Clinical information associated with bacterial culture proven Burkholderia pseudomallei among melioiodosis patients in Buriram province

Abstract

Indirect hemagglutination assay (IHA) is a general rapid diagnosis procedure in melioidosis patients combined with clinical information. The Burkholderia pseudomallei culture technique requires prolonged time before getting culture results. Related factors of bacterial culture proven melioidosis and the appropriate cut-off point for IHA are unfashionable and need to be updated. A cross-sectional study was conducted among melioidosis patients using data reported in the medical records. Univariable analysis was performed by Chi-square test and Student T-test as appropriate. Multivariable logistic regression was finally used to identify the contributing factors to bacterial culture proven cases. The results were shown as adjusted odds ratio (AdjOR) and 95%CI. Validity domains, sensitivity, specificity, predictive values, and likelihood ratios at each cut-off point for IHA were demonstrated. The results revealed that after adjustment for abdominal pain symptoms, diabetes mellitus (DM)(p-value < 0.001) and dyspnea symptoms (p-value = 0.025) were the associated factors of bacterial culture proven cases. The IHA titer > 1: 10240 provided the highest positive and negative predictive values, 30% and 69% respectively. Both positive and negative likelihood ratios of this cut-off point were also accounted for as 0.95 and 1.003, respectively. Health personnel should perform melioidosis diagnosis by the use of clinical information and an appropriate cut-off point for IHA, especially in diabetic patients who have dyspnea.