86-year-old patient with a past medical history of ischemic stroke, anemia, diabetes, and hypertension was transferred to the Intensive Care Unit
Therapy was escalated to appropriately cover the P. aeruginosa infection in a geographic region endemic for multi-drug resistant P. aeruginosa that was not identified via the blood culture. The patient recovered from the infection and was discharged to a rehabilitation facility.
An 86-year-old patient with a past medical history of ischemic stroke, anemia, diabetes, and hypertension was transferred to the Intensive Care Unit due to shock, respiratory distress, fever, and increased WBC. The patient was recovering from a recent hospitalization for a sacral decubitus ulcer and UTI.
Wound Swab: K. pneumoniae and E. faecium
Urine culture from catheter: E. faecalis
Rectal swab: K. pneumoniae
The patient was admitted to the ICU with orders for new blood cultures, urine cultures, T2Bacteria Panel, and was started on empiric antibiotics, IV fluids, and vasopressors.
Patient Selection Criteria
A patient suspected of sepsis with other microbiological evidence of infection
Evaluation and Treatment Decision
Diagnosis: Septic Shock (unknown origin of infection)
Empiric Therapy: Ampicillin/sulbactam and tedizolid
T2Bacteria Result: Positive for P. aeruginosa
Blood Culture Result: no growth
Decision making based on T2Bacteria Result
A rapid T2Bacteria result allowed for the identification of the P. aeruginosa bacteremia in a patient with septic shock and blood culture-negative infection. This result prompted the prescriber to escalate therapy to ceftolozane/tazobactam and amikacin.