1134. Novel T2Candida Panel Assay Compared to Blood Cultures for Detection of Candidemia in Transplant and Non-Transplant Patients.
Session: Poster Abstract Session: Fungi and Parasites in Immunocompromised Patients
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • T2 IDSA POSTER Noman-converted.pdf (555.2 kB)
  • Background:

    Blood culture (BC) the current “gold” standard for detection of candidemia has a sensitivity of ~50% and turnaround time (TAT) of 2-5 days. T2Candida Panel (T2) a magnetic resonance nano-diagnostic test done directly on blood samples detects C. albicans/C. tropicalis, C. krusei/C. glabrata, and C. parapsilosis. Clinical trials of T2 showed good sensitivity, specificity, NPV 99% and TAT of 3-5 hours. The performance of T2 in high-risk transplant (Tx) population is unknown. T2 was implemented at our institution in Oct 2015. We evaluated the performance characteristics of T2 and BC in our Tx and non-transplant (non-Tx) patient (pt) populations.

    Methods:

    This was an observational, retrospective, cross-sectional evaluation of pts with suspected candidemia that had T2 done from 10/2015 - 10/2017 at a multihospital healthcare system in Detroit, MI. Performance characteristics of the T2 and BC in Tx and non-Tx pts were compared. BC obtained within 7 days before or after the T2 test were included in the analysis. TAT, sensitivity, specificity, PPV and NPV were calculated using positive BC as the standard. Differences between groups were assessed using two sample proportions testing at alpha = 0.05.

    Results:

    1272 pts with suspected candidemia had T2 done: 1162 (91%) non-Tx and 110 (9%) Tx pts. Average TAT for T2 was 13 hours (5-41) vs. 34 hours (21-109) to initial positive BC result and 4 days (3-13) to species-specific BC result. In 4 non-Tx pts with negative T2, C. lusitaniae, C. dubliniensis and C. kefyr were isolated in BC. Performance characteristics of T2 and BC in the two groups is shown (Table 1). Of the T2+/BC- cases (n=102), 9% had retinitis and 9% had invasive candidiasis.

    Conclusion:

    The rapid TAT, good sensitivity and high NPV of T2 in Tx pts has clinical implications and can help support antifungal stewardship efforts in this population. The clinical significance of T2 positivity in the presence of negative BC needs further investigation.

    Table1: Performance characteristics of T2 compared to BC (N=1272)

    Tx (n=110)

    Non-Tx (n=1162)

    P-value

    T2 + and blood culture +

    5 (4.5%)

    35 (3.01%)

    0.3917

    T2 + and blood culture -

    19 (17.3%)

    86 (7.4%)

    0.0003

    T2 - and blood culture +

    1 (0.9%)

    41 (3.5%)

    0.1431

    Sensitivity

    83.3 %

    46.1 %

    Specificity

    81.9 %

    92.4 %

    PPV

    20.8 %

    28.9 %

    NPV

    98.8 %

    96.2 %

    Noman Hussain, MD1, Zohra Chaudhry, MD2, Hira Rizvi, MD3, Odaliz Abreu-Lanfranco, MD1, Mayur Ramesh, MD1, Ramon Del Busto, MD1, Zachary Osborn, MPH4 and George Alangaden, MD, FIDSA1, (1)Infectious Diseases, Henry Ford Health System, Detroit, MI, (2)Infectious Disease, Henry Ford Hospital, Detroit, MI, (3)Infectious Disease, Henry Ford Health System, Detroit, MI, (4)Medicine- Infectious Diseases, Henry Ford Hospital, Detroit, MI

    Disclosures:

    N. Hussain, None

    Z. Chaudhry, None

    H. Rizvi, None

    O. Abreu-Lanfranco, None

    M. Ramesh, None

    R. Del Busto, None

    Z. Osborn, None

    G. Alangaden, T2 Biosystems: Speaker's Bureau , Educational grant and Speaker honorarium .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.