Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Mycoses. 2012 Jul;55(4):366-71. doi: 10.1111/j.1439-0507.2011.02131.x. Epub 2011 Nov 1.
The purpose of this study was to investigate the interaction between intravenous ampicillin-sulbactam treatment and (1,3)-beta-D-glucan (BDG) assay. Fifteen patients with a median age of 60 (16-81) without known risk factors for invasive fungal infections who received a daily dose of 3×2g ampicillin-sulbactam monotherapy from different batches were included in the study. Thirteen patients had soft tissue infections. The 5 of 13 patients who went under surgery had surgical dressings. Serum samples were obtained both before and after antibiotic infusion on the first, third, seventh and tenth days of an ampicillin-sulbactam treatment course. BDG was assayed using the Fungitell kit (Associates of Cape Cod, East Falmouth, MA, USA) according to manufacturers' specifications. All serum samples were also tested for galactomannan (GM) antigenemia by Platelia Aspergillus ELISA (Bio-Rad Laboratories, Marnes-la-Coquette, France). A total of 37 of 117 serum samples were positive for BDG at a threshold of 80pg ml(-1) . Seven of 37 BDG positive serum samples had a GM index ≥0.5. When a cutoff value of ≥0.5 was used for GM positivity, 16 (13.3%) serum samples were positive. For a cutoff value of ≥0.7, eight (6.6%) serum samples were positive. There were no statistically significant differences in the median BDG levels (P=0.47) or median GM indices (P =0.28) of the various sampling times. None of the SAM vials tested positive for BDG or GM. After ruling out fungal infections and all known potential causes of false BDG positivity, environmental contamination remained possible cause of BDG reactivity. We did not observe any significant association of ampicillin-sulbactam administration and positive assays for BDG or GM.
这项研究的目的是调查静脉注射氨苄西林-舒巴坦治疗与（1,3）-β-D-葡聚糖（BDG）检测之间的相互作用。本研究纳入了 15 名中位年龄为 60 岁（16-81 岁）的患者，他们均无侵袭性真菌感染的已知危险因素，且接受了不同批次的每日 3×2g 氨苄西林-舒巴坦单药治疗。13 名患者患有软组织感染。在接受氨苄西林-舒巴坦治疗疗程的第 1、3、7 和 10 天，在抗生素输注前后，从 5 名 13 名手术患者中采集了血清样本。BDG 检测使用 Fungitell 试剂盒（马恩拉科特的 Cape Cod 协会，MA，美国），根据制造商的说明书进行。所有血清样本还通过 Platelia Aspergillus ELISA（法国的 Marnes-la-Coquette 的 Bio-Rad Laboratories）检测半乳甘露聚糖（GM）抗原血症。在 80pg ml(-1)的阈值下，117 份血清样本中共有 37 份呈 BDG 阳性。在 37 份 BDG 阳性血清样本中，有 7 份 GM 指数≥0.5。当使用 GM 阳性的≥0.5 作为截止值时，有 16（13.3%）份血清样本呈阳性。当使用≥0.7 作为截止值时，有 8（6.6%）份血清样本呈阳性。不同采样时间的 BDG 水平中位数（P=0.47）或 GM 指数中位数（P=0.28）没有统计学差异。没有一个 SAM 瓶检测出 BDG 或 GM 阳性。排除真菌感染和所有已知的假 BDG 阳性的潜在原因后，环境污染仍然可能是 BDG 反应的原因。我们没有观察到氨苄西林-舒巴坦给药与 BDG 或 GM 检测阳性之间有任何显著关联。
