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.

This high risk, immunocompromised patient was initially treated with ceftriaxone and azithromycin for empiric treatment of pneumonia. Rapid species identification prompted escalation of therapy to the anti-pseudomonal antibiotic, cefepime. The patient defervesced the day after therapy escalation and continued to clinically improve with cefepime continuation until hospital discharge. 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

Presentation

A 58-year-old female with history of metastatic breast cancer presented to clinic with shortness of breath, fever, and pancytopenia. She was then admitted to the hospital with orders for blood cultures, T2Bacteria and empiric antibiotics.

Patient Selection Criteria

Patient admitted to hematology-oncology unit with suspected blood stream infection

Evaluation and Treatment Decision

Diagnosis: Pneumonia

Empiric Therapy: ceftriaxone and azithromycin

T2Bacteria Result: Positive for P. aeruginosa and E. coli

Blood Culture Result: no growth

Chest x-ray: evidence of right lower lobe pneumonia

Decision making based on T2Bacteria Result

A rapid T2Bacteria result allowed for identification of the P. aeruginosa and E. coli bacteremia in a patient with culture negative infection. This prompted the prescriber to escalate therapy to cefepime for the coverage of the P. aeruginosa that was not identified via the blood culture.

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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