Rapid T2Bacteria Result Helps Prevent Potential Complications due to Premature Discharge

A patient was admitted with a two-day history of right lower quadrant pain, fever, and vomiting

Discussion

This case highlights the benefit of rapid species identification with the T2Bacteria Panel and the potential prevention of additional sequelae with a premature discharge from the ED.

Presentation

An elderly patient was admitted with a two-day history of right lower quadrant pain, fever, and vomiting.   A set of blood cultures and a T2Bacteria were drawn.

The patient received a fluid bolus and empiric antibiotics and started to stabilize, tolerating, orals, and was asking to go home.  The patient was discharged after being in the ED for approximately 6 hours and given oral antibiotics with a follow up in 2 days with a primary care provider due to her suspicious urinalysis.  After the patient was discharged from the emergency department, the T2 resulted, approximately 4.5 hours after the draw. 

Patient Selection Criteria

A septic patient presenting in the Emergency Department

Evaluation and Treatment Decision

Diagnosis: Suspected UTI

Empiric Therapy: The patient was started on ceftriaxone

T2Bacteria Panel Result: Positive for E. coli

Blood Culture Result: Positive E. coli

Urine culture: Positive for E.coli

Hospital course and decision making based on the T2Bacteria Result

A rapid T2Bacteria positive for E. coli prompted the ED team to bring the patient back to the hospital for admission, which potentially prevented additional clinical complications.

Once the patient was re-admitted, they began to spike fevers. Approximately 12 hours after re-admission, the blood cultures turned positive.  A Gram-stain was done, and a Gram-negative was identified (about 14 hours after the T2 resulted).   At the same time, the urine culture turned positive, confirming the source as genitourinary.  The patient was administered IV ceftriaxone until discharge, approximately 2.5 days after admission.   Blood cultures finalized approximately three days after the initial blood draw confirming the E.coli.  The patient was sent home on oral antibiotics to complete her course of therapy.

 

  • Media Contact

    Gina Kent
    610-455-2763
    gkent@vaultcommunications.com

    Media Center

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