Detection of Polymicrobial Infections Using T2Bacteria

The patient presented to the emergency department with flu-like symptoms

Discussion

This case highlights the ability of the T2Bacteria® Panel to provide rapid species identification of causative pathogens in sepsis cases. It examines clinical challenges with current methods, including delayed blood culture growth, as well as polymicrobial infections. A rapid T2Bacteria result could have allowed for more informed treatment decisions, including earlier initiation of antibiotic therapy and earlier admission to the hospital.

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Fever of Unknown Origin

The patient admitted to the hospital with COPD exacerbation and respiratory distress

Discussion

This case highlights how the T2Bacteria Panel can guide treatment by rapidly identifying the causative pathogen in sepsis cases that are missed by blood cultures. Rapid detection of bloodstream infection by T2Bacteria could have allowed for the escalation of effective antibiotic therapy, potentially leading to the prevention of further clinical deterioration.

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Possible Pneumonia

The patient presented to the Emergency Department with acute respiratory failure and was admitted to the ICU with orders for blood cultures, T2Bacteria, and empiric antibiotics.

Discussion

In this case, rapid detection of bloodstream infection by the T2Bacteria Panel could have allowed for more informed treatment decisions, including the continuation of effective antibiotic therapy, which may have led to the prevention of clinical deterioration.

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Patient with Risk Factors for Candidemia

A 45-year-old male presented to an acute care hospital with a perforated small bowel

Discussion

This case highlights the benefit of T2Candida’s rapid fungal species identification. These results allowed for a prompt escalation of antifungal therapy once a species with a high prevalence of resistance was identified. Additionally, unnecessary antibiotics were discontinued.

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Sepsis Secondary to UTI

Discussion

In this case, rapid detection of bloodstream infection by the T2Bacteria Panel could have allowed for more informed treatment decisions, including early initiation of effective antibiotic therapy, potentially leading to prevention of clinical deterioration and avoidance of readmission.

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Clinical Utility of the T2Candida NPV

57 year old male transferred to long-term acute care (LTAC) facility for long-term ventilatory support and rehabilitation

Discussion

This case highlights how the high negative predictive value (NPV) of the T2Candida Panel enables the ability rule out the five most common Candida species in a clinical setting. In this case, because of the rapid negative result, antifungal therapy could be de-escalated early in the patient’s course.

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Critical Care Patient with Septic Shock

A patient suffering from status epilepticus and traumatic brain injury was admitted to the ICU

Discussion

In the case presented, the T2Bacteria result enabled clinicians to initiate appropriate antibiotic therapy within three hours from the diagnosis of septic shock and helped to avoid the unnecessary Gram-positive antibiotic coverage while targeting therapy to cover for P. aeruginosa.

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Candida Retinitis and Candida Infective Endocarditis

A 68 year old male with fevers, lethargy and anorexia was admitted

Discussion

This case highlights not only the benefit of rapid species identification with the T2Canida Panel but also timely diagnosis of Candida endocarditis that may present as culture-negative endocarditis.  It also illustrates the potential role of T2Candida in monitoring clinical response in a persistently positive Candida endocarditis patient.

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Suspected Blood Stream Infection

A 58-year-old female with history of metastatic breast cancer presented to clinic.

Discussion

This case highlights the ability of the T2Bacteria® Panel to provide rapid species identification and detection of the causative organisms when blood cultures do not, including polymicrobial infections.

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Sepsis in an Immunocompromised Patient with a Central Line

An immunocompromised patient was admitted after developing fever and rigors.

Discussion

This high risk, immunocompromised patient was initially treated with ceftriaxone. The rapid T2Bacteria result for pseudomonas allowed for the escalation of therapy to meropenem and amikacin. Additionally, the positive T2Bacteria result prompted the removal of the central line as the suspected source of the infection. The culture from the catheter tip confirmed P. aeruginosa, five days after the initial P. aeruginosa result from T2Bacteria. Rapid species identification allowed for rapid escalation of therapy. Without the availability of T2Bacteria, the patient may have remained on inappropriate therapy for days until further clinical deterioration may have led to an empiric switch/broadening of therapy.  

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  • According to the CDC, of the 154 million prescriptions for antibiotics written in doctors' offices and emergency departments each year, 30% are unnecessary.12