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Direct detection of ESKAPEc pathogens from whole blood using the T2Bacteria Panel allows early antimicrobial stewardship intervention in patients with sepsis
MicrobiologyOpen ( IF 3.9 ) Pub Date : 2021-06-16 , DOI: 10.1002/mbo3.1210
Pavel Drevinek 1 , Jakub Hurych 1 , Milena Antuskova 1 , Jan Tkadlec 1 , Jan Berousek 2 , Zuzana Prikrylova 2 , Jiri Bures 2 , Jaromir Vajter 2 , Martin Soucek 3 , Jan Masopust 3 , Vendula Martinkova 4 , Jaroslava Adamkova 4 , Veronika Hysperska 5 , Eliska Bebrova 1
Affiliation  

In the microbiological diagnosis of bloodstream infections (BSI), blood culture (BC) is considered the gold standard test despite its limitations such as low sensitivity and slow turnaround time. A new FDA-cleared and CE-marked platform utilizing magnetic resonance to detect amplified DNA of the six most common and/or problematic BSI pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Escherichia coli; referred to as ESKAPEc) is available and may shorten the time to diagnosis and potentially improve antimicrobial utilization. Whole blood samples from hospitalized patients with clinical signs of sepsis were analyzed using the T2Bacteria Panel (T2Biosystems) and compared to simultaneously collected BC. Discrepant results were evaluated based on clinical infection criteria, combining supporting culture results and the opinion of treating physicians. A total of 55 samples from 53 patients were evaluated. The sensitivity and specificity of the T2Bacteria panel was 94% (16 out of 17 detections of T2Bacteria-targeted organisms) and 100%, respectively, with 36.4% (8 of 22) causes of BSI detected only by this method. The T2Bacteria Panel detected pathogens on average 55 hours faster than standard BC. In our study, 9 of 15 patients with positive T2Bacteria Panel results received early-targeted antibiotic therapy and/or modification of antimicrobial treatment based on T2Bacteria Panel findings. Given the high reliability, faster time to detection, and easy workflow, the technique qualifies as a point-of-care testing approach.

中文翻译:


使用 T2Bacteria Panel 直接检测全血中的 ESKAPEc 病原体,可以对脓毒症患者进行早期抗菌管理干预



在血流感染 (BSI) 的微生物学诊断中,血培养 (BC) 被认为是金标准测试,尽管其存在敏感性低和周转时间慢等局限性。一个获得 FDA 批准和 CE 标志的新平台,利用磁共振来检测六种最常见和/或有问题的 BSI 病原体(屎肠球菌金黄色葡萄球菌肺炎克雷伯菌鲍曼不动杆菌铜绿假单胞菌大肠杆菌)的扩增 DNA;称为如 ESKAPEc)可用,可以缩短诊断时间并有可能提高抗菌药物的利用率。使用 T2Bacteria Panel (T2Biosystems) 分析具有败血症临床症状的住院患者的全血样本,并与同时收集的 BC 进行比较。根据临床感染标准,结合支持性培养结果和治疗医生的意见,对差异结果进行评估。总共评估了来自 53 名患者的 55 个样本。 T2Bacteria panel 的灵敏度和特异性分别为 94%(检测到 T2Bacteria 目标生物体中的 17 例中的 16 例)和 100%,仅通过该方法检测到 BSI 的原因为 36.4%(22 例中的 8 例)。 T2Bacteria Panel 检测病原体的速度比标准 BC 平均快 55 小时。在我们的研究中,15 名 T2 细菌小组结果呈阳性的患者中有 9 名接受了早期靶向抗生素治疗和/或根据 T2 细菌小组结果修改抗菌治疗。由于可靠性高、检测速度更快且工作流程简单,该技术有资格作为即时检测方法。
更新日期:2021-06-17
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