JAC Advance Access published online on July 21, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn308
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Original research |
False positivity of the Aspergillus galactomannan Platelia ELISA because of piperacillin/tazobactam treatment: does it represent a clinical problem?
1 Department of Internal Medicine III, University of Bonn, Bonn, Germany 2 Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany
Received 6 April 2008; returned 11 June 2008; revised 21 June 2008; accepted 6 July 2008
* Correspondence address. Medizinische Klinik III, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Tel: +49-228-2871/4003; Fax: +49-228-2871/1423; E-mail: m.lilienfeld.toal{at}uni-bonn.de
Objectives: False-positive results of the galactomannan (GM) ELISA caused by concurrent administration of piperacillin/tazobactam have been reported in patients with febrile neutropenia.
Patients and methods: This prospective study investigated different sampling times in 30 patients receiving piperacillin/tazobactam for febrile neutropenia.
Results: Prior to the first piperacillin/tazobactam infusion, a median GM index of 0.2 [interquartile range (IQR) 0.1–0.3] was noted; in two patients (7%) the index was 0.5. Immediately after piperacillin/tazobactam infusion, the median index increased to 0.3 (IQR 0.2–0.4, P = 0.002) leading to 21% (7/30) false-positive results, if 
0.5 is assumed as the cut-off level. GM indices before the next piperacillin/tazobactam infusion were not increased (median 0.2, IQR 0.2–0.35, P > 0.05), but 10% (3/30) were still 0.5. With a cut-off level of >0.7, no false-positive results were noted at any sampling time point.
Conclusions: We conclude that the clinical relevance of false-positive GM results during piperacillin/tazobactam treatment is small if samples are collected prior to infusion and if a cut-off level of >0.7 is used.
Key Words: febrile neutropenia , cut-off level , fungal infection
These authors contributed equally.
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