False‐Positive Galactomannan Platelia<i>Aspergillus</i>Test Results for Patients Receiving Piperacillin‐Tazobactam

Viscoli, Claudio; Machetti, Marco; Cappellano, Paola; Bucci, Barbara; Bruzzi, Paolo; Lint, Maria Teresa Van; Bacigalupo, Andrea

doi:10.1086/382224

Cited by 231 publications

(164 citation statements)

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“…Of our liver transplant recipients with false-positive test results, 55% had received these antibiotics (5). Recent reports from Europe have documented false-positive tests related to the use of piperacillin-tazobactam in patients with hematologic malignancy or those who had undergone bone marrow transplantation (1,11,16).The goals of this study were to systematically assess whether commonly used antibiotics (of fungal, nonfungal, and nonmicrobial sources) would test positive in the Platelia Aspergillus EIA. For the drugs that tested positive as undiluted samples, we sought to determine whether achievable concentrations of these antibiotics in serum, based on a normal dosing regimen, could potentially result in reactivity with the galactomannan assay.…”

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Reactivity of Platelia Aspergillus Galactomannan Antigen with Piperacillin-Tazobactam: Clinical Implications Based on Achievable Concentrations in Serum

Singh

Obman

Husain

et al. 2004

Antimicrob Agents Chemother

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The possible reactivities of commonly used antibiotics of fungal, nonfungal, and nonmicrobial or synthetic sources with the Platelia Aspergillus galactomannan assay were assessed. For drugs that tested positive, the minimal concentration of the antibiotic in serum that yielded a positive test (index, >0.5) was determined. At undiluted concentrations, piperacillin and multiple lots of piperacillin-tazobactam tested positive, whereas amoxicillin, ampicillin-sulbactam, nafcillin, cefazolin, ceftazidime, erythromycin, gentamicin, and levofloxacin tested negative. All three lots of piperacillin-tazobactam and all bags within each lot tested positive, with a mean index value of 5.168. At achievable concentrations in serum, however, only one of three lots of piperacillin-tazobactam yielded a positive test. Concentrations of 75, 150, and 300 g/ml of serum tested positive with the Platelia Aspergillus enzyme immunoassay, whereas lower concentrations, mimicking the trough levels, tested negative. Thus, while achievable serum piperacillin-tazobactam concentrations may potentially result in a positive test for galactomannan, the timing of the collection of serum samples from patients may influence the test results, with reactivity being less likely in samples collected at trough levels or prior to the administration of a dose of the antibiotic.Galactomannan is a polysaccharide component of the cell wall of Aspergillus spp. that is released into the circulation in varying amounts during invasive aspergillosis (3, 7, 15). Galactomannan detection by the Platelia Aspergillus enzyme immunoassay (EIA) has proven to be a potentially promising tool for the early diagnosis of invasive aspergillosis. False-positive test results, however, have been reported for ϳ6 to 8% of neutropenic and hematopoietic stem cell transplant recipients, for 13% of liver transplant recipients, and for 20% of lung transplant recipients (4,5,9,10,12). Cytotoxic chemotherapeutic agents, autoreactive antibodies or paraproteins, or yet-unidentified serum components may account for the false-positive tests. The high rate of false EIA reactivity in neonates may result from cross-reactivity with the lipoteichoic acid of Bifidobacterium bifidum in the gut (P. E. Verweij, R. R. Klont, A. Warris, H. J. M. Op Den Camp, and M. A. S. MenninkKersten, Abstr. 43rd Intersci. Conf. Antimicrob. Agents Chemother., abstr. M-1027, 2003). Reactivity with the galactomannan of Paecilomyces and Penicillium spp. has been noted previously (13).In 1997, Ansorg et al. first reported that drugs of fungal origin, such as antibiotics and uricase, might be associated with false-positive test results (1a). Galactomannan was detected in a batch of ampicillin-sulbactam and in two batches of piperacillin (1a). Of our liver transplant recipients with false-positive test results, 55% had received these antibiotics (5). Recent reports from Europe have documented false-positive tests related to the use of piperacillin-tazobactam in patients with hematologic malignancy or those who had undergone b...

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Reactivity of Platelia Aspergillus Galactomannan Antigen with Piperacillin-Tazobactam: Clinical Implications Based on Achievable Concentrations in Serum

Singh

Obman

Husain

et al. 2004

Antimicrob Agents Chemother

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“…These outcomes are constant with the inspection that antifungal therapy might bring down the fungal burden in the lung tissue (12,(18)(19)(20). However, due to crossreactivity between GM antigen and some antibiotics (21)(22)(23)(24)(25)(26)(27)(28) in patients who receive these antibiotics, the result of the GM assay may be controversial. Thus, additional specific 4 Jundishapur J Microbiol.…”

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confidence: 99%

Investigating the Presence of Aspergillus fumigatus and A. flavus Using Galactomannan Enzyme Assay and TaqMan Real-Time PCR Technique

Roudbarmohammadi

Khorashad

Forouzandeh-Moghadam

et al. 2018

Jundishapur J Microbiol

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Background: Invasive aspergillosis (IA), a serious and fatal disease, is caused by numerous opportunistic fungi including Aspergillus species. Lack of early diagnosis and delay in treatment lead to the rapid spread of the infection and relapse, increase treatment costs, and ultimately cause death. Objectives: This study aimed at investigating the presence of Aspergillus species by Galactomannan EIA (GM) and TaqMan q PCR methods. Methods: Fluid samples of bronchoalveolar lavage (BAL) were collected from 89 patients, who were at risk for IA and underwent a bronchoscopy at Shariati hospital in Tehran, Iran. The specimens were examined using direct examination, culture methods, and GM and TaqMan real-time PCR. Results: A total of 23 samples were found to be positive in direct examination, 7 were identified as A. fumigatus, and 11 were positive as A.flavus in culture assays, 27 were GM positive, and 29 were positive with PAN Aspergillus probe. Moreover, 7 samples were positive with A. fumigatus probe and 11 were positive with A. flavus probe. Negative predictive value (NPV), sensitivity, positive predictive value

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“…A baixa sensibilidade de testes micológicos clássicos e o longo período de cultivo de fungos filamentosos em hemoculturas dificultam o reconhecimento precoce da infecção. 5,10,11 É descrito que muitos casos de aspergilose não são detectados antes do óbito do paciente. Somando a isso, a frequência de necropsias pulmonares no Brasil é baixa e, consequentemente, conclusões sobre a incidência da API e da condição epidemiológica não são fidedignos.…”

Section: Introductionunclassified

“…tico da API, no intervalo de 6 a 14 dias de infecção, em indivíduos neutropênicos. 10,11,13,14 Com base na dificuldade de diagnóstico clínico/laboratorial da API e, consequentemente, da obtenção de dados estatísticos realistas, o presente estudo teve por objetivo determinar o perfil clínico/epidemiológico de pacientes com suspeita de API, internados em um hospital de nível terciário do estado do Rio Grande do Sul, através dos resultados do teste da galactomanana. Este estudo tem o intuito de fomentar ações de prevenção e tratamento de doenças fúngicas em um ambiente hospitalar.…”

Section: Introductionunclassified

Perfil Clínico e Epidemiológico de Pacientes com Suspeita de Aspergilose Pulmonar em Hospital do Estado Rio Grande do Sul, Brasil

Migott

Santos²,

Pagnussat³

et al. 2017

Rev Epidemiol Control Infect

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. //dx.doi.org/10.17058/reci.v7i1.7154 Páginas 01 de 06 não para fins de citação Justificativa e Objetivos: A aspergilose pulmonar é uma grave infecção fúngica tendo como agente etiológico os fungos do gênero Aspergillus. A infecção acomete principalmente indivíduos imunocomprometidos, apresentando uma alta taxa de mortalidade entre os mesmos em decorrência do difícil diagnóstico e tratamento. Devido à dificuldade de obtenção de resultado positivo para a detecção de Aspergillus, em métodos tradicionais de cultura laboratorial, torna-se necessário avaliar técnicas alternativas para a detecção deste microrganismo. Um dos avanços no diagnóstico da aspergilose é o teste da galactomanana, que detecta tal polissacarídeo da membrana celular do fungo, o qual, durante a infecção, é secretado na corrente sanguínea do hospedeiro. Métodos: Este estudo consistiu em uma análise de 24 pacientes internados no período de 2012 a 2013 em um hospital terciário do Estado do Rio Grande do Sul, Brasil. Para análise epidemiológica, os seguintes dados foram coletados sobre os pacientes com suspeita de aspergilose pulmonar invasiva (API):idade, sexo, unidade de internação hospitalar, doença de base, dados clínicos e radiológicos, uso de antimicrobianos e resultados do teste da galactomanana.

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False‐Positive Galactomannan PlateliaAspergillusTest Results for Patients Receiving Piperacillin‐Tazobactam

Cited by 231 publications

References 20 publications

Reactivity of Platelia Aspergillus Galactomannan Antigen with Piperacillin-Tazobactam: Clinical Implications Based on Achievable Concentrations in Serum

Reactivity of Platelia Aspergillus Galactomannan Antigen with Piperacillin-Tazobactam: Clinical Implications Based on Achievable Concentrations in Serum

Investigating the Presence of Aspergillus fumigatus and A. flavus Using Galactomannan Enzyme Assay and TaqMan Real-Time PCR Technique

Perfil Clínico e Epidemiológico de Pacientes com Suspeita de Aspergilose Pulmonar em Hospital do Estado Rio Grande do Sul, Brasil

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