2037. Utilization of the T2 Magnetic Resonance in the Early Detection of Invasive Candidiasis
Session: Poster Abstract Session: Diagnostics: Mycology
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Utilization of the T2 Magnetic Resonance in the Early Detection of Invasive Candidiasis (IDWeek 2018).pdf (806.8 kB)
  • Background:

    The current gold standard for diagnosing invasive Candida infections is by blood culture, which has low specificity and take up to 2-5 days to grow. T2 magnetic resonance (T2MR) rapidly detects Candida species with high sensitivity/specificity. T2MR identifies five Candida species and reports it in 3 groups: C. albicans/C. tropicalis, C. parapsilosis, and C. glabrata/C. krusei.

    Methods:

    This was a retrospective quasi-experimental study at the Augusta University Medical Center. Patients with a positive sterile site culture for Candida species and/or T2MR result were reviewed between April 2014 to March 2016 (pre-T2MR group) and April 2016-May 2017 (T2MR group).

    Results:

    The pre-T2MR group consisted of 84 patients who had a Candida species isolated from a sterile site culture. The T2MR group consisted of 396 unique patients for whom there were a total of 549 T2MR tests ordered. Of these, 34 were positive, 466 were negative result, and 49 were invalid result (due to malfunctioning of T2MR).

    Of the 35 tests that were T2MR negative but sterile site culture positive, 27 (77%) of the cultures isolated a Candida sp that should be detected by the T2MR but did not. The most common site of isolation for these cultures was intraabdominal (41%), followed by blood (33%). For 23% of these results, sterile site cultures grew a Candida that the T2MR does not detect.

    Table 1: Performance of T2MR Results in Comparison to Sterile Site Cultures

    T2 +

    (n=549)

    T2 -

    (n= 466)

    Sterile Site Culture +

    16

    35

    Sterile Site Culture -

    18

    431

    Table 2: Comparison between Invasive Candidiasis as Detected by Standard Blood Cultures (pre-T2MR) and T2MR

    Pre-T2MR

    T2MR

    P-value

    Time to identification of Candida± SD (hrs)

    ± 210.1

    ± 14.4

    0.00

    All-cause 30-day mortality, n (%)

    19 (23%)

    7 (23%)

    0.56

    Conclusion:

    Unfortunately, Candida that grew in sterile site cultures was not always detected by the T2MR, particularly for intraabdominal Candidiasis. T2MR is thought to have high sensitivity and specificity for detecting Candidemia, but in our limited experience, it was found that up to one-third of Candidemias (as diagnosed by blood cultures) were missed by the T2MR.

    The most common Candida isolate in the T2MR group was C. parapsilosis, which is not typically thought of as a leading cause of invasive candidiasis.

    Sonal Patel, PharmD, BCPS1, David Behrman, MD (2021)2, Andrew Chao, MD3,4, Allison McMullen, PhD5, Jose Vazquez, MD, FACP, FIDSA4 and Arni Sr Srinivasa Rao, PhD6, (1)Pharmacy, Augusta University Medical Center, Augusta, GA, (2)Augusta University at the Medical College of Georgia, Augusta, GA, (3)Infectious Diseases, Baylor College of Medicine, Houston, TX, (4)Infectious Diseases, Augusta University Medical Center, Augusta, GA, (5)Augusta University Medical Center, Augusta, GA, (6)Population Health Sciences, Medical College of Georgia/Augusta University, Augusta, GA

    Disclosures:

    S. Patel, None

    D. Behrman, None

    A. Chao, None

    A. McMullen, None

    J. Vazquez, None

    A. S. Srinivasa Rao, None

    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.