Occurrence and Kinetics of False-Positive Aspergillus Galactomannan Test Results following Treatment with β-Lactam Antibiotics in Patients with Hematological Disorders

Abstract

Several reports have described a high rate of false-positive Aspergillus galactomannan (GM) test results for patients treated with piperacillin-tazobactam. In this retrospective study, we first examined the relationships between intravenous administration of three beta-lactam antibiotics and the occurrence of false-positive GM test results in hematology patients. We then estimated the kinetics of clearance of GM after the cessation of treatment. Sequential serum samples from 69 patients that had received beta-lactams were analyzed by using a Platelia Aspergillus test. A significant association was found between GM positivity (>/=0.5) and the administration of beta-lactams (P < 0.0001). The direct role of beta-lactams in patients' serum positivity was assessed by testing 39 batches of beta-lactams, of which 27 were positive for GM. None of the latter were positive according to a fungus- and Aspergillus-specific PCR. The kinetics of the decrease of GM was analyzed on sequential serum samples obtained after treatment. By use of a nonlinear regression model, the average time to negative antigen was assessed to be 5.5 days (95% confidence interval [CI], 4.1 to [7.0]), with a half-life of elimination of GM of 2.4 days (95% CI, 1.8 to 3.0). This study confirms that the administration of beta-lactams containing GM is responsible for false-positive diagnostic results, even up to 5 days after the cessation of treatment.