Direct detection of ESKAPEc pathogens from whole blood with the use of
the T2Bacteria Panel allows early antimicrobial stewardship intervention
in patients with sepsis
Abstract
In the microbiological diagnosis of bloodstream infections (BSI), blood
culture (BC) is considered the gold standard test despite its
limitations such as low sensitivity and slow turnaround time. A new
FDA-cleared and CE-marked platform utilizing magnetic resonance to
detect amplified DNA of the six most common and/or problematic BSI
pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella
pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and
Escherichia coli) is available and may shorten the time to diagnosis and
potentially improve antimicrobial utilization. Whole blood samples from
hospitalized patients with clinical signs of sepsis were analyzed using
the T2Bacteria Panel (T2Biosystems) and compared to simultaneously
collected BC. Discrepant results were evaluated based on clinical
infection criteria, combining supporting culture results and the opinion
of treating physicians. A total of 55 samples from 53 patients were
evaluated. The sensitivity and specificity of the T2Bacteria panel was
94% (16 out of 17 detections of T2Bacteria-targeted organisms) and
100%, respectively, with 36.4% (8 of 22) causes of BSI detected only
by this method. The T2Bacteria Panel detected pathogens on average 55
hours faster than standard BC. In our study, 9 of 15 patients with
positive T2Bacteria Panel results received early-targeted antibiotic
therapy, and/or their antimicrobial treatment was modified based on
T2Bacteria Panel findings. Given the high reliability, faster time to
detection, and easy workflow, the technique qualifies as a point of care
testing approach.