{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T02:18:59Z","timestamp":1777429139195,"version":"3.51.4"},"reference-count":24,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,5]]},"abstract":"<jats:p><jats:italic>Burkholderia pseudomallei<\/jats:italic> 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\u201379 years from Kapit Hospital in Sarawak, Malaysia, with symptoms of <jats:italic>B. pseudomallei<\/jats:italic> infection. We used three different methods for the detection of <jats:italic>B. pseudomallei<\/jats:italic>: a real-time polymerase chain reaction (PCR) assay, a rapid lateral flow immunoassay, and the standard-of-care bacterial culture\u2014the gold standard. Among the 100 participants, 24 (24%) were positive for <jats:italic>B. pseudomallei<\/jats:italic> by one or more of the detection methods. Comparing the two individual diagnostic methods against the gold standard\u2014bacterial culture\u2014of any positive test, there was low sensitivity for each test (25\u201344%) but high specificity (93\u201398%). It seems clear that more sensitive diagnostics or a sensitive screening diagnostic followed by specific confirmatory diagnostic is needed for this disease.<\/jats:p>","DOI":"10.4269\/ajtmh.19-0625","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T07:00:48Z","timestamp":1574751648000},"page":"388-391","source":"Crossref","is-referenced-by-count":12,"title":["Burkholderia pseudomallei Detection among Hospitalized Patients, Sarawak"],"prefix":"10.4269","volume":"102","author":[{"given":"Jessica Y.","family":"Choi","sequence":"first","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina;"},{"name":"Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"King Ching","family":"Hii","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily S.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina;"},{"name":"Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia Yun","family":"Chuang","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei Yieng","family":"Tang","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund Kwang","family":"Yuen Wong","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiana","family":"Ti","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kat Siong","family":"Pau","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoinette","family":"Berita","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izreena","family":"Saihidi","sequence":"additional","affiliation":[{"name":"Kapit Hospital, Ministry of Health Malaysia, Kapit, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakie","family":"Ting","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia;"},{"name":"Faculty of Medicine, SEGi University, Kota Damansara, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiing-Tiing","family":"Chua","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teck-Hock","family":"Toh","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia;"},{"name":"Faculty of Medicine, SEGi University, Kota Damansara, Malaysia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"AuCoin","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nevada, Reno, Nevada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"DeShazer","sequence":"additional","affiliation":[{"name":"US Army Medical Research Institute of Infectious Diseases, Ft. Detrick, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory C.","family":"Gray","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina;"},{"name":"Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina;"},{"name":"Global Health Research Center, Duke-Kunshan University, Kunshan, China;"},{"name":"Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Rural Remote Health","first-page":"2763","article-title":"Melioidosis: a review","volume":"14","author":"Foong","year":"2014"},{"key":"b2","series-title":"BMC Infect Dis","first-page":"302","article-title":"Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia","volume":"10","author":"Hassan","year":"2010"},{"key":"b3","series-title":"Ann Acad Med Singapore","first-page":"478","article-title":"Epidemiological surveillance of melioidosis in Singapore","volume":"27","author":"Heng","year":"1998"},{"key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e0004738","article-title":"Melioidosis: clinical impact and public health threat in the tropics","volume":"11","author":"Perumal Samy","year":"2017"},{"key":"b5","series-title":"Lancet Infect Dis","first-page":"892","article-title":"Global burden of melioidosis in 2015: a systematic review and data synthesis","volume":"19","author":"Birnie","year":"2019"},{"key":"b6","series-title":"Nat Microbiol","first-page":"15008","article-title":"Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis","volume":"1","author":"Limmathurotsakul","year":"2016"},{"key":"b7","series-title":"Trop Med Infect Dis","first-page":"E25","article-title":"Melioidosis in Malaysia: incidence, clinical challenges, and advances in understanding pathogenesis","volume":"3","author":"Nathan","year":"2018"},{"key":"b8","series-title":"Plos Negl Trop Dis","first-page":"e0005182","article-title":"Melioidosis in Malaysia: a review of case reports","volume":"10","author":"Kingsley","year":"2016"},{"key":"b9","series-title":"Trop Med Infect Dis","first-page":"E39","article-title":"Melioidosis in vietnam: recently improved recognition but still an uncertain disease burden after almost a century of reporting","volume":"3","author":"Trinh","year":"2018"},{"key":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e2727","article-title":"Development of a prototype lateral flow immunoassay (LFI) for the rapid diagnosis of melioidosis","volume":"8","author":"Houghton","year":"2014"},{"key":"b11","series-title":"Diagn Microbiol Infect Dis","first-page":"95","article-title":"An improved selective and differential medium for the isolation of Burkholderia pseudomallei from clinical specimens","volume":"55","author":"Francis","year":"2006"},{"key":"b12","series-title":"J Clin Microbiol","first-page":"85","article-title":"Development and evaluation of a real-time PCR assay targeting the type III secretion system of Burkholderia pseudomallei","volume":"44","author":"Novak","year":"2006"},{"key":"b13","series-title":"J Clin Microbiol","first-page":"2059","article-title":"Comparison of TaqMan PCR assays for detection of the melioidosis agent Burkholderia pseudomallei in clinical specimens","volume":"50","author":"Kaestli","year":"2012"},{"key":"b14","series-title":"Clin Microbiol Infect","first-page":"79.e1","article-title":"Association between activities related to routes of infection and clinical manifestations of melioidosis","volume":"22","author":"Lim","year":"2016"},{"key":"b15","series-title":"Biochem Med (Zagreb)","first-page":"276","article-title":"Interrater reliability: the kappa statistic","volume":"22","author":"McHugh","year":"2012"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"812","article-title":"Quantitation of B. Pseudomallei in clinical samples","volume":"77","author":"Wuthiekanun","year":"2007"},{"key":"b17","series-title":"Southeast Asian J Trop Med Public Health","first-page":"781","article-title":"Lack of correlation of Burkholderia pseudomallei quantities in blood, urine, sputum and pus","volume":"40","author":"Wongsuvan","year":"2009"},{"key":"b18","series-title":"PLoS Negl Trop Dis","first-page":"e0005217","article-title":"In vivo distribution and clearance of purified capsular polysaccharide from Burkholderia pseudomallei in a murine model","volume":"10","author":"Nualnoi","year":"2016"},{"key":"b19","series-title":"MBio","first-page":"e00136","article-title":"Identification of circulating bacterial antigens by in vivo microbial antigen discovery","volume":"2","author":"Nuti","year":"2011"},{"key":"b20","series-title":"PLoS One","first-page":"e0195308","article-title":"Immunoglobulin G subclass switching impacts sensitivity of an immunoassay targeting Francisella tularensis lipopolysaccharide","volume":"13","author":"Nualnoi","year":"2018"},{"key":"b21","series-title":"J Med Microbiol","first-page":"845","article-title":"Rapid diagnostics for melioidosis: a comparative study of a novel lateral flow antigen detection assay","volume":"64","author":"Robertson","year":"2015"},{"key":"b22","series-title":"J Clin Microbiol","first-page":"e02002","article-title":"Evaluation of a rapid diagnostic test for detection of Burkholderia pseudomallei in the Lao people\u2019s Democratic Republic","volume":"56","author":"Woods","year":"2018"},{"key":"b23","series-title":"PLoS One","first-page":"e0194595","article-title":"Performance evaluation of active melioidosis detect-lateral flow assay (AMD-LFA) for diagnosis of melioidosis in endemic settings with limited resources","volume":"13","author":"Shaw","year":"2018"},{"key":"b24","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"1169","article-title":"Diagnostic accuracy of the InBiOS AMD rapid diagnostic test for the detection of Burkholderia pseudomallei antigen in grown blood culture broth","volume":"37","author":"Peeters","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/102\/2\/article-p388.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/102\/2\/article-p388.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/102\/2\/article-p388.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T21:59:49Z","timestamp":1722463189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/102\/2\/article-p388.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,5]]},"references-count":24,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.19-0625","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,5]]}}}