Utilizing T2Candida Result to Impact Appropriate Therapy

A 67-year-old patient had experienced infections, including multi-drug resistant pneumonia, sepsis, and C. difficile colitis during admission.

Discussion

This case highlights the benefit of T2Candida’s rapid fungal species identification, which allowed for the continuation of appropriate antifungal therapy as well as the discontinuation of unnecessary broad-spectrum antibiotics, resulting in clinical improvement.

Presentation

A 67-year-old patient with a history of ALS and chronic respiratory failure was being managed at a long term acute care (LTAC) facility for the last five months. The patient had experienced infections, including multi-drug resistant pneumonia, sepsis, and C. difficile colitis during admission.

Evaluation and Treatment Decision

Day 1: An infectious disease (ID) physician was called early morning because the patient was experiencing a new symptom of hypothermia. Multiple cultures were obtained, and the patient was started on empiric antibiotic treatment with IV vancomycin, meropenem, polymyxin B, and anidulafungin.

Day 2: The stewardship team recommended that anidulafungin be changed to fluconazole. The ID physician ordered a T2Candida Panel and continued anidulafungin until the results were available.

T2 Result: Positive for C. glabrata/C. kruseii.  

Fungal Culture Result: no growth reported

Hospital Course and Decision Making Based on the T2Candida Result

On the third day, based on the T2Candida Panel results that were positive for C. glabrata/C. krusei– anidulafungin was continued. On day 5, meropenem and polymyxin B treatment were discontinued, and on day 6, vancomycin was discontinued.

The patient improved and remained off of systemic antibiotic treatment following this episode of fungal sepsis. The patient was transferred in stable medical condition to a subacute facility.

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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