We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
PURITAN MEDICAL

Download Mobile App




Cost-Effectiveness of Media for Melioidosis Diagnosis Reviewed

By LabMedica International staff writers
Posted on 09 Aug 2019
Print article
Image: Burkholderia pseudomallei colonies grown on Ashdown\'s agar after four days incubation showing the characteristic cornflower head morphology (Photo courtesy of Gavin Koh).
Image: Burkholderia pseudomallei colonies grown on Ashdown\'s agar after four days incubation showing the characteristic cornflower head morphology (Photo courtesy of Gavin Koh).
Melioidosis is a frequently fatal disease caused by a soil bacterium called Burkholderia pseudomallei that is widespread in the rural tropics. The yield of B. pseudomallei from sites with a normal flora is increased by culture using selective, differential media such as Ashdown’s agar and selective broth.

Because staff are often not familiar with B. pseudomallei and because it may be hidden if it is outgrown by other bacteria, special culture media can help laboratories diagnose the disease. However, this costs more money so it is not always done even in areas where the disease is known to be present.

A team of international scientists led by the University of Oxford (Oxford, England) reviewed the results of all cultures in the microbiology laboratories of a hospital in Laos and a Hospital for Children in Cambodia, in 2017. They identified patients with melioidosis who were only diagnosed as a result of culture of non-sterile sites and established the total number of such samples cultured using selective media and the associated costs in each laboratory.

The investigators then conducted a rudimentary cost-effectiveness analysis by determining the incremental cost-effectiveness ratio (ICER) per DALY averted and compared this against the 2017 GDP per capita in each country. In both laboratories, colonies suspected of being B. pseudomallei were screened by Gram stain, oxidase test and latex agglutination. Routine confirmation of identity was by API 20NE.

The team reported that overall, 29 patients in Laos and nine in Cambodia (20% and 16.9% of all culture-positive patients respectively) would not have been diagnosed without the use of selective media, the majority of whom (18 and eight respectively) were diagnosed by throat swab culture. The cost per additional patient detected by selective culture was approximately USD100 in Laos and USD39 in Cambodia. Despite the different patient populations (all ages in Laos versus only children in Cambodia) and testing strategies (all samples in Laos versus based on clinical suspicion in Cambodia), selective B. pseudomallei culture proved highly cost effective in both settings, with an ICER of ~USD170 and ~USD28 in Laos and Cambodia, respectively.

The authors concluded that in any patients with suspected melioidosis they recommend that, in addition to blood culture, a throat swab, or a good quality sputum sample if available, should be sent specifically for culture on Ashdown’s agar (ASH) and in Ashdown’s selective enrichment broth subcultured onto Ashdown’s agar only (SB), and a centrifuged deposit of urine should also be cultured on ASH. In areas of high melioidosis incidence, they also recommend the use of ASH and SB for any sputum and endotracheal aspirates received from patients with pneumonia. The study was published on July 15, 2019, in the journal PLOS Neglected Tropical Diseases.

Related Links:
University of Oxford

Platinum Member
COVID-19 Rapid Test
OSOM COVID-19 Antigen Rapid Test
Specimen Collection & Transport
Complement 3 (C3) Test
GPP-100 C3 Kit
Gold Member
Real-time PCR System
GentierX3 Series

Print article

Channels

Clinical Chemistry

view channel
Image: Reaching speeds up to 6,000 RPM, this centrifuge forms the basis for a new type of inexpensive, POC biomedical test (Photo courtesy of Duke University)

POC Biomedical Test Spins Water Droplet Using Sound Waves for Cancer Detection

Exosomes, tiny cellular bioparticles carrying a specific set of proteins, lipids, and genetic materials, play a crucial role in cell communication and hold promise for non-invasive diagnostics.... Read more

Molecular Diagnostics

view channel
Image: The study showed the blood-based cancer screening test detects 83% of people with colorectal cancer with specificity of 90% (Photo courtesy of Guardant Health)

Blood Test Shows 83% Accuracy for Detecting Colorectal Cancer

Colorectal cancer is the second biggest cause of cancer deaths among adults in the U.S., with forecasts suggesting 53,010 people might die from it in 2024. While fewer older adults are dying from this... Read more

Hematology

view channel
Image: The Gazelle Hb Variant Test (Photo courtesy of Hemex Health)

First Affordable and Rapid Test for Beta Thalassemia Demonstrates 99% Diagnostic Accuracy

Hemoglobin disorders rank as some of the most prevalent monogenic diseases globally. Among various hemoglobin disorders, beta thalassemia, a hereditary blood disorder, affects about 1.5% of the world's... Read more

Industry

view channel
Image: These new assays are being developed for use on the recently introduced DxI 9000 Immunoassay Analyzer (Photo courtesy of Beckman Coulter)

Beckman Coulter and Fujirebio Expand Partnership on Neurodegenerative Disease Diagnostics

Beckman Coulter Diagnostics (Brea, CA, USA) and Fujirebio Diagnostics (Tokyo, Japan) have expanded their partnership focused on the development, manufacturing and clinical adoption of neurodegenerative... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.