T. Dharakul et al., DIAGNOSTIC-VALUE OF AN ANTIBODY ENZYME-LINKED-IMMUNOSORBENT-ASSAY USING AFFINITY-PURIFIED ANTIGEN IN AN AREA ENDEMIC FOR MELIOIDOSIS, The American journal of tropical medicine and hygiene, 56(4), 1997, pp. 418-423
Citations number
18
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
Melioidosis, an infection caused by Burkholderia pseudomallei, is ende
mic In southeast Asia. The septicemic form of melioidosis is the leadi
ng cause of death from nonhospital-acquired septicemia in the northeas
tern part of Thailand. A major factor that contributes to the high mor
tality is tile delay in isolation and identification of the causative
organism. The present study tvas undertaken to evaluate the use of enz
yme-linked;ed immunosorbent assays based on an immunoaffinity-purified
antigen for detecting specific IgG and IgM antibodies to this organis
m as a rapid serodiagnostic method for melioidosis. The diagnostic val
ue of these tests was evaluated in an actual clinical situation in an
area endemic for melioidosis. The specificity of specific IgG test (82
.5%) and the specific IgM test (63.5%) were significantly better than
that of the indirect hemagglutination (IHA) test (74.7%). The sensitiv
ity of the specific IgG assay (85.7%) was higher than that of the IHA
test (71.0%) and the specific IgM lest (63.5%). Specific IgG antibody
was detected in a majority of septicemic melioidosis (87.8%), as well
as in localized forms (8.6%). The specific IgG test was also better th
an the specific IgM test and the IHA test in identifying acute melioid
osis cases in the first live days after admission. In addition, the Ig
G antibody level to this antigen remained high over a period of more t
han five years in chose who had recovered from melioidosis and remaine
d clinically free of the disease. These results indicate that the dete
ction of specific IgG antibody is clinically useful for the diagnosis
of acute melioidosis in an endemic area.