Affiliations 

  • 1 Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
  • 2 Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia
  • 3 Faculty of Medicine, SEGi University, Kota Damansara, Malaysia
  • 4 Clinical Research Center, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia
  • 5 School of Medicine, University of Nevada, Reno, Nevada
  • 6 US Army Medical Research Institute of Infectious Diseases, Ft. Detrick, Maryland
  • 7 Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore
Am J Trop Med Hyg, 2020 02;102(2):388-391.
PMID: 31769397 DOI: 10.4269/ajtmh.19-0625

Abstract

Burkholderia pseudomallei infections are prevalent in Southeast Asia and northern Australia and often misdiagnosed. Diagnostics are often neither sensitive nor rapid, contributing up to 50% mortality rate. In this 2018 pilot study, we enrolled 100 patients aged 6 months-79 years from Kapit Hospital in Sarawak, Malaysia, with symptoms of B. pseudomallei infection. We used three different methods for the detection of B. pseudomallei: a real-time polymerase chain reaction (PCR) assay, a rapid lateral flow immunoassay, and the standard-of-care bacterial culture-the gold standard. Among the 100 participants, 24 (24%) were positive for B. pseudomallei by one or more of the detection methods. Comparing the two individual diagnostic methods against the gold standard-bacterial culture-of any positive test, there was low sensitivity for each test (25-44%) but high specificity (93-98%). It seems clear that more sensitive diagnostics or a sensitive screening diagnostic followed by specific confirmatory diagnostic is needed for this disease.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.