Utilization of the T2 Candida Panel for Rapid Candida Species Detection in a Large Community Hospital

Abstract

BackgroundCandidemia is the fourth 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.MethodsProspective, 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.ResultsPatients 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.ConclusionT2 Candida Panel demonstrated greater sensitivity and faster to detect Candidemia compared with 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.Disclosures All authors: No reported disclosures.