Clinical Scorecard: Evaluating the Effectiveness of the Active Melioidosis Detect Plus Rapid Test for Identifying Burkholderia pseudomallei in Throat Swab Samples

At a Glance

Key Highlights

• AMD-RDT sensitivity was 18.4% (95% CI, 9.2%–33.4%), and specificity was 100% (95% CI, 95.2%–100%).

• Positive AMD-RDT results occurred only in specimens positive on direct culture and were associated with greater bacterial burden and culture positivity within 48 hours.

• Researchers tested 38 culture-positive specimens and 76 culture-negative controls.

• The throat swab was the sole culture-positive specimen in 20 of 38 cases (52.6%).

• Culture identified B. pseudomallei in 38 of 1451 throat swab specimens (2.6%); 9 of the 38 positive specimens required enrichment culture for detection.

Guideline-Based Recommendations

The source is a diagnostic accuracy study rather than a clinical guideline. The following points reflect its findings and discussion.

Diagnosis

• Culture remains the diagnostic gold standard for melioidosis.

• The authors do not recommend routine AMD-RDT use on throat swabs because sensitivity is inadequate.

• A negative throat swab AMD-RDT result cannot reliably exclude melioidosis.

Management

• The study does not evaluate treatment strategies. AMD-RDT results were not reported to clinical teams or used to guide patient management.

Monitoring & Follow-up

• The study does not provide recommendations for clinical monitoring or follow-up.

Risks

• Diagnostic delays contribute to high mortality because B. pseudomallei is intrinsically resistant to many first-line antimicrobials.

• Broader-spectrum empirical therapy may promote antimicrobial resistance.

Patient & Prescribing Data

Between July 11, 2023, and December 31, 2024, the laboratories received 1451 throat swab specimens from 1375 patients with suspected melioidosis. Only the first throat swab per illness episode was eligible for inclusion.

The study provides no prescribing or treatment-outcome data. Its discussion notes that targeted treatment is usually prescribed only after laboratory confirmation.

Clinical Best Practices

• Throat swabs and enrichment culture remain essential components of the diagnostic workup for melioidosis.

• Throat swabs are frequently collected from children and adults unable to expectorate and may provide the only culture-positive specimen.

• Greater bacterial burden is associated with AMD-RDT positivity, but the test’s poor sensitivity limits its usefulness on throat swabs.

Related Resources & Content

• Diagnostic accuracy of the Active Melioidosis Detect Plus rapid test for detection of Burkholderia pseudomallei in throat swabs — Arjun Chandna, Sena Sao, Joy Silisouk, et al. — International Journal of Infectious Diseases, volume 172, article 109114, 2026; accepted September 9, 2026.