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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

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.

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