Retrospective study on the diagnostic value of IgG ELISA, dot immunoassay and indirect hemagglutination in septicemic melioidosis

Three serological methods for diagnosis of melioidosis were compared with t he culture method currently used as the "gold standard". The diagnostic val ues of the serological methods were evaluated retrospectively in 306 patien ts residing in an endemic area. The enzyme-linked immunosorbent assay (ELIS A), using affinity purified antigen for detecting specific IgG antibody, sh owed a slightly higher specificity (86.0%) than the dot immunoassay (DOT) ( 84.0%) and both were superior to indirect hemagglutination (IHA) (72.0%). T he sensitivity of DOT (96.4%) and ELISA (85.7%) were considerably higher th an that of IHA (50.0%). The primary benefit of the high negative predictive value of both ELISA (96.4%) and DOT (99.0%) in an area of high prevalence is the ability to rule out most of the non-melioidosis patients.