Detecting Infections Rapidly and Easily for Candidemia Trial, Part 2 (DIRECT2): A Prospective, Multicenter Study of the T2Candida Panel
| Autor: | Luis Ostrosky-Zeichner, M. Hong Nguyen, Cornelius J. Clancy, Alan H.B. Wu, Marc A. Judson, Richard N. Greenberg, Peter G. Pappas, Angela M. Caliendo, Senu Apewokin, Annette C. Reboli, Kevin W. Garey, G. Marshall Lyon, Dimitrios P. Kontoyiannis, Ellis H. Tobin, Jose A. Vazquez, George Richard Thompson |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Magnetic Resonance Spectroscopy 030106 microbiology Neutropenia Candida parapsilosis Sensitivity and Specificity Gastroenterology Candida tropicalis 03 medical and health sciences 0302 clinical medicine Internal medicine Candida krusei medicine Humans Serologic Tests Prospective Studies 030212 general & internal medicine Candida albicans Candida Whole blood biology Candida glabrata business.industry Candidemia Middle Aged biology.organism_classification medicine.disease Corpus albicans Infectious Diseases Female business |
| Zdroj: | Clinical Infectious Diseases. 66:1678-1686 |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | 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. Clinical Trials Registration NCT01525095. |
| Databáze: | OpenAIRE |
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