{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:05:45Z","timestamp":1787673945537,"version":"build-2736575974"},"reference-count":25,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2009,6,1]],"date-time":"2009-06-01T00:00:00Z","timestamp":1243814400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Melioidosis, a disease endemic to northern Australia and Southeast Asia, is caused by the soil saprophyte\n            <jats:italic>Burkholderia pseudomallei<\/jats:italic>\n            . 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.\n          <\/jats:p>","DOI":"10.1128\/cvi.00026-09","type":"journal-article","created":{"date-parts":[[2009,4,30]],"date-time":"2009-04-30T01:25:41Z","timestamp":1241054741000},"page":"924-930","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":41,"title":["Clinical Features That Affect Indirect-Hemagglutination-Assay Responses to\n            <i>Burkholderia pseudomallei<\/i>"],"prefix":"10.1128","volume":"16","author":[{"given":"Patrick N. A.","family":"Harris","sequence":"first","affiliation":[{"name":"Pathology Queensland, Townsville Hospital"},{"name":"School of Veterinary and Biomedical Sciences, James Cook University, Queensland, Australia 4811"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natkunam","family":"Ketheesan","sequence":"additional","affiliation":[{"name":"Pathology Queensland, Townsville Hospital"},{"name":"School of Veterinary and Biomedical Sciences, James Cook University, Queensland, Australia 4811"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Owens","sequence":"additional","affiliation":[{"name":"Pathology Queensland, Townsville Hospital"},{"name":"School of Veterinary and Biomedical Sciences, James Cook University, Queensland, Australia 4811"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Norton","sequence":"additional","affiliation":[{"name":"Pathology Queensland, Townsville Hospital"},{"name":"School of Veterinary and Biomedical Sciences, James Cook University, Queensland, Australia 4811"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1574-695X.2008.00464.x","volume":"54","year":"2008","unstructured":"Allwood, E. M., C.-A. Logue, G. J. Hafner, N. Ketheesan, R. E. Norton, I. R. Peak, and I. R. Beacham. 2008. Evaluation of recombinant antigens for diagnosis of melioidosis. FEMS Immunol. Med. Microbiol.54:144-153.","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.14.4.361-364.1981"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"474","DOI":"10.4269\/ajtmh.1984.33.474","volume":"33","year":"1984","unstructured":"Ashdown, L. R., and R. W. Guard. 1984. The prevalence of human melioidosis in Northern Queensland. Am. J. Trop. Med. Hyg.33:474-478.","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5694\/j.1326-5377.1987.tb133542.x","volume":"147","year":"1987","unstructured":"Ashdown, L. R. 1987. Indirect haemagglutination for melioidosis. Med. J. Aust.147:364-365.","journal-title":"Med. J. 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