Piperacillin/tazobactam (TazocinTM) seems to be no longer responsible for false-positive results of the galactomannan assay

Mikulska, Małgorzata; Furfaro, Elisa; Bono, Valerio Del; Raiola, Anna Maria; Ratto, S; Bacigalupo, Andrea; Viscoli, Claudio

doi:10.1093/jac/dks111

Cited by 100 publications

(57 citation statements)

References 11 publications

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“…As false positive results may occur, factors such as co-medication, underlying diseases, host factors, diagnostic imaging, clinical signs, and former medication of the patient must be taken into account for the correct interpretation of GM levels. [15][16][17] Furthermore, sensitivity of serum GM may decrease significantly in case of administration of antifungal prophylaxis or empirical/pre-emptive therapy. 18,19 Aspergillus PCR has been shown to be a very promising method for detection of fungal infection by using BALF or blood from immunocompromised patients, [20][21][22][23][24] especially when combined with the GM test 25,26 and performed early in the course of the infection.…”

Section: Introductionmentioning

confidence: 99%

Galactomannan testing andAspergillusPCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis

et al. 2016

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In recent years galactomannan antigen testing (GM) and also Aspergillus PCR have become increasingly important for diagnosis of invasive aspergillosis (IA). Whether or not these tests need to be performed with bronchoalveolar lavage fluid (BALF; i.e., primary site of infection), or testing of blood samples is sufficient, remains, however, a matter of debate. We evaluated the diagnostic performance of GM ELISA, and Aspergillus PCR by using BALF samples and blood samples obtained at the same day from a total of 53 immunocompromised patients (16 with probable/proven IA and 37 with no evidence of IA according to the revised EORTC/MSG criteria; 38 patients with hematological malignancies were prospectively enrolled at the Medical University of Graz, Austria, 15 patients with mixed underlying diseases at the Mannheim University Hospital). Patients with possible IA were excluded from this analysis. A total of 34/53 (64%) of all patients and 12/16 (75%) of patients with probable/proven IA received mold-active antifungal prophylaxis/therapy at the time of the BALF procedure. Sensitivities of GM and Aspergillus PCR were 38% and 44% in BALF, and 31% and 0% in blood, respectively. Best sensitivity (75%) for detecting proven/probable IA was achieved when BALF Aspergillus PCR, BALF Eigl et al. 529GM (>1.0 ODI), BALF-culture and serum-GM (>0.5 ODI) were combined (specificity 95%).In conclusion, sensitivities of the evaluated diagnostic tests-when interpreted on their own-were low in BALF and even lower in blood, sensitivities increased markedly when diagnostic tests were combined.

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Section: Introductionmentioning

confidence: 99%

Galactomannan testing andAspergillusPCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis

et al. 2016

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“…The test, however, has several limitations. As false-positive results may occur, patient factors, such as comedication (e.g., ␤-lactam antibacterials), underlying diseases, host factors (e.g., renal failure), diagnostic imaging, clinical signs, and former medication(s) must be taken into account to correctly interpret GM levels (15)(16)(17). Furthermore, some studies have shown that the sensitivity of the GM test decreases significantly in the case of the administration of antifungal prophylaxis/empirical therapy, whereas other reports have shown its usefulness for diagnosing breakthrough IFI (13,(18)(19)(20).…”

mentioning

confidence: 99%

Performance of Galactomannan, Beta- d -Glucan, Aspergillus Lateral-Flow Device, Conventional Culture, and PCR Tests with Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis

et al. 2014

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Galactomannan detection in bronchoalveolar lavage (BAL) fluid samples (GM test) 0) and PCR resulted in 100% sensitivity (specificity for probable/proven IPA, 95 to 98%). The performance of conventional culture was limited by low sensitivity, while that of the BDG test was limited by low specificity. We evaluated established and novel diagnostic methods for IPA and found that the Aspergillus PCR, LFD, and GM tests were the most useful methods for diagnosing the disease by using BAL fluid samples. In particular, the combination of the GM test and PCR or, if PCR is not available, the LFD test, allows for sensitive and specific diagnosis of IPA.

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“…These outcomes are constant with the inspection that antifungal therapy might bring down the fungal burden in the lung tissue (12,(18)(19)(20). However, due to crossreactivity between GM antigen and some antibiotics (21)(22)(23)(24)(25)(26)(27)(28) in patients who receive these antibiotics, the result of the GM assay may be controversial. Thus, additional specific 4 Jundishapur J Microbiol.…”

Section: Discussionmentioning

confidence: 99%

Investigating the Presence of Aspergillus fumigatus and A. flavus Using Galactomannan Enzyme Assay and TaqMan Real-Time PCR Technique

Roudbarmohammadi

Khorashad

Forouzandeh-Moghadam

et al. 2018

Jundishapur J Microbiol

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Background: Invasive aspergillosis (IA), a serious and fatal disease, is caused by numerous opportunistic fungi including Aspergillus species. Lack of early diagnosis and delay in treatment lead to the rapid spread of the infection and relapse, increase treatment costs, and ultimately cause death. Objectives: This study aimed at investigating the presence of Aspergillus species by Galactomannan EIA (GM) and TaqMan q PCR methods. Methods: Fluid samples of bronchoalveolar lavage (BAL) were collected from 89 patients, who were at risk for IA and underwent a bronchoscopy at Shariati hospital in Tehran, Iran. The specimens were examined using direct examination, culture methods, and GM and TaqMan real-time PCR. Results: A total of 23 samples were found to be positive in direct examination, 7 were identified as A. fumigatus, and 11 were positive as A.flavus in culture assays, 27 were GM positive, and 29 were positive with PAN Aspergillus probe. Moreover, 7 samples were positive with A. fumigatus probe and 11 were positive with A. flavus probe. Negative predictive value (NPV), sensitivity, positive predictive value

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Piperacillin/tazobactam (TazocinTM) seems to be no longer responsible for false-positive results of the galactomannan assay

Cited by 100 publications

References 11 publications

Galactomannan testing andAspergillusPCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis

Galactomannan testing andAspergillusPCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis

Performance of Galactomannan, Beta- d -Glucan, Aspergillus Lateral-Flow Device, Conventional Culture, and PCR Tests with Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis

Investigating the Presence of Aspergillus fumigatus and A. flavus Using Galactomannan Enzyme Assay and TaqMan Real-Time PCR Technique

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