Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, 301 Governors Drive SW, Huntsville, AL, 35801, USA.
Department of Pharmacy, Huntsville Hospital, 101 Sivley Road, Huntsville, AL, 35801, USA.
Eur J Clin Microbiol Infect Dis. 2021 May;40(5):997-1001. doi: 10.1007/s10096-020-04144-8. Epub 2021 Jan 2.
The T2 Candida Panel (T2CP) has high sensitivity and specificity to detect candidemia. Its role in the diagnosis and management of candidemia compared to blood cultures (BC) remains unclear. The purpose of this study was to evaluate the T2CP versus BC in detecting and treating candidemia. A retrospective, observational cohort study was conducted to compare clinical outcomes in patients with candidemia identified by BC versus T2CP. Patients with a positive BC or T2CP for Candida spp. from January 2012 to August 2020 were grouped by initial method of detection (BC vs T2CP). Co-primary endpoints assessed included time to detection of candidemia and time to antifungal therapy. Key secondary endpoints included length of stay (LOS), ICU LOS, and mortality. One hundred sixty-three patients with a positive BC and 89 patients with a positive T2CP were included in the evaluation. The average time to detection of candidemia was significantly shorter in the T2CP group compared to BC group (9 vs 41 h, p < 0.001). The time to antifungal was also significantly shorter in the T2CP group compared to the BC group (4 vs 37 h, p < 0.001). However, LOS was significantly shorter in the BC positive group than the T2CP group with no difference in ICU LOS. There was no difference in in-hospital or 30-day mortality between the two groups. Of patients diagnosed with candidemia at our large community hospital, identification by T2CP led to faster detection and initiation of antifungal compared to blood cultures without improvement in LOS or mortality.
T2 念珠菌检测试剂盒（T2CP）具有较高的灵敏度和特异性，可用于检测念珠菌血症。但其在念珠菌血症诊断和管理方面的作用与血培养（BC）相比尚不清楚。本研究旨在评估 T2CP 与 BC 在检测和治疗念珠菌血症方面的作用。本研究为回顾性、观察性队列研究，比较了通过 BC 和 T2CP 检测到念珠菌血症的患者的临床结局。将 2012 年 1 月至 2020 年 8 月期间通过 BC 或 T2CP 检测到 Candida spp.阳性的患者按初始检测方法（BC 或 T2CP）分组。主要共同终点评估包括念珠菌血症的检测时间和抗真菌治疗时间。关键次要终点包括住院时间（LOS）、ICU LOS 和死亡率。共纳入了 163 例 BC 阳性和 89 例 T2CP 阳性的患者。T2CP 组检测到念珠菌血症的平均时间明显短于 BC 组（9 小时 vs. 41 小时，p<0.001）。T2CP 组的抗真菌治疗时间也明显短于 BC 组（4 小时 vs. 37 小时，p<0.001）。然而，BC 阳性组的 LOS 明显短于 T2CP 组，但两组的 ICU LOS 无差异。两组患者的住院期间或 30 天死亡率无差异。在我们的大型社区医院诊断为念珠菌血症的患者中，与血培养相比，T2CP 可更快地检测到念珠菌血症并开始抗真菌治疗，但 LOS 或死亡率并未改善。
