Accuracy And Impact On Patient Management Of New Tools For Diagnosis Of Sepsis: Experience With The T2 Magnetic Resonance Bacteria Panel

PATHOGENS(2021)

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摘要
The rapid and accurate identification of pathogens responsible for sepsis is essential for prompt and effective antimicrobial therapy. Molecular technologies have been developed to detect the most common causative agents, with high sensitivity and short time to result (TTR). T2 Bacteria Panel (T2), based on a combination of PCR and T2 magnetic resonance, can identify directly in blood samples Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, and Acinetobacter baumannii pathogens. This study evaluates the role of T2 in the diagnosis of sepsis and its impact on patient management, specifically in terms of TTR and the switch from empirical to directed therapy, comparing results of blood culture (BC) and T2 assay in 82 patients with sepsis. T2 significantly improved the detection of the causative agents of sepsis. For pathogens included in the panel, T2 sensitivity was 100% (95% CI 86.3-100.0), significantly higher than that of BC (54.8%, 95% CI 36.0-72.7). The TTR (median, IQR) of positive T2 (3.66 h, 3.59-4.31) was significantly shorter than that of the positive BC (37.58 h, 20.10-47.32). A significant reduction in the duration of empiric therapy and an increase in the percentage of patients with switched therapy was observed in patients with a positive T2 result. In conclusion, T2 can shorten and improve the etiological diagnosis of sepsis with a positive impact on patient management.
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关键词
sepsis diagnosis, T2 magnetic resonance, bacteria, blood culture, directed therapy
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