Boonsarngsuk Viboon, Niyompattama Anuchit, Teosirimongkol Chalermporn, Sriwanichrak Kanchana
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Scand J Infect Dis. 2010 Jul;42(6-7):461-8. doi: 10.3109/00365541003602064.
Our objective was to identify false-positive serum and bronchoalveolar lavage (BAL) fluid galactomannan (GM) tests caused by various antibiotics commonly used in general practice. Serum and BAL samples from patients who did not have the diagnostic criteria of invasive aspergillosis and received different antibiotics were prospectively analyzed for GM. Serum and BAL samples were also collected from patients who did not receive antibiotics. At the cut-off index of >or=0.5, false-positive serum results were found in patients who received amoxicillin-clavulanate, piperacillin-tazobactam, cefepime, and cefoperazone-sulbactam (26.7%, 58.3%, 14.3%, and 66.7%, respectively). Fungal colonization in BAL samples had a higher BAL GM than those without fungal colonization. In 71 patients who had a negative BAL culture for fungi, at the cut-off value of >or=1.0, false-positive BAL fluid results were found in patients who received amoxicillin-clavulanate (27.3%), piperacillin-tazobactam (50%), cefepime (16.7%), carbapenem (45.5%), and ceftriaxone (45.5%). False-positive serum and BAL GM assays were also detected in patients who did not receive any antibiotics. In summary, this study demonstrates the false-positive GM levels in serum and BAL caused by beta-lactam antibiotics that are commonly used in general practice. Physicians should be aware of this possible interference.
我们的目的是确定由全科医疗中常用的各种抗生素导致的血清和支气管肺泡灌洗（BAL）液半乳甘露聚糖（GM）检测假阳性情况。对未达到侵袭性曲霉病诊断标准且接受不同抗生素治疗的患者的血清和BAL样本进行前瞻性GM分析。还收集了未接受抗生素治疗患者的血清和BAL样本。在截断指数≥0.5时，接受阿莫西林-克拉维酸、哌拉西林-他唑巴坦、头孢吡肟和头孢哌酮-舒巴坦治疗的患者中发现血清假阳性结果（分别为26.7%、58.3%、14.3%和66.7%）。BAL样本中有真菌定植的患者其BAL GM高于无真菌定植者。在71例BAL真菌培养阴性的患者中，在截断值≥1.0时，接受阿莫西林-克拉维酸（27.3%）、哌拉西林-他唑巴坦（50%）、头孢吡肟（16.7%）、碳青霉烯类（45.5%）和头孢曲松（45.5%）治疗的患者中发现BAL液假阳性结果。在未接受任何抗生素治疗的患者中也检测到血清和BAL GM检测假阳性。总之，本研究证明了全科医疗中常用的β-内酰胺类抗生素可导致血清和BAL中GM水平出现假阳性。医生应意识到这种可能的干扰。
