This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Google Scholar
Right arrow Articles by Harris, P. N. A.
Right arrow Articles by Norton, R. E.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Harris, P. N. A.
Right arrow Articles by Norton, R. E.

 Previous Article  |  Next Article 

Clinical and Vaccine Immunology, June 2009, p. 924-930, Vol. 16, No. 6
1071-412X/09/$08.00+0     doi:10.1128/CVI.00026-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Clinical Features That Affect Indirect-Hemagglutination-Assay Responses to Burkholderia pseudomallei{triangledown}

Patrick N. A. Harris,1 Natkunam Ketheesan,2 Leigh Owens,2 and Robert E. Norton1*

Pathology Queensland, Townsville Hospital,1 School of Veterinary and Biomedical Sciences, James Cook University, Queensland, Australia 48112

Received 20 January 2009/ Returned for modification 26 February 2009/ Accepted 17 April 2009

Melioidosis, a disease endemic to northern Australia and Southeast Asia, is caused by the soil saprophyte Burkholderia pseudomallei. The indirect hemagglutination assay (IHA) is the most frequently used serological test to help confirm exposure to the causative organism. However, despite culture-confirmed disease, patients often have a negative IHA result at presentation and occasionally fail to seroconvert in serial testing. We retrospectively examined results for all patients with culture-confirmed melioidosis from our laboratory between January 1996 and August 2008. One hundred forty patients had a recorded IHA titer at presentation, 71 of which were positive at a titer of 1:40 or greater. Fifty-three patients went on to have subsequent IHAs 1 month or more after presentation. The relationships between IHA responses and clinical features were examined. The presence of bacteremia was significantly associated with a negative IHA at presentation. The coexistence of diabetes was associated with the presence of a positive IHA at presentation. In total, 14 patients (26%) demonstrated persistently negative IHA titers upon serial testing. No clinical factors were found to be significantly associated with this phenomenon. Supplementary testing using melioidosis-specific immunoglobulin G by EIA demonstrated different effects, with only Aboriginal or Torres Straits Islander ethnicity being significantly associated with a positive EIA at presentation. Reasons for these findings are examined, and directions for future research are discussed.

* Corresponding author. Mailing address: Pathology Queensland, Townsville Hospital, Queensland, Australia 4811. Phone: 07 47961111. Fax: 07 47962415. E-mail: robert_norton{at}health.qld.gov.au

{triangledown} Published ahead of print on 29 April 2009.

Clinical and Vaccine Immunology, June 2009, p. 924-930, Vol. 16, No. 6
1071-412X/09/$08.00+0     doi:10.1128/CVI.00026-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»