We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Detecting Infections Rapidly and Easily for Candidemia Trial, Part 2 (DIRECT2): A Prospective, Multicenter Study of the T2Candida Panel.
- Authors
Clancy, Cornelius J; Pappas, Peter G; Vazquez, Jose; Judson, Marc A; Kontoyiannis, Dimitrios P; Thompson, George R; Garey, Kevin W; Reboli, Annette; Greenberg, Richard N; Apewokin, Senu
- Abstract
Background. Blood cultures are approximately 50% sensitive for diagnosing invasive candidiasis. The T2Candida nanodiagnostic panel uses T2 magnetic resonance and a dedicated instrument to detect Candida directly within whole blood samples. Methods. Patients with Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, or Candida krusei candidemia were identified at 14 centers using diagnostic blood cultures (dBCs). Follow-up blood samples were collected concurrently for testing by T2Candida and companion cultures (cBCs). T2Candida results are reported qualitatively for C. albicans/C. tropicalis, C. glabrata/C. krusei, and C. parapsilosis. T2Candida and cBCs were positive if they detected a species present in the dBC. Results. Median time between collection of dBC and T2Candida/cBC samples in 152 patients was 55.5 hours (range, 16.4-148.4). T2Candida and cBCs were positive in 45% (69/152) and 24% (36/152) of patients, respectively (P < .0001). T2Candida clinical sensitivity was 89%, as positive results were obtained in 32/36 patients with positive cBCs. Combined test results were both positive (T2+/cBC+), 21% (32/152); T2+/cBC-, 24% (37/152); T2-/cBC+, 3% (4/152); and T2-/cBC-, 52% (79/152). Prior antifungal therapy, neutropenia, and C. albicans candidemia were independently associated with T2Candida positivity and T2+/cBC- results (P values < .05). Conclusions. T2Candida was sensitive for diagnosing candidemia at the time of positive blood cultures. In patients receiving antifungal therapy, T2Candida identified bloodstream infections that were missed by cBCs. T2Candida may improve care by shortening times to Candida detection and species identification compared to blood cultures, retaining sensitivity during antifungal therapy and rendering active candidemia unlikely if results are negative.
- Subjects
ANTIFUNGAL agents; BLOOD; BLOODBORNE infections; CANDIDA; CANDIDA albicans; CELL culture; PATIENT aftercare; LONGITUDINAL method; MAGNETIC resonance imaging; MEDICAL cooperation; NEUTROPENIA; RESEARCH; TIME; CATHETER-related infections; CANDIDEMIA; DIAGNOSIS
- Publication
Clinical Infectious Diseases, 2018, Vol 66, Issue 11, p1678
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cix1095