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Sci Rep. 2024;14(1):2552.

False-positive results of galactomannan assays in patients administered glucose-containing solutions.

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제1저자 신동우 · 교신저자 홍윤지, 송경호

소속 (7)
  1. Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  2. Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  3. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  4. Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
  5. Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. aeiea@snu.ac.kr.
  6. Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. aeiea@snu.ac.kr.
  7. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea. khsongmd@gmail.com.

Abstract

Galactomannan (GM) is a polysaccharide cell wall component released by Aspergillus spp., and an immunoenzymatic GM assay is used for the diagnosis of invasive pulmonary aspergillosis. We evaluated the cause of strong positivity for GM in patients with no typical signs of aspergillosis. Repeat assays were performed using different instruments and reagent lots, but there were no differences in results among the assays. Patients with strongly positive GM results were investigated. Medication histories revealed that 14 of 23 patients had been administered total parenteral nutrition solution from one manufacturer and 4 patients had been administered dextrose solution from a different manufacturer before being tested. The results of GM assays conducted on samples of dextrose solution and the glucose fraction of the total parenteral nutrition solution were strongly positive, confirming the causes of the false-positive reactions. We hypothesize that a trace amount of GM was introduced into the glucose-containing solutions because glucoamylase, which is necessary for the saccharification step of glucose synthesis, was derived from Aspergillus niger. To enhance patient care and prevent unnecessary antifungal prescriptions, healthcare providers and manufacturers of healthcare products need to be aware of the possibility of false-positive reactions for GM.

© 2024. The Author(s).

Figures

Figure 1
Figure 1 Galactomannan (GM) assay results and history of administration of total parenteral nutrition from manufacturer A (TPN-A) and 5% dextrose solution from manufacturer X (dextrose-X). Gray boxes, administration of TPN-A; white boxes, administration of 5% dextrose-X. Numbers indicate GM assay index values (N, negative). P1-P14, patients with false-positive results for GM due to administration of TPN-A prior to testing. P15-P18, patients with probable invasive pulmonary aspergillosis and an abrupt increase of index values after administration of TPN-A. P19-P22, false-positive results for GM due to administration of 5% dextrose-X prior to testing. P20 received 5% dextrose-X 16–18 September (not shown). P23, medication history in another hospital (22 October to 25 November) prior to transfer to our hospital was not available.
Figure 2
Figure 2 Cases in which galactomannan assay results were confirmed to turn negative after discontinuing administration of total parenteral nutrition from manufacturer A (TPN-A). P2, P9, and P10 were administered TPN-A for more than a week and discontinued on 1 December, 12 November, and 26 October, respectively. It took 125, 68, and 79 days, respectively, for the galactomannan assay results of P2, P9, and P10 to change to negative after cessation of TPN-A.

그림 출처: PubMed Central 공개 논문 (PMC10827775)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article
저널
Scientific reports · eISSN 2045-2322
전자 출판
2024-01-31
MeSH
Humans · Aspergillosis* / drug therapy · Mannans · Galactose / analogs & derivatives · Glucose / therapeutic use · Parenteral Nutrition Solutions · Sensitivity and Specificity · Antigens, Fungal
Substances
galactomannan · Mannans · Galactose · Glucose · Parenteral Nutrition Solutions · Antigens, Fungal
참고문헌
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