Detection of Aspergillus Galactomannan Antigenemia To Determine Biological and Clinical Implications of Beta-Lactam Treatments
Detection of Aspergillus galactomannan (GM) in serum with the Platelia Aspergillus enzyme immunoassay (EIA) is useful for diagnosing invasive aspergillosis. From May 2003 to November 2004, 65 patients who did not develop aspergillosis had at least two positive sera while receiving a beta-lactam trea...
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| Veröffentlicht in: | Journal of Clinical Microbiology 2005-10, Vol.43 (10), p.5214-5220 |
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| container_title | Journal of Clinical Microbiology |
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| creator | Bart-Delabesse, Emmanuelle Basile, Maria Al Jijakli, Ahmad Souville, Didier Gay, Frédérick Philippe, Bruno Bossi, Philippe Danis, Martin Vernant, Jean-Paul Datry, Annick |
| description | Detection of Aspergillus galactomannan (GM) in serum with the Platelia Aspergillus enzyme immunoassay (EIA) is useful for diagnosing invasive aspergillosis. From May 2003 to November 2004, 65 patients who did not develop aspergillosis had at least two positive sera while receiving a beta-lactam treatment (GM index [GMI], [>/=]0.5). Of the 69 treatment episodes scored, 41 consisted of a beta-lactam other than piperacillin-tazobactam (n = 29), namely, amoxicillin-clavulanate (n = 25), amoxicillin (n = 10), ampicillin (n = 3), or phenoxymethylpenicillin (n = 2). In all cases, antigenemia became negative 24 h to 120 h upon stopping the antibiotic. Monitoring of 35 patients, including 26 with hematological malignancies, revealed three antigenemia kinetic patterns: each was observed with any drug regimen and consisted of a persistent GMI of >2.0 (65.7%), >0.5, and |
| doi_str_mv | 10.1128/JCM.43.10.5214-5220.2005 |
| format | Article |
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From May 2003 to November 2004, 65 patients who did not develop aspergillosis had at least two positive sera while receiving a beta-lactam treatment (GM index [GMI], [>/=]0.5). Of the 69 treatment episodes scored, 41 consisted of a beta-lactam other than piperacillin-tazobactam (n = 29), namely, amoxicillin-clavulanate (n = 25), amoxicillin (n = 10), ampicillin (n = 3), or phenoxymethylpenicillin (n = 2). In all cases, antigenemia became negative 24 h to 120 h upon stopping the antibiotic. Monitoring of 35 patients, including 26 with hematological malignancies, revealed three antigenemia kinetic patterns: each was observed with any drug regimen and consisted of a persistent GMI of >2.0 (65.7%), >0.5, and </=1.5 (25.7%) or a variable GMI (14.3%) from the onset of antibiotic therapy. All available drug batches given to 26 patients cross-reacted with the EIA. Galactomannan titration in batches failed to predict the GM titers in the five patients studied at cumulative doses of ampicillin or amoxicillin-clavulanate, regardless of the time lapse between serum sampling and infusion period. Our results show that beta-lactams other than piperacillin-tazobactam may lead to false presumption of aspergillosis. The resulting kinetic patterns of GM antigenemia are variable, and sampling serum prior to the next beta-lactam dose may not decrease GMI below the threshold. Consequently, testing of suspected antibiotic batches remains the only indicator of possible false EIA positivity.</description><identifier>ISSN: 0095-1137</identifier><identifier>EISSN: 1098-660X</identifier><identifier>DOI: 10.1128/JCM.43.10.5214-5220.2005</identifier><identifier>PMID: 16207986</identifier><identifier>CODEN: JCMIDW</identifier><language>eng</language><publisher>Washington, DC: American Society for Microbiology</publisher><subject>Antigens, Fungal - blood ; Aspergillosis - diagnosis ; Aspergillosis - drug therapy ; Aspergillosis - microbiology ; Aspergillus ; Aspergillus - isolation & purification ; beta-Lactams - administration & dosage ; beta-Lactams - therapeutic use ; Biological and medical sciences ; False Positive Reactions ; Fundamental and applied biological sciences. Psychology ; Fungemia - diagnosis ; Fungemia - drug therapy ; Fungemia - microbiology ; Humans ; Infectious diseases ; Mannans - blood ; Medical sciences ; Microbiology ; Miscellaneous ; Mycology</subject><ispartof>Journal of Clinical Microbiology, 2005-10, Vol.43 (10), p.5214-5220</ispartof><rights>2005 INIST-CNRS</rights><rights>Copyright © 2005, American Society for Microbiology 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-b584c8837d6f3ece2b8fadf64f953c0c1435a64fd3d985c4e6d9838d12c238a83</citedby><cites>FETCH-LOGICAL-c530t-b584c8837d6f3ece2b8fadf64f953c0c1435a64fd3d985c4e6d9838d12c238a83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1248458/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1248458/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,3175,3176,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17175315$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16207986$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bart-Delabesse, Emmanuelle</creatorcontrib><creatorcontrib>Basile, Maria</creatorcontrib><creatorcontrib>Al Jijakli, Ahmad</creatorcontrib><creatorcontrib>Souville, Didier</creatorcontrib><creatorcontrib>Gay, Frédérick</creatorcontrib><creatorcontrib>Philippe, Bruno</creatorcontrib><creatorcontrib>Bossi, Philippe</creatorcontrib><creatorcontrib>Danis, Martin</creatorcontrib><creatorcontrib>Vernant, Jean-Paul</creatorcontrib><creatorcontrib>Datry, Annick</creatorcontrib><title>Detection of Aspergillus Galactomannan Antigenemia To Determine Biological and Clinical Implications of Beta-Lactam Treatments</title><title>Journal of Clinical Microbiology</title><addtitle>J Clin Microbiol</addtitle><description>Detection of Aspergillus galactomannan (GM) in serum with the Platelia Aspergillus enzyme immunoassay (EIA) is useful for diagnosing invasive aspergillosis. From May 2003 to November 2004, 65 patients who did not develop aspergillosis had at least two positive sera while receiving a beta-lactam treatment (GM index [GMI], [>/=]0.5). Of the 69 treatment episodes scored, 41 consisted of a beta-lactam other than piperacillin-tazobactam (n = 29), namely, amoxicillin-clavulanate (n = 25), amoxicillin (n = 10), ampicillin (n = 3), or phenoxymethylpenicillin (n = 2). In all cases, antigenemia became negative 24 h to 120 h upon stopping the antibiotic. Monitoring of 35 patients, including 26 with hematological malignancies, revealed three antigenemia kinetic patterns: each was observed with any drug regimen and consisted of a persistent GMI of >2.0 (65.7%), >0.5, and </=1.5 (25.7%) or a variable GMI (14.3%) from the onset of antibiotic therapy. All available drug batches given to 26 patients cross-reacted with the EIA. Galactomannan titration in batches failed to predict the GM titers in the five patients studied at cumulative doses of ampicillin or amoxicillin-clavulanate, regardless of the time lapse between serum sampling and infusion period. Our results show that beta-lactams other than piperacillin-tazobactam may lead to false presumption of aspergillosis. The resulting kinetic patterns of GM antigenemia are variable, and sampling serum prior to the next beta-lactam dose may not decrease GMI below the threshold. Consequently, testing of suspected antibiotic batches remains the only indicator of possible false EIA positivity.</description><subject>Antigens, Fungal - blood</subject><subject>Aspergillosis - diagnosis</subject><subject>Aspergillosis - drug therapy</subject><subject>Aspergillosis - microbiology</subject><subject>Aspergillus</subject><subject>Aspergillus - isolation & purification</subject><subject>beta-Lactams - administration & dosage</subject><subject>beta-Lactams - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>False Positive Reactions</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fungemia - diagnosis</subject><subject>Fungemia - drug therapy</subject><subject>Fungemia - microbiology</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Mannans - blood</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Mycology</subject><issn>0095-1137</issn><issn>1098-660X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1vEzEQhlcIREPhL4CFBLcN_tx1LkhpgFIUxIFU4mZNvN6NK3-k9gbEhd-Ol0S0nDiNR37mHVtPVSGC54RQ-ebT6vOcs3lpBSW8FpTiOcVYPKhmBC9k3TT428NqhvFC1ISw9qx6kvMNxoRzIR5XZ6ShuF3IZlb9emdGo0cbA4o9Wua9SYN17pDRJTjQY_QQAgS0DKMdTDDeAtpENE0lb4NBFza6OFgNDkHo0MrZ8Ke58ntXDlNynqIvzAj1uiSCR5tkYPQmjPlp9agHl82zUz2vrj-836w-1usvl1er5brWguGx3grJtZSs7ZqeGW3oVvbQ9Q3vF4JprAlnAkrXsW4hheamKZXJjlBNmQTJzqu3x9z9YetNp8vuBE7tk_WQfqoIVv17E-xODfG7IpRLLqaA16eAFG8PJo_K26yNcxBMPGTVyEZILNh_QdKyRdEjCiiPoE4x52T6v68hWE2WVbGsOJvaybKaLKvJchl9fv83d4MnrQV4dQIgFxl9gqBtvuNa0gpGpqCXR25nh90Pm4yC7NWN9vf2FujFEeohKhhSCbr-SjFhmGBGOWHsN2fsx9U</recordid><startdate>20051001</startdate><enddate>20051001</enddate><creator>Bart-Delabesse, Emmanuelle</creator><creator>Basile, Maria</creator><creator>Al Jijakli, Ahmad</creator><creator>Souville, Didier</creator><creator>Gay, Frédérick</creator><creator>Philippe, Bruno</creator><creator>Bossi, Philippe</creator><creator>Danis, Martin</creator><creator>Vernant, Jean-Paul</creator><creator>Datry, Annick</creator><general>American Society for Microbiology</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20051001</creationdate><title>Detection of Aspergillus Galactomannan Antigenemia To Determine Biological and Clinical Implications of Beta-Lactam Treatments</title><author>Bart-Delabesse, Emmanuelle ; Basile, Maria ; Al Jijakli, Ahmad ; Souville, Didier ; Gay, Frédérick ; Philippe, Bruno ; Bossi, Philippe ; Danis, Martin ; Vernant, Jean-Paul ; Datry, Annick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c530t-b584c8837d6f3ece2b8fadf64f953c0c1435a64fd3d985c4e6d9838d12c238a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Antigens, Fungal - blood</topic><topic>Aspergillosis - diagnosis</topic><topic>Aspergillosis - drug therapy</topic><topic>Aspergillosis - microbiology</topic><topic>Aspergillus</topic><topic>Aspergillus - isolation & purification</topic><topic>beta-Lactams - administration & dosage</topic><topic>beta-Lactams - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>False Positive Reactions</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fungemia - diagnosis</topic><topic>Fungemia - drug therapy</topic><topic>Fungemia - microbiology</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Mannans - blood</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Mycology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bart-Delabesse, Emmanuelle</creatorcontrib><creatorcontrib>Basile, Maria</creatorcontrib><creatorcontrib>Al Jijakli, Ahmad</creatorcontrib><creatorcontrib>Souville, Didier</creatorcontrib><creatorcontrib>Gay, Frédérick</creatorcontrib><creatorcontrib>Philippe, Bruno</creatorcontrib><creatorcontrib>Bossi, Philippe</creatorcontrib><creatorcontrib>Danis, Martin</creatorcontrib><creatorcontrib>Vernant, Jean-Paul</creatorcontrib><creatorcontrib>Datry, Annick</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of Clinical Microbiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bart-Delabesse, Emmanuelle</au><au>Basile, Maria</au><au>Al Jijakli, Ahmad</au><au>Souville, Didier</au><au>Gay, Frédérick</au><au>Philippe, Bruno</au><au>Bossi, Philippe</au><au>Danis, Martin</au><au>Vernant, Jean-Paul</au><au>Datry, Annick</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of Aspergillus Galactomannan Antigenemia To Determine Biological and Clinical Implications of Beta-Lactam Treatments</atitle><jtitle>Journal of Clinical Microbiology</jtitle><addtitle>J Clin Microbiol</addtitle><date>2005-10-01</date><risdate>2005</risdate><volume>43</volume><issue>10</issue><spage>5214</spage><epage>5220</epage><pages>5214-5220</pages><issn>0095-1137</issn><eissn>1098-660X</eissn><coden>JCMIDW</coden><abstract>Detection of Aspergillus galactomannan (GM) in serum with the Platelia Aspergillus enzyme immunoassay (EIA) is useful for diagnosing invasive aspergillosis. From May 2003 to November 2004, 65 patients who did not develop aspergillosis had at least two positive sera while receiving a beta-lactam treatment (GM index [GMI], [>/=]0.5). Of the 69 treatment episodes scored, 41 consisted of a beta-lactam other than piperacillin-tazobactam (n = 29), namely, amoxicillin-clavulanate (n = 25), amoxicillin (n = 10), ampicillin (n = 3), or phenoxymethylpenicillin (n = 2). In all cases, antigenemia became negative 24 h to 120 h upon stopping the antibiotic. Monitoring of 35 patients, including 26 with hematological malignancies, revealed three antigenemia kinetic patterns: each was observed with any drug regimen and consisted of a persistent GMI of >2.0 (65.7%), >0.5, and </=1.5 (25.7%) or a variable GMI (14.3%) from the onset of antibiotic therapy. All available drug batches given to 26 patients cross-reacted with the EIA. Galactomannan titration in batches failed to predict the GM titers in the five patients studied at cumulative doses of ampicillin or amoxicillin-clavulanate, regardless of the time lapse between serum sampling and infusion period. Our results show that beta-lactams other than piperacillin-tazobactam may lead to false presumption of aspergillosis. The resulting kinetic patterns of GM antigenemia are variable, and sampling serum prior to the next beta-lactam dose may not decrease GMI below the threshold. Consequently, testing of suspected antibiotic batches remains the only indicator of possible false EIA positivity.</abstract><cop>Washington, DC</cop><pub>American Society for Microbiology</pub><pmid>16207986</pmid><doi>10.1128/JCM.43.10.5214-5220.2005</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antigens, Fungal - blood Aspergillosis - diagnosis Aspergillosis - drug therapy Aspergillosis - microbiology Aspergillus Aspergillus - isolation & purification beta-Lactams - administration & dosage beta-Lactams - therapeutic use Biological and medical sciences False Positive Reactions Fundamental and applied biological sciences. Psychology Fungemia - diagnosis Fungemia - drug therapy Fungemia - microbiology Humans Infectious diseases Mannans - blood Medical sciences Microbiology Miscellaneous Mycology |
| title | Detection of Aspergillus Galactomannan Antigenemia To Determine Biological and Clinical Implications of Beta-Lactam Treatments |
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