T2Bacteria Identifies Causative Pathogen in a Critically Ill Patient with a Respiratory Infection

A 20-year-old patient with a history of lupus presented to the emergency department with shortness of breath

Discussion

This case highlights the benefit of T2Bacteria’s rapid bacterial species identification, which enabled early identification of the causative pathogen in a critically-ill, immunocompromised patient. Bacterial infections commonly occur following successful treatment of viral infections.  These infections are often missed due to prior antimicrobial use, especially in at-risk patient populations, leading to treatment delays and negative clinical outcomes. 

Presentation

A 20-year-old patient with a history of lupus presented to the emergency department with shortness of breath. They had recently recovered from influenza and were otherwise asymptomatic. The patient did not have a previous history of infections, but due to severe shortness of breath of uncertain etiology, was admitted. The patient’s condition worsened, leading to intubation and transfer to the intensive care unit overnight. 

Evaluation and Treatment Decision

Day 1: The patient was started on ceftriaxone and azithromycin to cover for possible pneumonia due to rapid deterioration upon admission to the ICU.
Day 2: Due to the lack of clinical improvement,  the intensivist ordered a T2Bacteria Panel and blood cultures, as well as respiratory cultures

T2Bacteria Result: Positive for P. aeruginosa
Blood Culture: Negative
Respiratory Culture:  Positive for P. aeruginosa (36 hours after T2Bacteria result)

Hospital Course and Decision Making Based on the T2Bacteria Result

Based on the T2Bacteria result, the patient was started on meropenem to cover P. aeruginosa and the ceftriaxone was discontinued. The patient began to improve on Day 3 and continued to improve slowly over the remainder of the week. The patient was discharged on Day 7 in stable condition. 
 

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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