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High Negative Predictive Value Enables De-escalation of Therapy

A 72 year-old-patient presented to the ER with a productive cough for three days, left flank pain, and intermittent nausea.

Discussion

This case highlights the benefits of using the high negative predictive value (NPV) of the T2Bacteria Panel for early de-escalation of therapy, mainly when using antimicrobial agents that can commonly cause acute kidney injury.

De-escalation of Therapy Before Blood Culture Result is Returned

A severely dehydrated elderly patient was admitted for septic shock overnight.

Discussion

This case highlights not only T2Bacteria’s ability to rapidly identify specific bacterial pathogens in whole blood but also the capability to detect the causative organism in the presence of antibiotics where blood cultures remained negative, as well as an opportunity to use the result to de-escalate therapy.

Critical Results Received without Interference from Empiric Therapy

The patient presented to the emergency department 5 days after appendectomy

Discussion

This case highlights the benefit of the T2Bacteria Panel’s rapid bacterial species identification in a scenario where a patient has already received several days of empiric therapy without significant clinical improvement. Once the causative organism was identified and effective therapy was initiated, the patient experienced rapid clinical improvement. This improvement enabled the patient to be discharged 2 days after the T2Bacteria result, potentially resulting in a reduced length of stay.

Rapid Targeting of Therapy Based on T2Bacteria

An 86 year old patient was transferred to the treating hospital with signs of septic shock.

Discussion

This case highlights the benefit of T2Bacteria’s rapid bacterial species identification, which allowed for a rapid escalation of antibiotic therapy and discontinuation of unnecessary antibiotics once Pseudomonas aeruginosa was identified.

Escalation of Appropriate Therapy for P. Aeruginosa

86-year-old patient with a past medical history of ischemic stroke, anemia, diabetes, and hypertension was transferred to the Intensive Care Unit.

Discussion

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.

Early ID of S. aureus Endocarditis Using T2Bacteria

54-year-old male, with a past medical history of Hepatitis C, presented to the emergency department.

Discussion

This case highlights the benefit of the T2Bacteria Panel’s rapid bacterial species identification. Using T2Bacteria allowed for early identification of S. aureus endocarditis in a patient with a limited medical history that had been transferred from an outside hospital. Based on the T2Bacteria results, unnecessary antibiotics were discontinued on Day 1, and the patient received cardiology and infectious disease consultations for the management of endocarditis. The patient’s follow-on blood cultures were negative, likely due to the presence of antibiotics, but the S. aureus bacteremia was confirmed from a blood culture draw obtained prior to admission.

Earlier Targeted Therapy Based on T2 Positive

52-year-old male, currently undergoing hemodialysis three times weekly with a complicated medical history.

Discussion

This case highlights the benefit of the T2Bacteria Panel’s rapid species identification, allowing for the rapid initiation of appropriate antimicrobial therapy and resulting in clinical improvement.
Male nurses standing over a patient in a hospital bed

Septic Shock Secondary to Pyelonephritis

A 55-year-old male presented to the hospital from an outside facility with sepsis secondary to pyelonephritis.

Discussion

This case highlights not only T2Bacteria’s ability of rapid identification but also the capability to detect the causative organism in the presence of antibiotics. The patient, in this case, received a dose of ceftriaxone and azithromycin before the blood cultures and T2Bacteria were drawn. Bloodstream infection was missed by blood culture but was identified with rapid detection provided by the T2Bacteria Panel. The use of T2Bacteria, in this case, allowed an early confirmation of effective antibiotic therapy.

Positive for P. aeruginosa

An 81-year-old patient with a complicated medical history was admitted to the hospital for a tracheoesophageal fistula repair.

Discussion

This case highlights the benefit of the T2Bacteria Panel’s turnaround time for species identification. Tigecycline has been associated with high rates of gastrointestinal adverse events such as nausea and vomiting and does not provide adequate coverage of P. aeruginosa. The rapid result provided by T2Bacteria allowed for discontinuation of Tigecycline after only one dose. Additionally, amikacin was added as an antimicrobial known to be effective against P. aeruginosa based on the institution’s antibiogram.

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

T2 BIOSYSTEMS OVERVIEW

T2 Biosystems, an emerging leader in the field of in vitro diagnostics, is dedicated to saving lives and reducing the cost of healthcare by empowering clinicians to effectively treat patients faster than ever before. T2 Biosystems is focused on addressing critical unmet needs in healthcare starting with sepsis, one of the deadliest and most expensive conditions in hospitals today.

The T2Dx Instrument, the T2Bacteria and T2Candida Panels have received marketing authorization from the U.S. Food and Drug Administration. All other T2 Biosystems products are considered investigational and for research use only.

T2 Biosystems®, T2MR®, T2Bacteria®, T2Candida®, and T2Dx® are registered trademarks of T2 Biosystems, Inc. “T2Biosystems” and the T2 Biosystems, Inc. logo design are registered trademarks or trademarks of T2Biosystems, Inc. All software and documentation is subject to T2 Biosystems, Inc. copyrights. All rights reserved. T2Direct Diagnostics™, T2HemoStat™, T2Plex™, T2Cauris™, T2Resistance™ and T2SARS-CoV-2™ are trademarks of T2 Biosystems, Inc.

© 2022 T2 Biosystems, Inc.

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