title: Rapid detection of Burkholderia pseudomallei in blood cultures using a monoclonal antibody-based immunofluorescent assay.
abstract: Melioidosis is a severe bacterial infection caused by Burkholderia pseudomallei. Rapid antimicrobial therapy is necessary to improve patient outcome, which is aided by direct detection of B. pseudomallei in clinical samples. A drawback for all antigen assays is that the number of B. pseudomallei in blood usually falls below the achievable level of detection. We performed a prospective cohort study of 461 patients with 541 blood cultures to evaluate the utility of a pre-incubation step prior to detection of B. pseudomallei using a monoclonal antibody-based immunofluorescent assay (Mab-IFA). The Mab-IFA was positive in 74 of 76 patients with melioidosis (sensitivity = 97.4%), and negative in 385 patients who did not have blood cultures containing B. pseudomallei (specificity = 100%). The Mab-IFA could be a valuable supplementary tool for rapid detection. We recommend the use of the Mab-IFA to test blood cultures that flag positive in regions where melioidosis is endemic.
authors.forename: Narisara
authors.initials: N
authors.lastname: Chantratita
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
mesh_terms: D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial / Q000097:blood*; D016470:Bacteremia / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D016957:Burkholderia pseudomallei / Q000276:immunology / Q000302:isolation & purification*; D003470:Culture Media; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D008554:Melioidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013785:Thailand / Q000453:epidemiology
chemical_list: D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial; D003470:Culture Media
references.citation: J Clin Pathol. 1989 Jun;42(6):645-8
references.pmid: 2472432
references.citation: Clin Diagn Lab Immunol. 2005 Apr;12(4):555-6
references.pmid: 15817767
references.citation: Am J Trop Med Hyg. 2007 Nov;77(5):814-7
references.pmid: 17984332
references.citation: Br Med Bull. 2011;99:125-39
references.pmid: 21558159
references.citation: Am J Trop Med Hyg. 2007 Nov;77(5):812-3
references.pmid: 17984331
references.citation: N Engl J Med. 2012 Sep 13;367(11):1035-44
references.pmid: 22970946
references.citation: Am J Trop Med Hyg. 2013 Jul;89(1):165-168
references.pmid: 23716405
references.citation: J Clin Microbiol. 2008 Feb;46(2):568-73
references.pmid: 18039797
references.citation: Am J Trop Med Hyg. 2010 Jun;82(6):1113-7
references.pmid: 20519609