115. Evaluation of the Clinical Impact of the T2MR for the Diagnosis of Bloodstream Infections

Abstract

BackgroundThe EK-189 study evaluates the clinical impact of T2 magnetic resonance (T2MR) for rapid detection of bloodstream infections (BSI) caused by ESKAPE-pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and Escherichia coli) compared with blood culture (BC). Here we present preliminary results from this ongoing study.MethodsPatients newly admitted to an infectious diseases department with suspected blood stream infection with ESKAPE pathogens (based on predefined criteria) are included and randomized into BSI diagnosis with (a) T2MR and blood culture or (b) blood culture alone. Routine diagnostic workup including chest X-ray, complete laboratory workup (including blood count, C-reactive protein, interleukin-6) is performed in all patients. Antibiotic regimens are selected empirically based on suspected pathogens and are switched to targeted therapy at the discretion of the treating physician once a pathogen is detected. Outcome parameters include time to targeted (predefined) antibiotic therapy and time to discharge. Test characteristics of the T2MR compared with BC are also assessed.ResultsSo far 44 patients were included (22 in each group). In 9/22 patients (41%) in the T2MR-group a pathogen was detected (4 Escherichia coli, 2 Klebsiella pneumoniae, 1 Staphylococcus aureus, 1 Pseudomonas aeruginosa and 1 Acinetobacter baumanii) and in 3/22 (14%) patients in the BC-group (all E. coli). The comparison of T2MR vs. BC is depicted in Table 1. Sensitivity and specificity of T2MR in comparison to BC were 100% and 64.7%. All positive results in T2MR were considered true positive results. The days until clinical improvement, the need for admission at ICU and the in-hospital mortality were similar in both groups.ConclusionThe results from this preliminary analysis show that in patients with suspected BSI with ESKAPE pathogens, T2MR detects more pathogens than BC and potentially provides a quicker detection and shorter time to targeted therapy. Further analyses of this ongoing study with a larger sample size are needed to evaluate the impact of the use of T2MR on patient’s outcome Disclosures All authors: No reported disclosures.