{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:53:08Z","timestamp":1783407188127,"version":"3.54.6"},"reference-count":20,"publisher":"American Society for Microbiology","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin. Vaccine Immunol."],"published-print":{"date-parts":[[2011,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The indirect hemagglutination assay (IHA) is the most frequently used serological test to confirm exposure to<jats:named-content content-type=\"genus-species\">Burkholderia pseudomallei<\/jats:named-content>. Patients with culture-confirmed disease often have a nonreactive IHA at presentation and occasionally fail to seroconvert on serial testing. We investigated whether using antigens derived from the cultured isolates of persistently IHA-nonreactive patient sera improved the sensitivity of the IHA. In addition, we assessed the antigen-specific lymphocyte response in this group of patients to a panel of<jats:named-content content-type=\"genus-species\">B. pseudomallei<\/jats:named-content>antigens, including those derived from their own cultured isolates. Eleven patients with culture-proven melioidosis were identified as having persistently IHA-nonreactive sera. A modified IHA using erythrocytes sensitized with patient isolate-derived antigen tested against convalescent-phase serum was performed. The majority (82%) of sera showed a negative (\u22641:5) result, one was borderline (1:20), and one was positive at the cutoff value (1:40). IHA-nonreactive sera were also tested by enzyme immunoassay (EIA), with 73% (8\/11) demonstrating IgG positivity. In addition, lymphocytes isolated from persistently IHA-nonreactive patient sera demonstrated significantly increased proliferation in response to<jats:named-content content-type=\"genus-species\">B. pseudomallei<\/jats:named-content>antigens compared to controls. These studies demonstrate the presence of<jats:named-content content-type=\"genus-species\">B. pseudomallei<\/jats:named-content>-specific antibody by EIA and<jats:named-content content-type=\"genus-species\">B. pseudomallei<\/jats:named-content>-specific lymphocytes in patient sera categorized as persistently nonreactive according to the IHA. New immunoassays are required and should incorporate<jats:named-content content-type=\"genus-species\">B. pseudomallei<\/jats:named-content>antigens that are immunoreactive for this subset of IHA-nonreactive patient sera.<\/jats:p>","DOI":"10.1128\/cvi.00077-11","type":"journal-article","created":{"date-parts":[[2011,6,16]],"date-time":"2011-06-16T01:07:58Z","timestamp":1308186478000},"page":"1288-1291","source":"Crossref","is-referenced-by-count":12,"title":["Evidence of Burkholderia pseudomallei-Specific Immunity in Patient Sera Persistently Nonreactive by the Indirect Hemagglutination Assay"],"prefix":"10.1128","volume":"18","author":[{"given":"Patrick N. 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