title: Evaluation of PCR for diagnosis of melioidosis.
abstract: Previously published PCR-based diagnostic tests for melioidosis were evaluated for clinical usefulness. A Burkholderia pseudomallei 16S rRNA-derived primer set had a sensitivity approaching 100% for clinical samples from 22 culture-confirmed cases of melioidosis and enabled diagnosis of 3 culture-negative cases. However, samples from 10 of 30 inpatients from Royal Darwin Hospital with other diagnoses were positive by PCR, giving a specificity of 67% and a positive predictive value of only 70%. Although there are a number of intriguing possible explanations for our results, concerns of inappropriate therapy resulting from a positive result by PCR have led us to forgo the advantage of rapid PCR diagnosis for melioidosis until a better system is validated.
authors.affiliation: Royal Darwin Hospital, Tiwi, Northern Territory, Australia. antje.haase@nt.gov.au
authors.forename: A
authors.initials: A
authors.lastname: Haase
authors.forename: M
authors.initials: M
authors.lastname: Brennan
authors.forename: S
authors.initials: S
authors.lastname: Barrett
authors.forename: Y
authors.initials: Y
authors.lastname: Wood
authors.forename: S
authors.initials: S
authors.lastname: Huffam
authors.forename: D
authors.initials: D
authors.lastname: O'Brien
authors.forename: B
authors.initials: B
authors.lastname: Currie
mesh_terms: D006801:Humans; D008554:Melioidosis / Q000175:diagnosis*; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics
chemical_list: D012336:RNA, Ribosomal, 16S