Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia
Abstract Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a signifi...
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| Veröffentlicht in: | Medical mycology (Oxford) 2017-07, Vol.55 (5), p.535-540 |
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| creator | Demiraslan, Hayati Atalay, M. Altay Eren, Esma Demir, Koray Kaynar, Leylagul Koc, A. Nedret Doganay, Mehmet |
| description | Abstract
Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam. The study group was divided into two groups: patients receiving original and generic piperacillin/tazobactam. Serum GM index was positive in one of 35 patients receiving original piperacillin/tazobactam, whereas it was positive in 46 out of 50 patients receiving generic piperacillin/tazobactam (P < .001). However, the patients receiving generic piperacillin/tazobactam underwent computed tomography (CT) scans more frequently than those receiving original piperacillin/tazobactam (P = .047). In addition, in vitro analysis of GM was performed in two generics and one original piperacillin/tazobactam vials. One generic piperacillin/tazobactam vial included high GM level. False positivity of serum GM with generic formulations of piperacillin/tazobactam is still an ongoing issue in hematology patients. A high rate of serum GM index false positivity may unexpectedly lead to a higher rate of CT scan. Selected piperacillin/tazobactam vials in each batch should be checked for GM to identify a false positivity of GM before purchase. |
| doi_str_mv | 10.1093/mmy/myw129 |
| format | Article |
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Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam. The study group was divided into two groups: patients receiving original and generic piperacillin/tazobactam. Serum GM index was positive in one of 35 patients receiving original piperacillin/tazobactam, whereas it was positive in 46 out of 50 patients receiving generic piperacillin/tazobactam (P < .001). However, the patients receiving generic piperacillin/tazobactam underwent computed tomography (CT) scans more frequently than those receiving original piperacillin/tazobactam (P = .047). In addition, in vitro analysis of GM was performed in two generics and one original piperacillin/tazobactam vials. One generic piperacillin/tazobactam vial included high GM level. False positivity of serum GM with generic formulations of piperacillin/tazobactam is still an ongoing issue in hematology patients. A high rate of serum GM index false positivity may unexpectedly lead to a higher rate of CT scan. Selected piperacillin/tazobactam vials in each batch should be checked for GM to identify a false positivity of GM before purchase.</description><identifier>ISSN: 1369-3786</identifier><identifier>EISSN: 1460-2709</identifier><identifier>DOI: 10.1093/mmy/myw129</identifier><identifier>PMID: 27915301</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Anti-Bacterial Agents - standards ; Anti-Bacterial Agents - therapeutic use ; Antigens, Fungal - blood ; False Positive Reactions ; Febrile Neutropenia - complications ; Febrile Neutropenia - drug therapy ; Febrile Neutropenia - microbiology ; Female ; Humans ; Invasive Pulmonary Aspergillosis - diagnosis ; Male ; Mannans - blood ; Microbiological Techniques - standards ; Middle Aged ; Penicillanic Acid - analogs & derivatives ; Penicillanic Acid - standards ; Penicillanic Acid - therapeutic use ; Piperacillin - standards ; Piperacillin - therapeutic use</subject><ispartof>Medical mycology (Oxford), 2017-07, Vol.55 (5), p.535-540</ispartof><rights>The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2017</rights><rights>The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-2e5ddc16745a1380bb416f0d55f0196085079d6437bcc981212b30160eb0e5513</citedby><cites>FETCH-LOGICAL-c353t-2e5ddc16745a1380bb416f0d55f0196085079d6437bcc981212b30160eb0e5513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27915301$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Demiraslan, Hayati</creatorcontrib><creatorcontrib>Atalay, M. Altay</creatorcontrib><creatorcontrib>Eren, Esma</creatorcontrib><creatorcontrib>Demir, Koray</creatorcontrib><creatorcontrib>Kaynar, Leylagul</creatorcontrib><creatorcontrib>Koc, A. Nedret</creatorcontrib><creatorcontrib>Doganay, Mehmet</creatorcontrib><title>Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia</title><title>Medical mycology (Oxford)</title><addtitle>Med Mycol</addtitle><description>Abstract
Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam. The study group was divided into two groups: patients receiving original and generic piperacillin/tazobactam. Serum GM index was positive in one of 35 patients receiving original piperacillin/tazobactam, whereas it was positive in 46 out of 50 patients receiving generic piperacillin/tazobactam (P < .001). However, the patients receiving generic piperacillin/tazobactam underwent computed tomography (CT) scans more frequently than those receiving original piperacillin/tazobactam (P = .047). In addition, in vitro analysis of GM was performed in two generics and one original piperacillin/tazobactam vials. One generic piperacillin/tazobactam vial included high GM level. False positivity of serum GM with generic formulations of piperacillin/tazobactam is still an ongoing issue in hematology patients. A high rate of serum GM index false positivity may unexpectedly lead to a higher rate of CT scan. Selected piperacillin/tazobactam vials in each batch should be checked for GM to identify a false positivity of GM before purchase.</description><subject>Anti-Bacterial Agents - standards</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antigens, Fungal - blood</subject><subject>False Positive Reactions</subject><subject>Febrile Neutropenia - complications</subject><subject>Febrile Neutropenia - drug therapy</subject><subject>Febrile Neutropenia - microbiology</subject><subject>Female</subject><subject>Humans</subject><subject>Invasive Pulmonary Aspergillosis - diagnosis</subject><subject>Male</subject><subject>Mannans - blood</subject><subject>Microbiological Techniques - standards</subject><subject>Middle Aged</subject><subject>Penicillanic Acid - analogs & derivatives</subject><subject>Penicillanic Acid - standards</subject><subject>Penicillanic Acid - therapeutic use</subject><subject>Piperacillin - standards</subject><subject>Piperacillin - therapeutic use</subject><issn>1369-3786</issn><issn>1460-2709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOxCAUQInROONj4wcYNibGpA6UoS3LifGVmLjRdUPpraIFKtAx484_F53RpSvu4txzw0HoiJJzSgSbGbOamdU7zcUWmtJ5QbK8JGI7zawQGSurYoL2QnghhJYiZ7tokpeCckboFH0uQoAQtH3C8Rmw1-EVuw53sg-ABxd01EvAAfxo8JPspYrOSGulxdK4tDTIqMHGgD0o0Mtvz6AH8FLpvtd2FuWHa9KWNLhzHnfQeN0DtjBG7wawWh6gnZ9rh5t3Hz1eXT5c3GR399e3F4u7TDHOYpYDb1tFi3LOJWUVaZo5LTrSct4RKgpScVKKtpizslFKVDSneZN-WBBoCHBO2T46XXsH795GCLE2Oijoe2nBjaGmVSqXl0mT0LM1qrwLwUNXD14b6Vc1JfV38jolr9fJE3y88Y6NgfYP_W2cgJM14MbhP9EXT7mMwQ</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Demiraslan, Hayati</creator><creator>Atalay, M. Altay</creator><creator>Eren, Esma</creator><creator>Demir, Koray</creator><creator>Kaynar, Leylagul</creator><creator>Koc, A. Nedret</creator><creator>Doganay, Mehmet</creator><general>Oxford University Press</general><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>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia</title><author>Demiraslan, Hayati ; Atalay, M. Altay ; Eren, Esma ; Demir, Koray ; Kaynar, Leylagul ; Koc, A. Nedret ; Doganay, Mehmet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-2e5ddc16745a1380bb416f0d55f0196085079d6437bcc981212b30160eb0e5513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anti-Bacterial Agents - standards</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antigens, Fungal - blood</topic><topic>False Positive Reactions</topic><topic>Febrile Neutropenia - complications</topic><topic>Febrile Neutropenia - drug therapy</topic><topic>Febrile Neutropenia - microbiology</topic><topic>Female</topic><topic>Humans</topic><topic>Invasive Pulmonary Aspergillosis - diagnosis</topic><topic>Male</topic><topic>Mannans - blood</topic><topic>Microbiological Techniques - standards</topic><topic>Middle Aged</topic><topic>Penicillanic Acid - analogs & derivatives</topic><topic>Penicillanic Acid - standards</topic><topic>Penicillanic Acid - therapeutic use</topic><topic>Piperacillin - standards</topic><topic>Piperacillin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Demiraslan, Hayati</creatorcontrib><creatorcontrib>Atalay, M. Altay</creatorcontrib><creatorcontrib>Eren, Esma</creatorcontrib><creatorcontrib>Demir, Koray</creatorcontrib><creatorcontrib>Kaynar, Leylagul</creatorcontrib><creatorcontrib>Koc, A. Nedret</creatorcontrib><creatorcontrib>Doganay, Mehmet</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical mycology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Demiraslan, Hayati</au><au>Atalay, M. Altay</au><au>Eren, Esma</au><au>Demir, Koray</au><au>Kaynar, Leylagul</au><au>Koc, A. Nedret</au><au>Doganay, Mehmet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia</atitle><jtitle>Medical mycology (Oxford)</jtitle><addtitle>Med Mycol</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>55</volume><issue>5</issue><spage>535</spage><epage>540</epage><pages>535-540</pages><issn>1369-3786</issn><eissn>1460-2709</eissn><abstract>Abstract
Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam. The study group was divided into two groups: patients receiving original and generic piperacillin/tazobactam. Serum GM index was positive in one of 35 patients receiving original piperacillin/tazobactam, whereas it was positive in 46 out of 50 patients receiving generic piperacillin/tazobactam (P < .001). However, the patients receiving generic piperacillin/tazobactam underwent computed tomography (CT) scans more frequently than those receiving original piperacillin/tazobactam (P = .047). In addition, in vitro analysis of GM was performed in two generics and one original piperacillin/tazobactam vials. One generic piperacillin/tazobactam vial included high GM level. False positivity of serum GM with generic formulations of piperacillin/tazobactam is still an ongoing issue in hematology patients. A high rate of serum GM index false positivity may unexpectedly lead to a higher rate of CT scan. Selected piperacillin/tazobactam vials in each batch should be checked for GM to identify a false positivity of GM before purchase.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>27915301</pmid><doi>10.1093/mmy/myw129</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Medical mycology (Oxford), 2017-07, Vol.55 (5), p.535-540 |
| issn | 1369-3786 1460-2709 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Anti-Bacterial Agents - standards Anti-Bacterial Agents - therapeutic use Antigens, Fungal - blood False Positive Reactions Febrile Neutropenia - complications Febrile Neutropenia - drug therapy Febrile Neutropenia - microbiology Female Humans Invasive Pulmonary Aspergillosis - diagnosis Male Mannans - blood Microbiological Techniques - standards Middle Aged Penicillanic Acid - analogs & derivatives Penicillanic Acid - standards Penicillanic Acid - therapeutic use Piperacillin - standards Piperacillin - therapeutic use |
| title | Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia |
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