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False positive galactomannan Platelia due to piperacillin-tazobactam

M P Gerlinger1, P Rousselot, S Rigaudeau

  • 1Unité de parasitologie, service de biologie, hôpital Andre-Mignot, Le Chesnay, France.

Medecine Et Maladies Infectieuses
|December 14, 2011
PubMed
Abstract

Insights

False positive galactomannan tests in hematology patients are linked to piperacillin-tazobactam, but this association varies by manufacturer. Testing antibiotic batches in vitro can help identify and prevent false positives.

Area of Science:

  • Medical Mycology
  • Clinical Microbiology
  • Hematology

Background:

  • Invasive aspergillosis poses a significant mortality risk in hematology patients.
  • Early diagnosis of invasive aspergillosis is critical for effective treatment and improved prognosis.
  • Galactomannan antigen detection is a key diagnostic tool, but can yield false positives, particularly with piperacillin-tazobactam use.

Purpose of the Study:

  • To evaluate the association between false-positive galactomannan results and piperacillin-tazobactam administration in hematology patients.
  • To investigate potential variability in false-positive rates among different manufacturers of piperacillin-tazobactam.

Main Methods:

  • A retrospective study including 207 hematology patients (69 false positives, 138 true negatives for galactomannan).
  • Statistical analysis to assess the correlation between galactomannan positivity and piperacillin-tazobactam from three manufacturers.
  • In vitro testing of piperacillin-tazobactam batches for galactomannan content.

Main Results:

  • No significant association was found between false-positive galactomannan and piperacillin-tazobactam from two manufacturers (P=0.87, P=0.94).
  • A significant association (P=0.02) was observed between false-positive galactomannan and piperacillin-tazobactam from a third manufacturer.
  • Four of 25 batches from the third manufacturer tested negative for galactomannan in vitro.

Conclusions:

  • The link between false-positive galactomannan and piperacillin-tazobactam is not universal but manufacturer-dependent.
  • Pre-administration in vitro testing of piperacillin-tazobactam batches is a valuable strategy to mitigate false-positive galactomannan results.

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