title: Monoclonal antibody-based immunofluorescence microscopy for the rapid identification of Burkholderia pseudomallei in clinical specimens.
abstract: The diagnosis of melioidosis depends on the culture of Burkholderia pseudomallei, which takes at least 48 hours. We used a polyclonal-FITC-based immunofluorescence microscopic assay (Pab-IFA) on clinical samples to provide a rapid presumptive diagnosis. This has limitations including photobleaching and batch-to-batch variability. This study evaluated an IFA based on a monoclonal antibody specific to B. pseudomallei (Mab-IFA) and Alexa Fluor 488. A diagnostic evaluation was performed on a prospective cohort of 951 consecutive patients with suspected melioidosis. A total of 1,407 samples were tested. Test accuracy was defined against culture as the gold standard, and was also compared against Pab-IFA. A total of 88 samples from 64 patients were culture positive for B. pseudomallei. The diagnostic sensitivity and specificity of the Mab-IFA was comparable to the Pab-IFA (48.4% versus 45.3% for sensitivity, and 99.8% versus 98.8% for specificity). We have incorporated the Mab-IFA into our routine practice.
authors.forename: Sarunporn
authors.initials: S
authors.lastname: Tandhavanant
authors.forename: Gumphol
authors.initials: G
authors.lastname: Wongsuvan
authors.forename: Vanaporn
authors.initials: V
authors.lastname: Wuthiekanun
authors.forename: Nittaya
authors.initials: N
authors.lastname: Teerawattanasook
authors.forename: Nicholas P J
authors.initials: NPJ
authors.lastname: Day
authors.forename: Direk
authors.initials: D
authors.lastname: Limmathurotsakul
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
authors.forename: Narisara
authors.initials: N
authors.lastname: Chantratita
mesh_terms: D000911:Antibodies, Monoclonal; D016957:Burkholderia pseudomallei / Q000276:immunology; D006801:Humans; D008554:Melioidosis / Q000175:diagnosis* / Q000276:immunology; D008856:Microscopy, Fluorescence / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000911:Antibodies, Monoclonal