Comparison of the polymerase chain reaction and serologic tests for diagnosis of septicemic melioidosis

For diagnosis of melioidosis, we compared polymerase chain reaction (PCR)-b ased DNA detection and three serologic methods with the culture method curr ently used as gold standard. The diagnostic values of the serologic methods were evaluated in 130 patients. All these patients resided in an endemic a rea. An enzyme-linked immunosorbent assay (ELISA) gave slightly higher spec ificity (86.2%) than a dot immunoassay (DOT) (85.3%), hut was superior to a n indirect hemagglutination assay (IHA) (79.8%). The sensitivities of the D OT (85.7%) and ELISA (71.4%) were considerably higher than that of IHA (61. 9%). However, the PCR was the most sensitive (95.2%) and specific (91.7%). Nevertheless, DOT and ELISA are more practical for local hospitals. With th e high negative predictive value of both the ELISA (94.0%) and DOT (96.9%) in a high prevalence area, clearly these methods can rule out most of the n on-melioidosis patients.