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607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting

BACKGROUND: Candidemia is the most common cause of invasive fungal infections with mortality rates up to 60%. The current standard for diagnosis of candidemia is traditional blood cultures (BC) but it has low sensitivity. The need for rapid identification of candidemia has led to the development of...

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Autores principales: Birk, Navina K, Soman, Sana, Kapur, Nandita, Pochhareddy, Vedanth, Dillon, William P, Veve, Michael, Samuel, Linoj, Ramesh, Mayur, Alangaden, George J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677497/
http://dx.doi.org/10.1093/ofid/ofad500.673
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author Birk, Navina K
Soman, Sana
Kapur, Nandita
Pochhareddy, Vedanth
Dillon, William P
Veve, Michael
Samuel, Linoj
Ramesh, Mayur
Alangaden, George J
author_facet Birk, Navina K
Soman, Sana
Kapur, Nandita
Pochhareddy, Vedanth
Dillon, William P
Veve, Michael
Samuel, Linoj
Ramesh, Mayur
Alangaden, George J
author_sort Birk, Navina K
collection PubMed
description BACKGROUND: Candidemia is the most common cause of invasive fungal infections with mortality rates up to 60%. The current standard for diagnosis of candidemia is traditional blood cultures (BC) but it has low sensitivity. The need for rapid identification of candidemia has led to the development of non-culture-based diagnostic platforms. T2Candida® (T2) is an FDA approved direct from blood PCR test. T2 detects 5 candida species (C. albicans/C. tropicalis, C. parapsilosis, & C. krusei/C. glabrata) with a turnaround time of three to five hours. T2 is used at our institution for the diagnosis of candidemia in the intensive care units (ICU) if prior blood cultures are negative. Patients with positive T2 results are managed the same as patients with positive BC. In February 2019, our health system switched from the VersaTREK™ to a more sensitive Bact/Alert Virtuo BC system. Our objective was to assess the impact of the new Virtuo system on the diagnosis of candidemia compared to T2 in a real-world setting. [Figure: see text] METHODS: All T2 and concurrent BC results were retrospectively collected from January 2018 to January 2019 (VersaTREK™ cohort) and March 2019 to March 2020 (Virtuo cohort) in our quaternary care facility in metro Detroit. Only patients with presumed candidemia were included (ICU patients with sepsis, recent exposure to anti-bacterial agents, and negative BC for candida in the past 7 days). Demographic data and the results of T2 and concurrent BC (obtained within 48 hours of T2) were analyzed for the presence or absence of candida. Indeterminate T2 results were excluded. Descriptive statistics were utilized to report the results. RESULTS: A total of 522 and 348 T2 tests performed with concurrent BC through VersaTREK™ and Virtuo systems respectively were included for analysis. In this ICU cohort with presumed candidemia, T2 remained superior: T2 positivity 45 (8.6%) vs. VersaTREK™ BC positivity 14 (2.7%) (p < 0.001) and T2 positivity 34 (9.8%) vs. Virtuo BC positivity 8 (2.3%) (p < 0.001) (Figure 1). The Virtuo cohort had overall fewer T2 tests performed. This may be because the more sensitive Virtuo system could have detected more cases of candidemia than VersaTREK™ obviating the need for T2 test. CONCLUSION: T2 may still have a role in the early diagnosis of candidemia despite the use of newer sensitive blood culture systems. DISCLOSURES: Michael Veve, PharmD, MPH, National Institutes of Health: Grant/Research Support|Paratek Pharmaceuticals: Grant/Research Support
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spelling pubmed-106774972023-11-27 607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting Birk, Navina K Soman, Sana Kapur, Nandita Pochhareddy, Vedanth Dillon, William P Veve, Michael Samuel, Linoj Ramesh, Mayur Alangaden, George J Open Forum Infect Dis Abstract BACKGROUND: Candidemia is the most common cause of invasive fungal infections with mortality rates up to 60%. The current standard for diagnosis of candidemia is traditional blood cultures (BC) but it has low sensitivity. The need for rapid identification of candidemia has led to the development of non-culture-based diagnostic platforms. T2Candida® (T2) is an FDA approved direct from blood PCR test. T2 detects 5 candida species (C. albicans/C. tropicalis, C. parapsilosis, & C. krusei/C. glabrata) with a turnaround time of three to five hours. T2 is used at our institution for the diagnosis of candidemia in the intensive care units (ICU) if prior blood cultures are negative. Patients with positive T2 results are managed the same as patients with positive BC. In February 2019, our health system switched from the VersaTREK™ to a more sensitive Bact/Alert Virtuo BC system. Our objective was to assess the impact of the new Virtuo system on the diagnosis of candidemia compared to T2 in a real-world setting. [Figure: see text] METHODS: All T2 and concurrent BC results were retrospectively collected from January 2018 to January 2019 (VersaTREK™ cohort) and March 2019 to March 2020 (Virtuo cohort) in our quaternary care facility in metro Detroit. Only patients with presumed candidemia were included (ICU patients with sepsis, recent exposure to anti-bacterial agents, and negative BC for candida in the past 7 days). Demographic data and the results of T2 and concurrent BC (obtained within 48 hours of T2) were analyzed for the presence or absence of candida. Indeterminate T2 results were excluded. Descriptive statistics were utilized to report the results. RESULTS: A total of 522 and 348 T2 tests performed with concurrent BC through VersaTREK™ and Virtuo systems respectively were included for analysis. In this ICU cohort with presumed candidemia, T2 remained superior: T2 positivity 45 (8.6%) vs. VersaTREK™ BC positivity 14 (2.7%) (p < 0.001) and T2 positivity 34 (9.8%) vs. Virtuo BC positivity 8 (2.3%) (p < 0.001) (Figure 1). The Virtuo cohort had overall fewer T2 tests performed. This may be because the more sensitive Virtuo system could have detected more cases of candidemia than VersaTREK™ obviating the need for T2 test. CONCLUSION: T2 may still have a role in the early diagnosis of candidemia despite the use of newer sensitive blood culture systems. DISCLOSURES: Michael Veve, PharmD, MPH, National Institutes of Health: Grant/Research Support|Paratek Pharmaceuticals: Grant/Research Support Oxford University Press 2023-11-27 /pmc/articles/PMC10677497/ http://dx.doi.org/10.1093/ofid/ofad500.673 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Birk, Navina K
Soman, Sana
Kapur, Nandita
Pochhareddy, Vedanth
Dillon, William P
Veve, Michael
Samuel, Linoj
Ramesh, Mayur
Alangaden, George J
607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting
title 607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting
title_full 607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting
title_fullStr 607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting
title_full_unstemmed 607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting
title_short 607. Candidemia: Role of T2Candida® compared to Bact/Alert Virtuo blood culture system in a real-world setting
title_sort 607. candidemia: role of t2candida® compared to bact/alert virtuo blood culture system in a real-world setting
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677497/
http://dx.doi.org/10.1093/ofid/ofad500.673
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