From Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 2, February 2015

 

Clinical diagnosis of melioidosis is difficult because the disease has no pathognomonic clinical manifestations. 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., or Pseudomonas spp.), especially by laboratory staff unfamiliar with this organism. 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.  …