Reduction in false-positive Aspergillus serum galactomannan enzyme immunoassay results associated with use of piperacillin-tazobactam in the United States

Paschalis Vergidis; Raymund R Razonable; L Joseph Wheat; Lynn Estes; Angela M Caliendo; Lindsey R Baden; John R Wingard; John Baddley; Maha Assi; Steven Norris; Pranatharthi Chandrasekar; Ryan Shields; Hong Nguyen; Alison Freifeld; Richard Kohler; Martin Kleiman; Thomas J Walsh; Chadi A Hage

doi:10.1128/JCM.00285-14

Reduction in false-positive Aspergillus serum galactomannan enzyme immunoassay results associated with use of piperacillin-tazobactam in the United States

J Clin Microbiol. 2014 Jun;52(6):2199-201. doi: 10.1128/JCM.00285-14. Epub 2014 Apr 9.

Authors

Paschalis Vergidis¹, Raymund R Razonable¹, L Joseph Wheat², Lynn Estes¹, Angela M Caliendo³, Lindsey R Baden⁴, John R Wingard⁵, John Baddley⁶, Maha Assi⁷, Steven Norris⁸, Pranatharthi Chandrasekar⁹, Ryan Shields¹⁰, Hong Nguyen¹⁰, Alison Freifeld¹¹, Richard Kohler¹², Martin Kleiman¹³, Thomas J Walsh¹⁴, Chadi A Hage¹⁵

Affiliations

¹ Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
² MiraVista Diagnostics and Mirabella Technologies, Indianapolis, Indiana, USA.
³ Alpert Medical School of Brown University, Providence, Rhode Island, USA.
⁴ Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁵ University of Florida, College of Medicine, Gainesville, Florida, USA.
⁶ University of Alabama, Birmingham, Alabama, USA.
⁷ University of Kansas School of Medicine, Wichita, Kansas, USA.
⁸ Community Infectious Diseases, Indianapolis, Indiana, USA.
⁹ Wayne State University, Detroit, Michigan, USA.
¹⁰ University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
¹¹ University of Nebraska Medical Center, Omaha, Nebraska, USA.
¹² Indiana University, Infectious Diseases, Wishard Memorial Hospital, Indianapolis, Indiana, USA.
¹³ Indiana University, Pediatric Infectious Diseases, Riley Memorial Hospital, Indianapolis, Indiana, USA.
¹⁴ Weill Cornell Medical Center, New York, New York, USA.
¹⁵ Indiana University, Thoracic Transplantation Program, Indianapolis, Indiana, USA chage@iu.edu.

Abstract

Piperacillin-tazobactam (PTZ) is known to cause false-positive results in the Platelia Aspergillus enzyme-linked immunoassay (EIA), due to contamination with galactomannan (GM). We tested 32 lots of PTZ and 27 serum specimens from patients receiving PTZ. GM was not detected in the lots of PTZ; one serum specimen (3.7%) was positive. PTZ formulations commonly used in the United States today appear to be a rare cause for false-positive GM results.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Anti-Bacterial Agents / chemistry
Anti-Bacterial Agents / therapeutic use*
Aspergillosis / diagnosis*
Aspergillus / isolation & purification*
Diagnostic Tests, Routine / methods*
Drug Contamination
False Positive Reactions*
Female
Galactose / analogs & derivatives
Humans
Immunoenzyme Techniques / methods
Mannans / blood*
Penicillanic Acid / analogs & derivatives
Penicillanic Acid / chemistry
Penicillanic Acid / therapeutic use
Piperacillin / chemistry
Piperacillin / therapeutic use
Piperacillin, Tazobactam Drug Combination
Serum / chemistry*
United States

Substances

Anti-Bacterial Agents
Mannans
galactomannan
Piperacillin, Tazobactam Drug Combination
Penicillanic Acid
Piperacillin
Galactose