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

BACKGROUND: Candidemia 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. METHODS: Prospective, 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. RESULTS: Patients 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. CONCLUSION: T2 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.