Author:
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-
1.
Limmathurotsakul D et al., 2016. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 1: 15008.
-
2.
Limmathurotsakul D et al., 2010. Increasing incidence of human melioidosis in northeast Thailand. Am J Trop Med Hyg 82: 1113–1117.
-
3.
Currie BJ , Ward L , Cheng AC , 2010. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 4: e900.
-
4.
Limmathurotsakul D et al., 2013. Activities of daily living associated with acquisition of melioidosis in Northeast Thailand: a matched case–control study. PLoS Negl Trop Dis 7: e2072.
-
5.
Currie BJ , Jacups SP , 2003. Intensity of rainfall and severity of melioidosis, Australia. Emerg Infect Dis 9: 1538–1542.
-
6.
Vidyalakshmi K et al., 2008. Tuberculosis mimicked by melioidosis. Int J Tuberc Lung Dis 12: 1209–1215.
-
7.
Phuong DM et al., 2008. Clinical and microbiological features of melioidosis in northern Vietnam. Trans R Soc Trop Med Hyg 102(Suppl 1): S30–S36.
-
8.
Limmathurotsakul D et al., 2010. Defining the true sensitivity of culture for the diagnosis of melioidosis using Bayesian latent class models. PLoS One 5: e12485.
-
9.
Hoffmaster AR et al., 2015. Melioidosis diagnostic workshop, 2013. Emerg Infect Dis 21: e141045.
-
10.
Meumann EM et al., 2006. Clinical evaluation of a type III secretion system real-time PCR assay for diagnosing melioidosis. J Clin Microbiol 44: 3028–3030.
-
11.
Wuthiekanun V et al., 2007. Quantitation of B. pseudomallei in clinical samples. Am J Trop Med Hyg 77: 812–813.
-
12.
Burtnick MN et al., 2011. The cluster 1 type VI secretion system is a major virulence determinant in Burkholderia pseudomallei. Infect Immun 79: 1512–1525.
-
13.
Pumpuang A et al., 2017. Comparison of O-polysaccharide and hemolysin co-regulated protein as target antigens for serodiagnosis of melioidosis. PLoS Negl Trop Dis 11: e0005499.
-
14.
Felgner PL et al., 2009. A Burkholderia pseudomallei protein microarray reveals serodiagnostic and cross-reactive antigens. Proc Natl Acad Sci USA 106: 13499–13504.
-
15.
Kohler C et al., 2016. Rapid and sensitive multiplex detection of Burkholderia pseudomallei-specific antibodies in melioidosis patients based on a protein microarray approach. PLoS Negl Trop Dis 10: e0004847.
-
16.
Ashdown LR et al., 1989. Enzyme-linked immunosorbent assay for the diagnosis of clinical and subclinical melioidosis. J Infect Dis 160: 253–260.
-
17.
Chantratita N et al., 2007. Accuracy of enzyme-linked immunosorbent assay using crude and purified antigens for serodiagnosis of melioidosis. Clin Vaccine Immunol 14: 110–113.
-
18.
Trinh TT et al., 2018. A simple laboratory algorithm for diagnosis of melioidosis in resource-constrained areas: a study from north-central Vietnam. Clin Microbiol Infect 24: 84e81–84e84.
-
19.
Godoy D et al., 2003. Multilocus sequence typing and evolutionary relationships among the causative agents of melioidosis and glanders, Burkholderia pseudomallei and Burkholderia mallei. J Clin Microbiol 41: 2068–2079.
-
20.
Suttisunhakul V et al., 2016. Development of rapid enzyme-linked immunosorbent assays for detection of antibodies to Burkholderia pseudomallei. J Clin Microbiol 54: 1259–1268.
-
21.
Phokrai P et al., 2018. A rapid immunochromatography test based on Hcp1 is a potential point-of-care test for serological diagnosis of melioidosis. J Clin Microbiol 56: e00346–18.
-
22.
Wagner GE et al., 2020. Melioidosis DS rapid test: a standardized serological dipstick assay with increased sensitivity and reliability due to multiplex detection. PLoS Negl Trop Dis 14: e0008452.
-
23.
Wikraiphat C et al., 2015. Colony morphology variation of Burkholderia pseudomallei is associated with antigenic variation and O-polysaccharide modification. Infect Immun 83: 2127–2138.
-
24.
Pumpuang A et al., 2019. Distinct classes and subclasses of antibodies to hemolysin co-regulated protein 1 and O-polysaccharide and correlation with clinical characteristics of patients with melioidosis. Sci Rep 9: 13972.
-
25.
Teerawattanasook N et al., 2017. Capacity and utilization of blood culture in two referral hospitals in Indonesia and Thailand. Am J Trop Med Hyg 97: 1257–1261.
-
26.
Hemlock C et al., 2020. Utilization of blood culture in South Asia for the diagnosis and treatment of febrile illness. Clin Infect Dis 71: S266–S275.
-
27.
Sullivan RP et al., 2020. 2020 Review and revision of the 2015 Darwin melioidosis treatment guideline: paradigm drift not shift. PLoS Negl Trop Dis 14: e0008659.
-
28.
Zaw KK et al., 2019. Chronic pulmonary melioidosis masquerading as lung malignancy diagnosed by EBUS guided sheath technique. Respir Med Case Rep 28: 100894.
-
29.
Wilson M et al., 2016. Melioidosis mimicking primary lung malignancy with superior vena cava obstruction. IDCases 6: 58–59.
-
30.
Currie BJ , 2003. Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions. Eur Respir J 22: 542–550.
-
31.
Nandi T , Tan P , 2013. Less is more: Burkholderia pseudomallei and chronic melioidosis. MBio 4: e00709–e00713.
-
32.
Wuthiekanun V et al., 2006. Development of antibodies to Burkholderia pseudomallei during childhood in melioidosis-endemic northeast Thailand. Am J Trop Med Hyg 74: 1074–1075.
-
33.
Wuthiekanun V et al., 2008. Burkholderia pseudomallei antibodies in children, Cambodia. Emerg Infect Dis 14: 301–303.
-
34.
Chaichana P et al., 2018. Antibodies in melioidosis: the role of the indirect hemagglutination assay in evaluating patients and exposed populations. Am J Trop Med Hyg 99: 1378–1385.
-
35.
Hantrakun V et al., 2018. Presence of B. thailandensis and B. thailandensis expressing B. pseudomallei-like capsular polysaccharide in Thailand, and their associations with serological response to B. pseudomallei. PLoS Negl Trop Dis 12: e0006193.
-
36.
Duval BD et al., 2014. Evaluation of a latex agglutination assay for the identification of Burkholderia pseudomallei and Burkholderia mallei. Am J Trop Med Hyg 90: 1043–1046.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 5228 | 2324 | 36 |
| Full Text Views | 93 | 70 | 0 |
| PDF Downloads | 68 | 48 | 0 |
Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam
Quyen T. L. Tran
Quyen T. L. Tran
VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam;
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Ha V. Nguyen
Ha V. Nguyen
VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam;
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Huyen T. Pham
Huyen T. Pham
General Hospital of Ha Tinh Province, Ha Tinh, Vietnam;
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Tuan V. Mai
Tuan V. Mai
Hue Central Hospital, Hue, Vietnam
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Quyen H. M. Nguyen
Quyen H. M. Nguyen
VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam;
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Dzung V. Le
Dzung V. Le
General Hospital of Ha Tinh Province, Ha Tinh, Vietnam;
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Linh N. H. Bui
Linh N. H. Bui
VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam;
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Lan T. H. Hoang
Lan T. H. Hoang
Hue Central Hospital, Hue, Vietnam
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Trung Q. Hoang
Trung Q. Hoang
General Hospital of Ha Tinh Province, Ha Tinh, Vietnam;
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Trung T. Trinh
Trung T. Trinh
VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam;
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ABSTRACT.
Melioidosis is a fatal infectious disease in the tropics and subtropics. Currently, bacterial culture is the gold standard for diagnosis of the disease, but its sensitivity is relatively low. In this study, we evaluated four ELISAs using sera collected from culture-confirmed cases of melioidosis (n = 63), cases with other bacterial infections (n = 62), and healthy donors (n = 60). Antigens used for ELISAs were the whole-cell (WC) antigens and recombinant proteins of hemolysis co-regulated protein 1 (Hcp1), chaperonin GroEL1, and alkyl hydroperoxide reductase subunit C (AhpC). Using the cutoff values for optical density at 490 nm defined at a specificity of > 95%, the sensitivity of the WC, Hcp1, GroEL1, and AhpC ELISAs was 93.7%, 87.3%, 61.9%, and 57.1%, respectively. The combined WC/Hcp1 ELISA showed the greatest sensitivity and specificity of 98.4% and 95.1%, respectively. Of 511 and 500 sera collected from clinically suspected febrile patients admitted to the General Hospital of Ha Tinh Province and the Hue Central Hospital, respectively, combined WC/Hcp1 ELISAs showed 52 (10.2%) and 41 (8.2%) patients positive for melioidosis, respectively. The assay detected 14 of 14 (100%) and 21 of 23 (91.3%) culture-confirmed cases of melioidosis at Ha Tinh and Hue, respectively. A follow-up study of 38 patients positive for melioidosis by combined WC/Hcp1 ELISAs but negative for Burkholderia pseudomallei by culture method or not assigned to examine for bacterial culture resulted in 2 (5.3%) culture-reconfirmed patients with melioidosis, 9 (23.7%) deaths, 17 (44.7%) unhealthy patients, and 10 (26.3%) healthy persons. Combined WC/Hcp1 ELISA was a reliable serological method to detect underdiagnosed cases of melioidosis. Further investigations are needed to estimate the true sensitivity and specificity of the assay and the true number of cases of melioidosis.
- Supplemental Materials (PDF 466 KB)
Author Notes
Financial support: This study was funded by the Ministry of Science and Technology in Vietnam (grant no. NDT.82.GB/20).
Authors’ addresses: Quyen T. L. Tran, Ha V. Nguyen, Quyen H. M. Nguyen, Linh N. H. Bui, and Trung T. Trinh, VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam, E-mails: quyenttl@vnu.edu.vn, ha.nguyenviet310@gmail.com, quyennhm@vnu.edu.vn, linhbui299@vnu.edu.vn, and tttrung@vnu.edu.vn. Huyen T. Pham, Dzung V. Le, and Trung Q. Hoang, General Hospital of Ha Tinh Province, Ha Tinh, Vietnam, E-mails: huyenpham.bvdkht@gmail.com, dzungtmht@gmail.com, and hoangquangtrung.bs@gmail.com. Tuan V. Mai and Lan T. H. Hoang, Hue Central Hospital, Hue, Vietnam, E-mails: maituanbvh@yahoo.com.vn and hglanhuong.hch@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Limmathurotsakul D et al., 2016. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 1: 15008.
-
2.
Limmathurotsakul D et al., 2010. Increasing incidence of human melioidosis in northeast Thailand. Am J Trop Med Hyg 82: 1113–1117.
-
3.
Currie BJ , Ward L , Cheng AC , 2010. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 4: e900.
-
4.
Limmathurotsakul D et al., 2013. Activities of daily living associated with acquisition of melioidosis in Northeast Thailand: a matched case–control study. PLoS Negl Trop Dis 7: e2072.
-
5.
Currie BJ , Jacups SP , 2003. Intensity of rainfall and severity of melioidosis, Australia. Emerg Infect Dis 9: 1538–1542.
-
6.
Vidyalakshmi K et al., 2008. Tuberculosis mimicked by melioidosis. Int J Tuberc Lung Dis 12: 1209–1215.
-
7.
Phuong DM et al., 2008. Clinical and microbiological features of melioidosis in northern Vietnam. Trans R Soc Trop Med Hyg 102(Suppl 1): S30–S36.
-
8.
Limmathurotsakul D et al., 2010. Defining the true sensitivity of culture for the diagnosis of melioidosis using Bayesian latent class models. PLoS One 5: e12485.
-
9.
Hoffmaster AR et al., 2015. Melioidosis diagnostic workshop, 2013. Emerg Infect Dis 21: e141045.
-
10.
Meumann EM et al., 2006. Clinical evaluation of a type III secretion system real-time PCR assay for diagnosing melioidosis. J Clin Microbiol 44: 3028–3030.
-
11.
Wuthiekanun V et al., 2007. Quantitation of B. pseudomallei in clinical samples. Am J Trop Med Hyg 77: 812–813.
-
12.
Burtnick MN et al., 2011. The cluster 1 type VI secretion system is a major virulence determinant in Burkholderia pseudomallei. Infect Immun 79: 1512–1525.
-
13.
Pumpuang A et al., 2017. Comparison of O-polysaccharide and hemolysin co-regulated protein as target antigens for serodiagnosis of melioidosis. PLoS Negl Trop Dis 11: e0005499.
-
14.
Felgner PL et al., 2009. A Burkholderia pseudomallei protein microarray reveals serodiagnostic and cross-reactive antigens. Proc Natl Acad Sci USA 106: 13499–13504.
-
15.
Kohler C et al., 2016. Rapid and sensitive multiplex detection of Burkholderia pseudomallei-specific antibodies in melioidosis patients based on a protein microarray approach. PLoS Negl Trop Dis 10: e0004847.
-
16.
Ashdown LR et al., 1989. Enzyme-linked immunosorbent assay for the diagnosis of clinical and subclinical melioidosis. J Infect Dis 160: 253–260.
-
17.
Chantratita N et al., 2007. Accuracy of enzyme-linked immunosorbent assay using crude and purified antigens for serodiagnosis of melioidosis. Clin Vaccine Immunol 14: 110–113.
-
18.
Trinh TT et al., 2018. A simple laboratory algorithm for diagnosis of melioidosis in resource-constrained areas: a study from north-central Vietnam. Clin Microbiol Infect 24: 84e81–84e84.
-
19.
Godoy D et al., 2003. Multilocus sequence typing and evolutionary relationships among the causative agents of melioidosis and glanders, Burkholderia pseudomallei and Burkholderia mallei. J Clin Microbiol 41: 2068–2079.
-
20.
Suttisunhakul V et al., 2016. Development of rapid enzyme-linked immunosorbent assays for detection of antibodies to Burkholderia pseudomallei. J Clin Microbiol 54: 1259–1268.
-
21.
Phokrai P et al., 2018. A rapid immunochromatography test based on Hcp1 is a potential point-of-care test for serological diagnosis of melioidosis. J Clin Microbiol 56: e00346–18.
-
22.
Wagner GE et al., 2020. Melioidosis DS rapid test: a standardized serological dipstick assay with increased sensitivity and reliability due to multiplex detection. PLoS Negl Trop Dis 14: e0008452.
-
23.
Wikraiphat C et al., 2015. Colony morphology variation of Burkholderia pseudomallei is associated with antigenic variation and O-polysaccharide modification. Infect Immun 83: 2127–2138.
-
24.
Pumpuang A et al., 2019. Distinct classes and subclasses of antibodies to hemolysin co-regulated protein 1 and O-polysaccharide and correlation with clinical characteristics of patients with melioidosis. Sci Rep 9: 13972.
-
25.
Teerawattanasook N et al., 2017. Capacity and utilization of blood culture in two referral hospitals in Indonesia and Thailand. Am J Trop Med Hyg 97: 1257–1261.
-
26.
Hemlock C et al., 2020. Utilization of blood culture in South Asia for the diagnosis and treatment of febrile illness. Clin Infect Dis 71: S266–S275.
-
27.
Sullivan RP et al., 2020. 2020 Review and revision of the 2015 Darwin melioidosis treatment guideline: paradigm drift not shift. PLoS Negl Trop Dis 14: e0008659.
-
28.
Zaw KK et al., 2019. Chronic pulmonary melioidosis masquerading as lung malignancy diagnosed by EBUS guided sheath technique. Respir Med Case Rep 28: 100894.
-
29.
Wilson M et al., 2016. Melioidosis mimicking primary lung malignancy with superior vena cava obstruction. IDCases 6: 58–59.
-
30.
Currie BJ , 2003. Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions. Eur Respir J 22: 542–550.
-
31.
Nandi T , Tan P , 2013. Less is more: Burkholderia pseudomallei and chronic melioidosis. MBio 4: e00709–e00713.
-
32.
Wuthiekanun V et al., 2006. Development of antibodies to Burkholderia pseudomallei during childhood in melioidosis-endemic northeast Thailand. Am J Trop Med Hyg 74: 1074–1075.
-
33.
Wuthiekanun V et al., 2008. Burkholderia pseudomallei antibodies in children, Cambodia. Emerg Infect Dis 14: 301–303.
-
34.
Chaichana P et al., 2018. Antibodies in melioidosis: the role of the indirect hemagglutination assay in evaluating patients and exposed populations. Am J Trop Med Hyg 99: 1378–1385.
-
35.
Hantrakun V et al., 2018. Presence of B. thailandensis and B. thailandensis expressing B. pseudomallei-like capsular polysaccharide in Thailand, and their associations with serological response to B. pseudomallei. PLoS Negl Trop Dis 12: e0006193.
-
36.
Duval BD et al., 2014. Evaluation of a latex agglutination assay for the identification of Burkholderia pseudomallei and Burkholderia mallei. Am J Trop Med Hyg 90: 1043–1046.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 5228 | 2324 | 36 |
| Full Text Views | 93 | 70 | 0 |
| PDF Downloads | 68 | 48 | 0 |