2037. Utilization of the T2 Magnetic Resonance in the Early Detection of Invasive Candidiasis

BACKGROUND: The current gold standard for diagnosing invasive Candida infections is by blood culture, which has low specificity and take up to 2–5 days to grow. T2 magnetic resonance (T2MR) rapidly detects Candida species with high sensitivity/specificity. T2MR identifies five Candida species and reports it in three groups: C. albicans/C. tropicalis, C. parapsilosis, and C. glabrata/C. krusei. METHODS: This was a retrospective quasi-experimental study at the Augusta University Medical Center. Patients with a positive sterile site culture for Candida species and/or T2MR result were reviewed between April 2014 and March 2016 (pre-T2MR group) and April 2016–May 2017 (T2MR group). RESULTS: The pre-T2MR group consisted of 84 patients who had a Candida species isolated from a sterile site culture. The T2MR group consisted of 396 unique patients for whom there were a total of 549 T2MR tests ordered. Of these, 34 were positive, 466 were negative result, and 49 were invalid result (due to malfunctioning of T2MR). Of the 35 tests that were T2MR negative but sterile site culture positive, 27 (77%) of the cultures isolated a Candida sp. that should be detected by the T2MR but did not. The most common site of isolation for these cultures was intraabdominal (41%), followed by blood (33%). For 23% of these results, sterile site cultures grew a Candida that the T2MR does not detect. CONCLUSION: Unfortunately, Candida that grew in sterile site cultures was not always detected by the T2MR, particularly for intraabdominal Candidiasis. T2MR is thought to have high sensitivity and specificity for detecting Candidemia, but in our limited experience, it was found that up to one-third of Candidemias (as diagnosed by blood cultures) were missed by the T2MR. The most common Candida isolate in the T2MR group was C. parapsilosis, which is not typically thought of as a leading cause of invasive candidiasis. DISCLOSURES: All authors: No reported disclosures.