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.

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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.

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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.

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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 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.

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