Galactomannan Antigenemia after Infusion of Gluconate-Containing Plasma-Lyte

Petraitienė, Rūta; Petraitis, Vidmantas; Witt, John R.; Durkin, Michelle; Bacher, John; Wheat, L. Joseph; Walsh, Thomas J.

doi:10.1128/jcm.05031-11

Cited by 43 publications

(24 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After discontinuation, GM tests became negative. The authors confirmed the false positivity of serum GM by testing several patients treated with Plasmalyte but without any sign of fungal infection (10 (12).…”

supporting

confidence: 53%

Plasmalyte: No Longer a Culprit in Causing False-Positive Galactomannan Test Results

et al. 2016

View full text Add to dashboard Cite

dFalse-positive galactomannan (GM) results have been reported in patients treated with gluconate-containing solutions, such as Plasmalyte. The GM optical density index was tested on 33 distinct batches of Plasmalyte and was found to be negative in all of the batches, confirming that Plasmalyte is no longer a cause of false-positive GM results. Invasive aspergillosis is a serious infection associated with a high mortality rate in patients at risk, such as those receiving chemotherapy or undergoing allogeneic hematopoietic stem cell transplantation or those admitted in the intensive care unit (ICU). Galactomannan (GM), a fungal antigen produced by Aspergillus spp. during growth, is an important biomarker for early nonculture-based diagnosis of invasive aspergillosis in immunocompromised patients. Currently, positive serum testing on the GM enzyme immunoassay (Platelia Aspergillus; Bio-Rad, Marnes-La-Coquette, France) is one of the criteria for establishing the diagnosis of probable invasive aspergillosis in immunocompromised patients according to the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) (1). For the last decade, GM testing has also been applied on bronchoalveolar lavage (BAL) fluid, especially in nonneutropenic ICU patients, as this has been shown to have good sensitivity and specificity in diagnosing invasive aspergillosis in patients without the classic immunocompromising risk factors (2).An important limiting factor for GM testing is the association with false-positive test results, which have been reported in patient serum or BAL fluid, if the patient is treated with generic piperacillin-tazobactam and amoxicillin clavulanate (3, 4). These antibiotics are produced by fermentation in Penicillium, which generates GM recognized by the monoclonal antibody used in the Platelia assay.Plasmalyte (Baxter, Lessines, Belgium) is a sterile, nonpyrogenic electrolyte solution that contains sodium chloride, potassium chloride, magnesium chloride, sodium acetate trihydrate, and bicarbonate ions with or without sodium gluconate. It is used for fluid resuscitation and hydration in severely ill patients. Fluid resuscitation in ICU patients has been a matter of debate during the last decade, with many studies investigating resuscitation efficacy in terms of hemodynamic and patient outcome versus potential adverse effects, such as kidney injury and the need for renal replacement therapy (5). Several studies suggested that balanced salt solutions, based on gluconate, acetate, or lactate should be used preferentially in order to avoid the side effects related to hyperchloremia and renal dysfunction associated with normal saline purely composed of chlorine salts (5). Since 2012, Plasmalyte, a balanced electrolyte solution, has been the default resuscitation fluid in our hospital, particularly in septic critically ill patients, as recommended by recent international consensus (6).In Belgium, only gluconate-containing Plasmalyte solutions are available (Plasmalyte A Viaflo and ...

show abstract

supporting

confidence: 53%

Plasmalyte: No Longer a Culprit in Causing False-Positive Galactomannan Test Results

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Previous studies have reported that patients and healthy volunteers receiving PL 148 have demonstrated a false-positive circulating galactomannan test lasting for up to 24 h[4-7]. Galactomannan antigen is a biomarker for pulmonary aspergillosis in immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

Plasma-Lyte 148: A clinical review

Weinberg

Collins

Mourik

et al. 2016

WJCCM

View full text Add to dashboard Cite

AIMTo outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine.METHODSWe performed an electronic literature search from Medline and PubMed (via Ovid), anesthesia and pharmacology textbooks, and online sources including studies that compared Plasma-Lyte 148 to other crystalloid solutions. The following keywords were used: “surgery”, “anaesthesia”, “anesthesia”, “anesthesiology”, “anaesthesiology”, “fluids”, “fluid therapy”, “crystalloid”, “saline”, “plasma-Lyte”, “plasmalyte”, “hartmann’s”, “ringers” “acetate”, “gluconate”, “malate”, “lactate”. All relevant articles were accessed in full. We summarized the data and reported the data in tables and text.RESULTSWe retrieved 104 articles relevant to the choice of Plasma-Lyte 148 for fluid intervention in critical illness, surgery and perioperative medicine. We analyzed the data and reported the results in tables and text.CONCLUSIONPlasma-Lyte 148 is an isotonic, buffered intravenous crystalloid solution with a physiochemical composition that closely reflects human plasma. Emerging data supports the use of buffered crystalloid solutions in preference to saline in improving physicochemical outcomes. Further large randomized controlled trials assessing the comparative effectiveness of Plasma-Lyte 148 and other crystalloid solutions in measuring clinically important outcomes such as morbidity and mortality are needed.

show abstract

“…D-F, Gomori methenamine silver staining (D; original magnification, ×400) shows acute angle-branching hyphae negative for anti-Aspergillus immunohistochemical staining (E; original magnification, ×400) but positive for anti-Rhizopus immunohistochemical staining (F; original magnification, ×400). products, or Plasma-Lyte [15][16][17]. In fact, all but 1 patient with PM whose GM assays were positive had received blood products or piperacillin-tazobactam, although the recent piperacillintazobactam preparations do not seem to cause false-positive GM results [18].…”

Section: Discussionmentioning

confidence: 99%

Using Immunohistochemistry to Assess the Accuracy of Histomorphologic Diagnosis of Aspergillosis and Mucormycosis

Jung¹,

Park²,

Sung

et al. 2015

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background. Data on the accuracy of conventional histomorphologic diagnosis are limited, especially in mucormycosis. We therefore investigated the accuracy of histomorphologic diagnosis of mucormycosis and aspergillosis, using immunohistochemistry (IHC) tests for mucormycosis and aspergillosis.Methods. Patients enrolled met the modified criteria for proven and probable mucormycosis (during a 22-year period) or invasive aspergillosis (during a 6-year period) and had formalin-fixed, paraffin-embedded tissues available. We first tested the diagnostic performance of IHC for mucormycosis and aspergillosis in proven cases. Then we determined the accuracy of histomorphologic diagnosis of probable cases, using the IHC tests.Results. In 7 proven cases of mucormycosis, the sensitivity and specificity of mucormycosis IHC were 100% (95% confidence interval, 65%-100%) and 100% (68%-100%), respectively. In 8 proven cases of aspergillosis, and the sensitivity and specificity of aspergillosis IHC staining were 87% (53%-98%) and 100% (65%-100%), respectively. Of 23 probable mucormycosis cases, 20 (87%) were positive with mucormycosis IHC, 2 (9%) were positive with aspergillosis IHC (including 1 positive for both), and 2 were negative with both. Of 16 probable aspergillosis cases, 10 (63%) were positive with aspergillosis IHC, 4 (25%) were positive with mucormycosis IHC, and 2 (13%) were negative with both tests.Conclusions. Aspergillosis and mucormycosis seem not to be correctly diagnosed morphologically, because some of the probable cases showed either test with both antibodies or failure to stain with the homologous antibody. In the absence of fungal culture results, the IHC tests seem helpful in differentiating between aspergillosis and mucormycosis.

show abstract

Galactomannan Antigenemia after Infusion of Gluconate-Containing Plasma-Lyte

Cited by 43 publications

References 19 publications

Plasmalyte: No Longer a Culprit in Causing False-Positive Galactomannan Test Results

Plasmalyte: No Longer a Culprit in Causing False-Positive Galactomannan Test Results

Plasma-Lyte 148: A clinical review

Using Immunohistochemistry to Assess the Accuracy of Histomorphologic Diagnosis of Aspergillosis and Mucormycosis

Contact Info

Product

Resources

About