False-positive Candida and Aspergillus antigen testing in recipients of allogeneic haematopoietic cell transplantation due to administration of parenteral nutrition and fixed combinations of piperacillin-tazobactam.
False positivity of antigen immunoassays used as an early diagnostic tool to detect invasive fungal infections is known. Interpretation of the assay needs the identification of sources which could affect the specificity of the test. We focused on the influence of parenteral nutrition (PN) and piperacillin-tazobactam (TZP) on fungal immunoassays. Measurable amounts of Candida antigen mannan were detected in several compounds of PN and TZP in a previous in vitro study. In the current study, 84 patients undergoing allogeneic haematopoietic cell transplantation receiving either TZP, PN or both were monitored with Aspergillus and Candida antigen assay. Six patients were analysed closer in a kinetic analysis with more frequent blood sampling to detect mannan. PN in diverse compositions as well as TZP did not increase significantly the amount of mannan and the Aspergillus antigen in serum. We could not confirm the positive results of the in vitro study. Physicians should be aware that mannan antigenemia due to drug infusion could be a transient issue and should be considered in the interpretation of fungal immunoassays, although we could not find clinically relevant effects on mannan levels.
['Walter|Wencke|W|https://orcid.org/0000-0003-1800-2330', 'Bornhäuser|Martin|M|', 'Stölzel|Friedrich|F|', 'Knoth|Holger|H|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000900:Anti-Bacterial Agents D000946:Antigens, Fungal D058365:Candidiasis, Invasive D005189:False Positive Reactions D005260:Female D018380:Hematopoietic Stem Cell Transplantation D006801:Humans D055744:Invasive Pulmonary Aspergillosis D008297:Male D008875:Middle Aged D010288:Parenteral Nutrition D000077725:Piperacillin, Tazobactam Drug Combination D011446:Prospective Studies D014184:Transplantation, Homologous D055815:Young Adult D065093:beta-Lactamase Inhibitors
Candida Aspergillus parenteral nutrition Mannans galactomannan piperacillin