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Journal of Clinical Microbiology, February 2006, p. 389-394, Vol. 44, No. 2
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.2.389-394.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Occurrence and Kinetics of False-Positive Aspergillus Galactomannan Test Results following Treatment with ß-Lactam Antibiotics in Patients with Hematological Disorders

Alban Aubry,1 Raphael Porcher,2 Julie Bottero,2 Sophie Touratier,3 Thierry Leblanc,4 Benoît Brethon,4 Philippe Rousselot,5 Emmanuel Raffoux,5 Jean Menotti,1 Francis Derouin,1 Patricia Ribaud,6 and Annie Sulahian1*

Laboratoire de Parasitologie-Mycologie,1 Département de Biostatistique et Informatique Médicale,2 Pharmacie CentraleServices,3 d'Hématologie Pédiatrique,4 d'Hématologie Adulte,5 d'Hématologie-Greffe de Moelle, Hôpital Saint-Louis, Assistance-Publique-Hôpitaux de Paris, Paris, France6

Received 22 June 2005/ Returned for modification 16 August 2005/ Accepted 24 November 2005

Several reports have described a high rate of false-positive Aspergillus galactomannan (GM) test results for patients treated with piperacillin-tazobactam. In this retrospective study, we first examined the relationships between intravenous administration of three ß-lactam antibiotics and the occurrence of false-positive GM test results in hematology patients. We then estimated the kinetics of clearance of GM after the cessation of treatment. Sequential serum samples from 69 patients that had received ß-lactams were analyzed by using a Platelia Aspergillus test. A significant association was found between GM positivity (≥0.5) and the administration of ß-lactams (P < 0.0001). The direct role of ß-lactams in patients' serum positivity was assessed by testing 39 batches of ß-lactams, of which 27 were positive for GM. None of the latter were positive according to a fungus- and Aspergillus-specific PCR. The kinetics of the decrease of GM was analyzed on sequential serum samples obtained after treatment. By use of a nonlinear regression model, the average time to negative antigen was assessed to be 5.5 days (95% confidence interval [CI], 4.1 to [7.0]), with a half-life of elimination of GM of 2.4 days (95% CI, 1.8 to 3.0). This study confirms that the administration of ß-lactams containing GM is responsible for false-positive diagnostic results, even up to 5 days after the cessation of treatment.

* Corresponding author. Mailing address: Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10, France. Phone: (33) 1 42 49 95 03. Fax: (33) 1 42 49 48 03. E-mail: annie.sulahian{at}sls.ap-hop-paris.fr.

Journal of Clinical Microbiology, February 2006, p. 389-394, Vol. 44, No. 2
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.2.389-394.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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