Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations

Copyright © 2018 by The American Society of Tropical Medicine and Hygiene. Melioidosis is a major neglected tropical disease with high mortality, caused by the Gram-negative bacterium Burkholderia pseudomallei (Bp). Microbiological culture remains the gold standard for diagnosis, but a simpler and...

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Main Authors: Panjaporn Chaichana, Kemajittra Jenjaroen, Premjit Amornchai, Suchintana Chumseng, Sayan Langla, Patpong Rongkard, Manutsanun Sumonwiriya, Atthanee Jeeyapant, Narisara Chantratita, Prapit Teparrukkul, Direk Limmathurotsakul, Nicholas P.J. Day, Vanaporn Wuthiekanun, Susanna J. Dunachie
Other Authors: University of Oxford
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Published: 2019
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/46064
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spelling th-mahidol.460642019-08-28T13:35:04Z Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations Panjaporn Chaichana Kemajittra Jenjaroen Premjit Amornchai Suchintana Chumseng Sayan Langla Patpong Rongkard Manutsanun Sumonwiriya Atthanee Jeeyapant Narisara Chantratita Prapit Teparrukkul Direk Limmathurotsakul Nicholas P.J. Day Vanaporn Wuthiekanun Susanna J. Dunachie University of Oxford Mahidol University Sunpasitthiprasong Hospital Immunology and Microbiology Medicine Copyright © 2018 by The American Society of Tropical Medicine and Hygiene. Melioidosis is a major neglected tropical disease with high mortality, caused by the Gram-negative bacterium Burkholderia pseudomallei (Bp). Microbiological culture remains the gold standard for diagnosis, but a simpler and more readily available test such as an antibody assay is highly desirable. In this study, we conducted a serological survey of blood donors (n = 1,060) and adult melioidosis patients (n = 200) in northeast Thailand to measure the antibody response to Bp using the indirect hemagglutination assay (IHA). We found that 38% of healthy adults (aged 17–59 years) have seropositivity (IHA titer 3 1:80). The seropositivity in healthy blood donors was associated with having a declared occupation of rice farmer and with residence in a nonurban area, but not with gender or age. In the melioidosis cohort, the seropositivity rate was higher in adult patients aged between 18 and 45 years (90%, 37/41) compared with those aged 3 45 years (68%, 108/159, P = 0.004). The seropositivity rate was significantly higher in people with diabetes (P = 0.008). Seropositivity was associated with decreased mortality on univariable analysis (P = 0.005), but not on multivariable analysis when adjusted for age, diabetes status, preexisting renal disease, and neutrophil count. This study confirms the presence of high background antibodies in an endemic region and demonstrates the limitations of using IHA during acute melioidosis in this population. 2019-08-23T11:24:00Z 2019-08-23T11:24:00Z 2018-01-01 Article American Journal of Tropical Medicine and Hygiene. Vol.99, No.6 (2018), 1378-1385 10.4269/ajtmh.17-0998 00029637 2-s2.0-85058178683 https://repository.li.mahidol.ac.th/handle/123456789/46064 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058178683&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Immunology and Microbiology
Medicine
spellingShingle Immunology and Microbiology
Medicine
Panjaporn Chaichana
Kemajittra Jenjaroen
Premjit Amornchai
Suchintana Chumseng
Sayan Langla
Patpong Rongkard
Manutsanun Sumonwiriya
Atthanee Jeeyapant
Narisara Chantratita
Prapit Teparrukkul
Direk Limmathurotsakul
Nicholas P.J. Day
Vanaporn Wuthiekanun
Susanna J. Dunachie
Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations
description Copyright © 2018 by The American Society of Tropical Medicine and Hygiene. Melioidosis is a major neglected tropical disease with high mortality, caused by the Gram-negative bacterium Burkholderia pseudomallei (Bp). Microbiological culture remains the gold standard for diagnosis, but a simpler and more readily available test such as an antibody assay is highly desirable. In this study, we conducted a serological survey of blood donors (n = 1,060) and adult melioidosis patients (n = 200) in northeast Thailand to measure the antibody response to Bp using the indirect hemagglutination assay (IHA). We found that 38% of healthy adults (aged 17–59 years) have seropositivity (IHA titer 3 1:80). The seropositivity in healthy blood donors was associated with having a declared occupation of rice farmer and with residence in a nonurban area, but not with gender or age. In the melioidosis cohort, the seropositivity rate was higher in adult patients aged between 18 and 45 years (90%, 37/41) compared with those aged 3 45 years (68%, 108/159, P = 0.004). The seropositivity rate was significantly higher in people with diabetes (P = 0.008). Seropositivity was associated with decreased mortality on univariable analysis (P = 0.005), but not on multivariable analysis when adjusted for age, diabetes status, preexisting renal disease, and neutrophil count. This study confirms the presence of high background antibodies in an endemic region and demonstrates the limitations of using IHA during acute melioidosis in this population.
author2 University of Oxford
author_facet University of Oxford
Panjaporn Chaichana
Kemajittra Jenjaroen
Premjit Amornchai
Suchintana Chumseng
Sayan Langla
Patpong Rongkard
Manutsanun Sumonwiriya
Atthanee Jeeyapant
Narisara Chantratita
Prapit Teparrukkul
Direk Limmathurotsakul
Nicholas P.J. Day
Vanaporn Wuthiekanun
Susanna J. Dunachie
format Article
author Panjaporn Chaichana
Kemajittra Jenjaroen
Premjit Amornchai
Suchintana Chumseng
Sayan Langla
Patpong Rongkard
Manutsanun Sumonwiriya
Atthanee Jeeyapant
Narisara Chantratita
Prapit Teparrukkul
Direk Limmathurotsakul
Nicholas P.J. Day
Vanaporn Wuthiekanun
Susanna J. Dunachie
author_sort Panjaporn Chaichana
title Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations
title_short Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations
title_full Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations
title_fullStr Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations
title_full_unstemmed Antibodies in melioidosis: The role of the indirect hemagglutination assay in evaluating patients and exposed populations
title_sort antibodies in melioidosis: the role of the indirect hemagglutination assay in evaluating patients and exposed populations
publishDate 2019
url https://repository.li.mahidol.ac.th/handle/123456789/46064
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