–149.
  14. Wuthiekanun V, Amornchai P, Chierakul W, Cheng AC, White NJ, Peacock SJ, Day NP, 2004. Evaluation of immunoglobulin M (IgM) and IgG rapid cassette test kits for diagnosis of melioidosis in an area of endemicity. J Clin Microbiol 42 : 3435–3437.
  15. Alexander AD, Huxsoll DL, Warner ARJ, Shepler V, Dorsey A, 1970. Serological diagnosis of human melioidosis with indirect hemagglutination and complement fixation tests. Appl Microbiol 20 : 825–833.
  16. Ashdown LR, Johnson RW, Koehler JM, Cooney CA, 1989. Enzyme-linked immunosorbent assay for the diagnosis of clinical and subclinical melioidosis. J Infect Dis 160 : 253–260.
  17. Currie BJ, Fisher DA, Anstey NM, Jacups SP, 2000. Melioidosis: acute and chronic disease, relapse and re-activation. Trans R Soc Trop Med Hyg 94 : 301–304.
  18. ACCP/SCCM, 1992. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20 : 864–874.
  19. Ileri S, 1965. The indirect haemagglutination tests in the diagnosis of melioidosis in goats. Br Vet J 121 : 164–170.
  20. Naigowit P, Petchkanchanapong W, Mannebungyung W, Vetchsprsit N, Chaeosil D, 1989. Indirect hemagglutination test for the diagnosis of melioidosis. Bull Fac Med Tech Mahidol U 13 : 17–25.
  21. Tiyawisutsri R, Peacock SJ, Langa S, Limmathurotsakul D, Cheng AC, Chierakul W, Chaowagul W, Day NP, Wuthickanun V, 2005. Antibodies from patients with melioidosis recognize Burkholderia mallei but not Burkholderia thailandensis antigens in the indirect hemagglutination Assay. J Clin Microbiol 43 : 4872–4874.
  22. Ashdown LR, 1987. Indirect haemagglutination test for melioidosis. Med J Aust 147 : 364–365.
  23. Chenthamarakshan V, Kumutha MV, Vadivelu J, Puthucheary SD, 2001. Distribution of immunoglobulin classes and IgG subclasses against a culture filtrate antigen of Burkholderia pseudomallei in melioidosis patients. J Med Microbiol 50 : 55–61.
  24. Vasu C, Vadivelu J, Puthucheary SD, 2003. The humoral immune response in melioidosis patients during therapy. Infection 31 : 24–30.
  25. Ngauy V, Lemeshev Y, Sadkowski L, Crawford G, 2005. Cutaneous melioidosis in a man who was taken as a prisoner of war by the Japanese during World War II. J Clin Microbiol 43 : 970–972.
  26. Spotnitz M, 1966. Disease may be Vietnamese time bomb. Med World News 7 : 55.
  27. Chodimella U, Hoppes WL, Whalen S, Ognibene AJ, Rutecki GW, 1997. Septicemia and suppuration in a Vietnam veteran. Hosp Pract 32 : 219–221.
  28. Read KM, Currie B, McDonald P, Gordon DL, 2001. Reactivity of latent melioidosis in association with staphylococcal endocarditis. Intern Med J 31 : 130–131.

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  • Received : 26 Jul 2005
  • Accepted : 09 Sep 2005

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