viernes, 23 de enero de 2015

Melioidosis Diagnostic Workshop, 20131 - Volume 21, Number 2—February 2015 - Emerging Infectious Disease journal - CDC

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Melioidosis Diagnostic Workshop, 20131 - Volume 21, Number 2—February 2015 - Emerging Infectious Disease journal - CDC





Volume 21, Number 2—February 2015

Online Report

Melioidosis Diagnostic Workshop, 20131

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Alex R. HoffmasterComments to Author , David AuCoin, Prasith Baccam, Henry C. Baggett, Rob Baird, Saithip Bhengsri, David D. Blaney, Paul J. Brett, Timothy J.G. Brooks, Katherine A. Brown, Narisara Chantratita, Allen C. Cheng, David A.B. Dance, Saskia Decuypere, Dawn Defenbaugh, Jay E. Gee, Raymond Houghton, Possawat Jorakate, Ganjana Lertmemongkolchai, Direk Limmathurotsakul, Toby L. Merlin, Chiranjay Mukhopadhyay, Robert Norton, Sharon J. Peacock, Dionne B. Rolim, Andrew J. Simpson, Ivo Steinmetz, Robyn A. Stoddard, Martha M. Stokes, David Sue, Apichai Tuanyok, Toni Whistler, Vanaporn Wuthiekanun, and Henry T. Walke
Author affiliations: US Centers for Disease Control and Prevention, Atlanta, Georgia, USA (A.R. Hoffmaster, D.D. Blaney, J.E. Gee, T.L. Merlin, R.A. Stoddard, D. Sue, H.T. Walke); University of Nevada School of Medicine, Reno, Nevada, USA (D. AuCoin); IEM, Research Triangle Park, North Carolina, USA (P. Baccam); Royal Darwin Hospital, Darwin, Northern Territory, Australia (R. Baird); US Centers for Disease Control and Prevention, Nonthaburi, Thailand (H.C. Baggett, S. Bhengsri, P. Jorakate, T. Whistler); University of South Alabama, Mobile, Alabama, USA (P.J. Brett); Public Health England, Salisbury, UK (T.J.G. Brooks, A.J. Simpson); University of Texas, Austin, Texas, USA (K.A. Brown); University of Cambridge, Cambridge, UK (K.A. Brown, S.J. Peacock); Mahidol University, Bangkok, Thailand (N. Chantratita, D. Limmathurotsakul, V. Wuthiekanun); Alfred Health, Monash University, Melbourne, Victoria, Australia (A. C. Cheng); Lao-Oxford-Mahosot Hospital–Wellcome Trust Research Unit, Vientiane, Laos, and University of Oxford, Oxford, UK (D.A.B. Dance); University of Western Australia, Perth, Western Australia, Australia (S. Decuypere); Defense Threat Reduction Agency, Fort Belvoir, Virginia, USA (D. Defenbaugh, M.M. Stokes); InBios International, Seattle, Washington, USA (R. Houghton); Khon Kaen University, Khon Kaen, Thailand (G. Lertmemogkolchai); Kasturba Medical College, Manipal, India (C. Mukhopadhyay);Townsville Hospital, Townsville, Queensland, Australia (R. Norton); Universidade de Fortaleza, Fortaleza, Brazil (D. B. Rolim); University of Greifswald, Greifswald, Germany (I. Steinmetz); University of Hawaii at Manoa, Honolulu, Hawaii, USA (A. Tuanyok)

Abstract

Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions.
Melioidosis is a frequently fatal infection caused by the gram-negative bacillus Burkholderia pseudomallei (1). It is highly endemic to northeastern Thailand and northern Australia, where the causative organism is commonly found in soil and fresh water. Melioidosis also occurs in those who travel to disease-endemic regions of the world, which include tropical regions of Asia and South America, Central America, various Pacific and Indian Ocean islands, and some countries in Africa (1). B. pseudomallei can also cause latent infection; the longest documented interval between exposure and clinical melioidosis is 62 years (2). The crude case- fatality rate for melioidosis ranges from 14% to 40% and may be as high as 80% if effective antimicrobial drugs are not given.
Clinical diagnosis of melioidosis is difficult because the disease has no pathognomonic clinical manifestations (1). The current diagnostic standard is culture; however, B. pseudomallei can be misidentified as a culture contaminant or as another species (e.g., Burkholderia cepacia, Bacillus spp., orPseudomonas spp.), especially by laboratory staff unfamiliar with this organism (1,3–5). In addition, B. pseudomallei is categorized as a Tier 1 select agent by the US government, and special precautions are recommended to reduce the possibility of exposure while conducting bacterial culture. There are currently no commercially available and reliable rapid diagnostic tests for melioidosis. Serologic tests, such as indirect hemagglutination assay (IHA), have been widely used, but these are neither sensitive nor specific.
With the goal of improving timely and accurate diagnosis of melioidosis, a workshop sponsored by the US Centers for Disease Control and Prevention was held in Bangkok, Thailand, on September 14–15, 2013, to discuss current recommendations and future research directions. International subject matter experts representing academia, government, and the private sector attended the workshop to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions. The workshop consisted of multiple sessions focused on specific diagnostic topics (e.g., culture, PCR, serology, and new methods). Each session included short presentations followed by extensive group discussions. Notes from these group discussions along with correspondence exchanged shortly after the workshop were used to clarify points and reach consensus. This article provides a workshop summary as an informative diagnostic guide for clinicians and laboratory staff.

Dr Hoffmaster is the team lead of the Zoonoses and Select Agent Laboratory in the Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention. His research interests include diagnostics and molecular epidemiology of numerous pathogens, including B. pseudomallei.

Acknowledgments

We thank Bart Currie, Mindy Glass Elrod, Rebecca Lipsitz, Rosemarie Aurigemma, Alec Ritchie, and Maureen Beanan for helpful discussions on this workshop’s agenda and speaker selection; Dennis Dixon, Suman Mukhopadhyay, and Thames Pickett for contributing to discussions during the workshop; and Yolanda Gaines and Kimberly Tutt for assistance with organizing this workshop.
The workshop was funded by the US Centers for Disease Control and Prevention. Names of vendors or manufacturers are provided as examples of available product sources; inclusion does not imply endorsement of the vendors, manufacturers, or products by the US Centers for Disease Control and Prevention or the US Department of Health and Human Services.
D.A. and R.H. are principal investigators and receive funding from Phase 1 US Department of Health and Human Services Small Business Technology Transfer award no. R41AI102482-02. R.H. is an employee of InBios International but does not have a stake in the company.

References

  1. Wiersinga WJ, Currie BJ, Peacock SJ. Melioidosis. N Engl J Med. 2012;367:1035–44. DOIPubMed
  2. Ngauy V, Lemeshev Y, Sadkowski L, Crawford G. Cutaneous melioidosis in a man who was taken as a prisoner of war by the Japanese during World War II. J Clin Microbiol. 2005;43:970–2. DOIPubMed
  3. Peacock SJ, Schweizer HP, Dance DA, Smith TL, Gee JE, Wuthiekanun V, Management of accidental laboratory exposure to Burkholderia pseudomallei and B. mallei. Emerg Infect Dis. 2008;14:e2. DOIPubMed
  4. John TJ, Jesudason MV, Lalitha MK, Ganesh A, Mohandas V, Cherian T, Melioidosis in India: the tip of the iceberg? Indian J Med Res. 1996;103:62–5.PubMed
  5. Kibbler CC, Roberts CM, Ridgway GL, Spiro SG. Melioidosis in a patient from Bangladesh. Postgrad Med J. 1991;67:764–6. DOIPubMed
  6. Stewart T, Engelthaler DM, Blaney DD, Tuanyok A, Wangsness E, Smith TL, Epidemiology and investigation of melioidosis, southern Arizona. Emerg Infect Dis. 2011;17:1286–8. DOIPubMed
  7. Zehnder AM, Hawkins MG, Koski MA, Lifland B, Byrne BA, Swanson AA, Burkholderia pseudomallei isolates in 2 pet iguanas, California, USA. Emerg Infect Dis. 2014;20:304–6. DOIPubMed
  8. Wuthiekanun V, Dance DA, Wattanagoon Y, Supputtamongkol Y, Chaowagul W, White NJ. The use of selective media for the isolation ofPseudomonas pseudomallei in clinical practice. J Med Microbiol. 1990;33:121–6. DOIPubMed
  9. Wuthiekanun V, Suputtamongkol Y, Simpson AJ, Kanaphun P, White NJ. Value of throat swab in diagnosis of melioidosis. J Clin Microbiol.2001;39:3801–2. DOIPubMed
  10. Cheng AC, Wuthiekanun V, Limmathurosakul D, Wongsuvan G, Day NP, Peacock SJ. Role of selective and nonselective media for isolation ofBurkholderia pseudomallei from throat swabs of patients with melioidosis. J Clin Microbiol. 2006;44:2316. DOIPubMed
  11. Peacock SJ, Chieng G, Cheng AC, Dance DA, Amornchai P, Wongsuvan G, Comparison of Ashdown’s medium, Burkholderia cepacia medium, andBurkholderia pseudomallei selective agar for clinical isolation of Burkholderia pseudomallei. J Clin Microbiol. 2005;43:5359–61 and.DOIPubMed
  12. Thorn P, Krause V, Boutlis C, Currie B. Melioidosis in the Top End. The Northern Territory Disease Control Bulletin. 2005;12:1–2 [cited 2014 Dec 4].http://www.health.nt.gov.au/library/scripts/objectifyMedia.aspx?file=pdf/11/41.pdf&siteID=1&str_title=Bulletin+December+2005.pdf
  13. Limmathurotsakul D, Wuthiekanun V, Chierakul W, Cheng AC, Maharjan B, Chaowagul W, Role and significance of quantitative urine cultures in diagnosis of melioidosis. J Clin Microbiol. 2005;43:2274–6. DOIPubMed
  14. Centers for Disease Control and Prevention. Laboratory exposure to Burkholderia pseudomallei—Los Angeles, California, 2003. MMWR Morb Mortal Wkly Rep. 2004;53:988–90 .PubMed
  15. Pumpuang A, Chantratita N, Wikraiphat C, Saiprom N, Day NP, Peacock SJ, Survival of Burkholderia pseudomallei in distilled water for 16 years.Trans R Soc Trop Med Hyg. 2011;105:598–600. DOIPubMed
  16. Yabuuchi E, Wang L, Arakawa M, Yano I. Survival of Pseudomonas pseudomallei strains at 5 degrees C. Kansenshogaku Zasshi. 1993;67:331–5.DOIPubMed
  17. Larsen E, Smith JJ, Norton R, Corkeron M. Survival, sublethal injury, and recovery of environmental Burkholderia pseudomallei in soil subjected to desiccation. Appl Environ Microbiol. 2013;79:2424–7. DOIPubMed
  18. Holland DJ, Wesley A, Drinkovic D, Currie BJ. Cystic fibrosis and Burkholderia pseudomallei: an emerging problem? Clin Infect Dis.2002;35:e138–40. DOIPubMed
  19. Wesley A, Holland D, Currie B. Burkholderia pseudomallei in two siblings with cystic fibrosis and evidence of likely person to person transmission in the family setting. In: Proceedings of Fourth Australian and New Zealand Cystic Fibrosis Conference; 2001 Aug 23–25, Brisbane, Australia. p. 46.
  20. Price EP, Sarovich DS, Mayo M, Tuanyok A, Drees KP, Kaestli M, Within-host evolution of Burkholderia pseudomallei over a twelve-year chronic carriage infection. MBiol. 2013;4:e00388–13.PubMed
  21. O’Sullivan BP, Torres B, Conidi G, Smole S, Gauthier C, Stauffer KE, Burkholderia pseudomallei infection in a child with cystic fibrosis: acquisition in the Western Hemisphere. Chest. 2011;140:239–42. DOIPubMed
  22. Huis in ’t Veld D, Wuthiekanun V, Cheng AC, Chierakul W, Chaowagul W, Brouwer AE, The role and significance of sputum cultures in the diagnosis of melioidosis. Am J Trop Med Hyg. 2005;73:657–61 .PubMed
  23. Limmathurotsakul D, Jamsen K, Arayawichanont A, Simpson JA, White LJ, Lee SJ, Defining the true sensitivity of culture for the diagnosis of melioidosis using Bayesian latent class models. PLoS ONE. 2010;5:e12485. DOIPubMed
  24. Roesnita B, Tay ST, Puthucheary SD, Sam IC. Diagnostic use of Burkholderia pseudomallei selective media in a low prevalence setting. Trans R Soc Trop Med Hyg. 2012;106:131–3. DOIPubMed
  25. Glass MB, Beesley CA, Wilkins PP, Hoffmaster AR. Comparison of four selective media for the isolation of Burkholderia mallei and Burkholderia pseudomallei. Am J Trop Med Hyg. 2009;80:1023–8 .PubMed
  26. Wongsuvan G, Limmathurotsakul D, Wannapasni S, Chierakul W, Teerawattanasook N, Wuthiekanun V. Lack of correlation of Burkholderia pseudomallei quantities in blood, urine, sputum and pus. Southeast Asian J Trop Med Public Health. 2009;40:781–4 .PubMed
  27. Dance DA, Wuthiekanun V, Naigowit P, White NJ. Identification of Pseudomonas pseudomallei in clinical practice: use of simple screening tests and API 20NE. J Clin Pathol. 1989;42:645–8. DOIPubMed
  28. Tandhavanant S, Wongsuvan G, Wuthiekanun V, Teerawattanasook N, Day NP, Limmathurotsakul D, Monoclonal antibody-based immunofluorescence microscopy for the rapid identification of Burkholderia pseudomallei in clinical specimens. Am J Trop Med Hyg.2013;89:165–8. DOIPubMed
  29. Inglis TJ, Chiang D, Lee GS, Chor-Kiang L. Potential misidentification of Burkholderia pseudomallei by API 20NE. Pathology. 1998;30:62–4.DOIPubMed
  30. Lowe P, Engler C, Norton R. Comparison of automated and nonautomated systems for identification of Burkholderia pseudomallei. J Clin Microbiol.2002;40:4625–7. DOIPubMed
  31. Inglis TJ, Merritt A, Chidlow G, Aravena-Roman M, Harnett G. Comparison of diagnostic laboratory methods for identification of Burkholderia pseudomallei. J Clin Microbiol. 2005;43:2201–6. DOIPubMed
  32. Glass MB, Popovic T. Preliminary evaluation of the API 20NE and RapID NF plus systems for rapid identification of Burkholderia pseudomallei and B. mallei. J Clin Microbiol. 2005;43:479–83. DOIPubMed
  33. Amornchai P, Chierakul W, Wuthiekanun V, Mahakhunkijcharoen Y, Phetsouvanh R, Currie BJ, Accuracy of Burkholderia pseudomallei identification using the API 20NE system and a latex agglutination test. J Clin Microbiol. 2007;45:3774–6. DOIPubMed
  34. Koh TH, Yong Ng LS, Foon Ho JL, Sng LH, Wang GC, Tzer Pin Lin RV. Automated identification systems and Burkholderia pseudomallei. J Clin Microbiol. 2003;41:1809. DOIPubMed
  35. Weissert C, Dollenmaier G, Rafeiner P, Riehm J, Schultze D. Burkholderia pseudomallei misidentified by automated system. Emerg Infect Dis.2009;15:1799–801. DOIPubMed
  36. Lowe P, Haswell H, Lewis K. Use of various common isolation media to evaluate the new VITEK 2 colorimetric GN card for identification ofBurkholderia pseudomallei. J Clin Microbiol. 2006;44:854–6. DOIPubMed
  37. Zong Z, Wang X, Deng Y, Zhou T. Misidentification of Burkholderia pseudomallei as Burkholderia cepacia by the VITEK 2 system. J Med Microbiol.2012;61:1483–4. DOIPubMed
  38. Podin Y, Kaestli M, McMahon N, Hennessy J, Ngian HU, Wong JS, Reliability of automated biochemical identification of Burkholderia pseudomallei is regionally dependent. J Clin Microbiol. 2013;51:3076–8. DOIPubMed
  39. Hodgson K, Engler C, Govan B, Ketheesan N, Norton R. Comparison of routine bench and molecular diagnostic methods in identification ofBurkholderia pseudomallei. J Clin Microbiol. 2009;47:1578–80. DOIPubMed
  40. Podin Y, Sarovich DS, Price EP, Kaestli M, Mayo M, Hii K, Burkholderia pseudomallei isolates from Sarawak, Malaysian Borneo, are predominantly susceptible to aminoglycosides and macrolides. Antimicrob Agents Chemother. 2014;58:162–6. DOIPubMed
  41. Anuntagool N, Naigowit P, Petkanchanapong V, Aramsri P, Panichakul T, Sirisinha S. Monoclonal antibody-based rapid identification of Burkholderia pseudomallei in blood culture fluid from patients with community-acquired septicaemia. J Med Microbiol. 2000;49:1075–8 .PubMed
  42. Dharakul T, Songsivilai S, Smithikarn S, Thepthai C, Leelaporn A. Rapid identification of Burkholderia pseudomallei in blood cultures by latex agglutination using lipopolysaccharide-specific monoclonal antibody. Am J Trop Med Hyg. 1999;61:658–62 .PubMed
  43. Ekpo P, Rungpanich U, Pongsunk S, Naigowit P, Petkanchanapong V. Use of protein-specific monoclonal antibody-based latex agglutination for rapid diagnosis of Burkholderia pseudomallei infection in patients with community-acquired septicemia. Clin Vaccine Immunol. 2007;14:811–2.DOIPubMed
  44. Kiratisin P, Santanirand P, Chantratita N, Kaewdaeng S. Accuracy of commercial systems for identification of Burkholderia pseudomallei versusBurkholderia cepacia. Diagn Microbiol Infect Dis. 2007;59:277–81 . DOIPubMed
  45. Lowe W, March JK, Bunnell AJ, O’Neill KL, Robison RA. PCR-based methodologies used to detect and differentiate the Burkholderia pseudomalleicomplex: B. pseudomallei, B. mallei, and B. thailandensis. Curr Issues Mol Biol. 2013;16:23–54 .PubMed
  46. Price EP, Dale JL, Cook JM, Sarovich DS, Seymour ML, Ginther JL, Development and validation of Burkholderia pseudomallei–specific real-time PCR assays for clinical, environmental or forensic detection applications. PLoS ONE. 2012;7:e37723. DOIPubMed
  47. Novak RT, Glass MB, Gee JE, Gal D, Mayo MJ, Currie BJ, Development and evaluation of a real-time PCR assay targeting the type III secretion system of Burkholderia pseudomallei. J Clin Microbiol. 2006;44:85–90. DOIPubMed
  48. Morse SA, Kellogg RB, Perry S, Meyer RF, Bray D, Nichelson D, Detecting biothreat agents: the Laboratory Response Network. ASM News.2003;69:433–7.
  49. Gee JE, Sacchi CT, Glass MB, De BK, Weyant RS, Levett PN, Use of 16S rRNA gene sequencing for rapid identification and differentiation ofBurkholderia pseudomallei and B. mallei. J Clin Microbiol. 2003;41:4647–54 . DOIPubMed
  50. Clinical and Laboratory Standards Institute. Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria. CLSI document M45–A2. Wayne (PA): The Institute; 2010.
  51. Wuthiekanun V, Cheng AC, Chierakul W, Amornchai P, Limmathurotsakul D, Chaowagul W, Trimethoprim/sulfamethoxazole resistance in clinical isolates of Burkholderia pseudomallei. J Antimicrob Chemother. 2005;55:1029–31. DOIPubMed
  52. Jenney AW, Lum G, Fisher DA, Currie BJ. Antibiotic susceptibility of Burkholderia pseudomallei from tropical northern Australia and implications for therapy of melioidosis. Int J Antimicrob Agents. 2001;17:109–13. DOIPubMed
  53. Piliouras P, Ulett GC, Ashhurst-Smith C, Hirst RG, Norton RE. A comparison of antibiotic susceptibility testing methods for cotrimoxazole withBurkholderia pseudomallei. Int J Antimicrob Agents. 2002;19:427–9. DOIPubMed
  54. Chantratita N, Tandhavanant S, Wongsuvan G, Wuthiekanun V, Teerawattanasook N, Day NP, Rapid detection of Burkholderia pseudomallei in blood cultures using a monoclonal antibody–based immunofluorescent assay. Am J Trop Med Hyg. 2013;89:971–2. DOIPubMed
  55. Wuthiekanun V, Desakorn V, Wongsuvan G, Amornchai P, Cheng AC, Maharjan B, Rapid immunofluorescence microscopy for diagnosis of melioidosis. Clin Diagn Lab Immunol. 2005;12:555–6 .PubMed
  56. Thibault FM, Valade E, Vidal DR. Identification and discrimination of Burkholderia pseudomallei, B. mallei, and B. thailandensis by real-time PCR targeting type III secretion system genes. J Clin Microbiol. 2004;42:5871–4 . DOIPubMed
  57. Kaestli M, Richardson LJ, Colman RE, Tuanyok A, Price EP, Bowers JR, Comparison of TaqMan PCR assays for detection of the melioidosis agentBurkholderia pseudomallei in clinical specimens. J Clin Microbiol. 2012;50:2059–62. DOIPubMed
  58. Meumann EM, Novak RT, Gal D, Kaestli ME, Mayo M, Hanson JP, Clinical evaluation of a type III secretion system real-time PCR assay for diagnosing melioidosis. J Clin Microbiol. 2006;44:3028–30. DOIPubMed
  59. Chantratita N, Meumann E, Thanwisai A, Limmathurotsakul D, Wuthiekanun V, Wannapasni S, Loop-mediated isothermal amplification method targeting the TTS1 gene cluster for the detection of Burkholderia pseudomallei and diagnosis of melioidosis. J Clin Microbiol. 2008;46:568–73 .DOIPubMed
  60. Houghton RL, Reed DE, Hubbard MA, Dillon MJ, Chen H, Currie BJ, Development of a prototype lateral flow immunoassay (LFI) for the rapid diagnosis of melioidosis. PLoS Negl Trop Dis. 2014;8:e2727. DOIPubMed
  61. Sim BM, Chantratita N, Ooi WF, Nandi T, Tewhey R, Wuthiekanun V, Genomic acquisition of a capsular polysaccharide virulence cluster by non-pathogenic Burkholderia isolates. Genome Biol. 2010;11:R89. DOIPubMed
  62. Cheng AC, O’Brien M, Freeman K, Lum G, Currie BJ. Indirect hemagglutination assay in patients with melioidosis in northern Australia. Am J Trop Med Hyg. 2006;74:330–4 .PubMed
  63. Cheng AC, Peacock SJ, Limmathurotsakul D, Wongsuvan G, Chierakul W, Amornchai P, Prospective evaluation of a rapid immunochromogenic cassette test for the diagnosis of melioidosis in northeast Thailand. Trans R Soc Trop Med Hyg. 2006;100:64–7. DOIPubMed
  64. Harris PN, Ketheesan N, Owens L, Norton RE. Clinical features that affect indirect-hemagglutination-assay responses to Burkholderia pseudomallei.Clin Vaccine Immunol. 2009;16:924–30. DOIPubMed
  65. Armstrong PK, Anstey NM, Kelly PM, Currie BJ, Martins N, Dasari P, Seroprevalence of Burkholderia pseudomallei in East Timorese refugees: implications for healthcare in East Timor. Southeast Asian J Trop Med Public Health. 2005;36:1496–502 .PubMed
  66. Clayton AJ, Lisella RS, Martin DG. Melioidosis: a serological survey in military personnel. Mil Med. 1973;138:24–6 .PubMed
  67. Chantratita N, Wuthiekanun V, Thanwisai A, Limmathurotsakul D, Cheng AC, Chierakul W, Accuracy of enzyme-linked immunosorbent assay using crude and purified antigens for serodiagnosis of melioidosis. Clin Vaccine Immunol. 2007;14:110–3. DOIPubMed
  68. Limmathurotsakul D, Chantratita N, Teerawattanasook N, Piriyagitpaiboon K, Thanwisai A, Wuthiekanun V, Enzyme-linked immunosorbent assay for the diagnosis of melioidosis: better than we thought. Clin Infect Dis. 2011;52:1024–8. DOIPubMed
  69. Trikalinos TA, Balion CM. Chapter 9: options for summarizing medical test performance in the absence of a “gold standard.”. J Gen Intern Med.2012;27(Suppl 1):S67–75. DOIPubMed
  70. Lim C, Wannapinij P, White L, Day NP, Cooper BS, Peacock SJ, Using a web-based application to define the accuracy of diagnostic tests when the gold standard is imperfect. PLoS ONE. 2013;8:e79489. DOIPubMed
  71. Karger A, Stock R, Ziller M, Elschner MC, Bettin B, Melzer F, Rapid identification of Burkholderia mallei and Burkholderia pseudomallei by intact cell matrix-assisted laser desorption/ionisation mass spectrometric typing. BMC Microbiol. 2012;12:229. DOIPubMed
  72. Weigel LM, Sue D, Michel PA, Kitchel B, Pillai SP. A rapid antimicrobial susceptibility test for Bacillus anthracis. Antimicrob Agents Chemother.2010;54:2793–800 . DOIPubMed
  73. Chetchotisakd P, Chierakul W, Chaowagul W, Anunnatsiri S, Phimda K, Mootsikapun P, Trimethoprim-sulfamethoxazole versus trimethoprim-sulfamethoxazole plus doxycycline as oral eradicative treatment for melioidosis (MERTH): a multicentre, double-blind, non-inferiority, randomised controlled trial. Lancet. 2014;383:807–14 . DOIPubMed

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Suggested citation for this article: Hoffmaster AR, AuCoin D, Baccam P, Baggett HC, Baird R, Bhengsri S, et al. Melioidosis Diagnostic Workshop, 2013. Emerg Infect Dis. 2015 Feb [date cited]. http://dx.doi.org/10.3201/eid2102.141045
DOI: 10.3201/eid2102.141045
1Held September 14, 2013, in Bangkok, Thailand.
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