2066. Utilization of the T2 Candida Panel for rapid Candida species detection in a large community hospital
Session: Poster Abstract Session: Diagnostics - Mycology
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • T2_Poster_Final (1).pdf (1.2 MB)
  • Background: Candidemia is the 4th leading hospital-acquired bloodstream infection. Blood cultures sensitivity is 50%. The T2 Candida Panel provide rapid (3-5 hours) species-specific detection of Candida species including C albicans, C. tropicalis, C. parapsilosis, C. krusei, and C. glabrata.

    Methods: Prospective, observational analysis included 345 patients who met specified criteria. The T2Candida Panel was restricted to Infectious Disease and Oncology physicians’ use for specific patient populations, including with: febrile neutropenia; ICU stay for >72 hours, central venous catheter, recent antibiotics, acute pancreatitis, recent major surgery, TPN, renal failure/hepatic failure, corticosteroids and unexplained fever. Antifungal use, patient characteristics, risk factors, T2 Candida Panel results, corresponding blood cultures, time to de-escalation, and duration of therapy (DOT) were collected.

    Results:

    Patients mean age 60 years, 54% were male. Candidemia risk factors included: 28% immunocompromised (cancer, chemotherapy, chronic steroids, febrile neutropenia), 26% renal failure, 19% malnutrition/TPN, 14% CVC/PICC line and 11% intra-abdominal infection/surgery. 78% of the patients were in the ICU. 9% of T2 tests were positive. The resulting species were as follows: C. albicans/tropicalis, 47 % C. parapsilosis 41% and 12% C glabrata/Krusei. Of the patients with a positive T2 result only 24% had a positive corresponding blood culture while those with positive blood culture results 94.9% were T2 positive. Negative T2 tests resulted in discontinuation of antifungal therapy in 23% and avoid antifungal therapy initiation in 41% of patients but 36% of patient’s antifungal regimens were not discontinued despite a negative T2 result. Average time to de-escalation was 40.8 hours. Negative T2 results decreased average duration of therapy of micafungin by 2.1 days.

    Conclusion: T2 Candida Panel demonstrated greater sensitivity and faster to detect Candidemia compared to blood cultures. Despite the test’s rapid nature and high sensitivity, time to de-escalation remains at 2 days suggesting variations in physicians’ utilization of T2 test results.

    Ali Hassoun, MD FIDSA FACP, Alabama Infectious Diseases Center, Huntsville, AL, Mohammed Abdulhaleem, MD, Internal Medicine, UAB-Huntsville campus, Huntsville, AL and Jonathan Edwards, PharmD, BCPS AQ-ID, Huntsville Hospital, Huntsville, AL

    Disclosures:

    A. Hassoun, None

    M. Abdulhaleem, None

    J. Edwards, None

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