TABLE 5.
Sensitivities and specificities of diagnostic tests for melioidosis
| Testa | Study location (n) | Sensitivity (%) | Specificity (%) | Reference |
|---|---|---|---|---|
| Antibody detection | ||||
| Complement fixation test | Unknown (47) | Not recorded | 100 | 314 |
| Serum IHA | Thailand (150) | 71 | 75 | 142 |
| Serum IHA | Thailand (184) | 77 | 92 | 15 |
| Serum IHA (purified antigens) | Thailand (101) | 46-94 | 34-82 | 386 |
| Serum IHA | Thailand (130) | 61.9 | 79.9 | 375 |
| Serum IHA | Thailand (148) | 64 | 93 | 479 |
| Serum IHA | Thailand (299) | 72 | 68 | 490 |
| Serum IHA | Australia (298) | 80 | 91 | 319 |
| Serum IHA (acute-phase serum only) | Australia (191) | 85 | 100 | 25 |
| Serum IFA (IgG, acute-phase serum only) | Australia (191) | 86 | 99 | 25 |
| Serum ELISA (IgG; acute-phase serum only) | Australia (191) | 79 | 99 | 25 |
| Serum ELISA (purified glycolipid antigen) | Japan, Vietnam, Thailand (416) | 100 | 97.8 | 330 |
| Serum ELISA (IgG; immunoaffinity-purified antigen) | Thailand (150) | 88 | 83 | 142 |
| Serum ELISA (IgM) | Thailand (150) | 87.8 | 81.8 | 142 |
| Serum ELISA (various antigens) | Thailand (101) | 74-82 | 75-80 | 386 |
| Serum ELISA (immunoaffinity-purified antigen) | Thailand (130) | 71.4 | 86.2 | 375 |
| Serum ELISA (culture filtrate antigen) | Thailand (148) | 93 | 97 | 479 |
| Serum DOT (culture filtrate antigen) | Thailand (101) | 72 | 64 | 386 |
| Serum DOT (culture filtrate antigen) | Thailand (130) | 85.7 | 85.3 | 375 |
| Serum DOT (culture filtrate antigen) | Thailand (148) | 94.1 | 99.2 | 479 |
| Immunochromogenic card test (IgG) | Australia (298) | 88 | 90 | 319 |
| Immunochromogenic card test (IgM) | Australia (298) | 77 | 69 | 319 |
| Immunochromogenic card test (IgG) | Thailand (299) | 79 | 90 | 490 |
| Immunochromogenic card test (IgM) | Thailand (299) | 67 | 80 | 490 |
| Serum (Western blot) | Thailand (101) | 70 | 91 | 386 |
| Serum (various antibody targets) | Thailand (101) | 23-59 | 56-95 | 386 |
| Serum IFA (whole-cell antigen) | India (22) | 45-63 | 291 | |
| Antigen detection | ||||
| Specimen immunofluoresence | Thailand (272) | 73 | 99 | 462 |
| Serum ELISA (19.5-kDa antigen) | Thailand (147) | 82 | 96 | 14 |
| Direct specimen ELISA (MAb 5F8) | Thailand (114) | 75 | 98 | 10 |
| Urine IFA | Thailand | 81 | 96 | 136 |
| Blood PCR (LPS1, LPS2) | Thailand (130) | 95.2 | 91.7 | 375 |
| Blood PCR (16S rRNA) | Australia (52) | 100 | 67 | 178 |
| Blood PCR (various primers) | Thailand | 31-41 | 47-100 | 251 |
| Blood PCR (16S rRNA) | Thailand (29) | 47 | 100 | 144 |
| Blood PCR | Thailand (7) | 100 | 100 | 352 |
| Blood culture supernatant | ||||
| MAb-LA | Thailand (1, 369) | 95.1 | 99.7 | 13 |
| MAb-LA | Thailand | 100 | 86 | 335 |
| MAb-LA | Thailand | 100 | 96 | 335 |
| MAb-LA | Thailand (88) | 100 | 100 | 143 |
a
IFA, immunofluorescence assay; DOT, DOT immunoassay; MAb-LA, monoclonal antibody latex agglutination.