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.
Presentation
An 86 year old patient was transferred to the treating hospital with signs of septic shock. The patient had a history of multiple hospitalizations over the last three months, with several courses of antibiotics to treat pneumonia, as well as wound and urinary tract infections. On admission, the patient was on ampicillin/sulbactam and tedizolid for the treatment of a recent wound infected with K. pneumonia and E. faecalis.
On admission, the left leg wound appeared acutely infected and the patient had a fever as well as low blood pressure requiring vasopressor support. Additionally, the patient had a low platelet count, potentially caused by tedizolid therapy.
Patient Selection Criteria
New-onset suspected sepsis and elevated SOFA score in a patient with risk factors for infection.
Evaluation and Treatment
Diagnosis
Suspected sepsis
Empiric Therapy
Ampicillin/sulbactam and tedizolid
Blood Culture Result
Negative
T2Bacteria Panel Result
P. aeruginosa
Decision Making Based on the T2Bacteria Result:
Ampicillin/sulbactam and tedizolid do not provide coverage for P. aeruginosa and both were discontinued. Ceftolozane/tazobactam was initiated for the treatment of P. aeruginosa based on the local antibiogram. The patient showed significant improvement on Day 2 and was released from the hospital after receiving aggressive wound care and completing antibiotic therapy.
