Giacobbe Daniele Roberto, Crea Francesca, Morici Paola, Magnasco Laura, Di Pilato Vincenzo, Briano Federica, Willison Edward, Pincino Rachele, Dettori Silvia, Tutino Stefania, Esposito Simone, Coppo Erika, Dentone Chiara, Portunato Federica, Mikulska Malgorzata, Robba Chiara, Vena Antonio, Battaglini Denise, Brunetti Iole, Ball Lorenzo, Pelosi Paolo, Marchese Anna, Bassetti Matteo
Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.
Antibiotics (Basel). 2022 Dec 15;11(12):1823. doi: 10.3390/antibiotics11121823.
The use of rapid molecular tests may anticipate the identification of causative agents and resistance determinants in the blood of critically ill patients with sepsis. From April to December 2021, all intensive care unit patients with sepsis or septic shock who were tested with the T2Bacteria and T2Resistance assays were included in a retrospective, single center study. The primary descriptive endpoints were results of rapid molecular tests and concomitant blood cultures. Overall, 38 combinations of T2Bacteria and T2Resistance tests were performed. One or more causative agent(s) were identified by the T2Bacteria assay in 26% of episodes (10/38), whereas negative and invalid results were obtained in 66% (25/38) and 8% (3/38) of episodes, respectively. The same pathogen detected by the T2Bacteria test grew from blood cultures in 30% of cases (3/10). One or more determinant(s) of resistance were identified by the T2Resistance assay in 11% of episodes (4/38). Changes in therapy based on T2Bacteria and/or T2Resistance results occurred in 21% of episodes (8/38). In conclusion, T2Bacteria/T2Resistance results can influence early treatment decisions in critically ill patients with sepsis or septic shock in real-life practice. Large, controlled studies remain necessary to confirm a favorable impact on patients' outcomes and antimicrobial stewardship interventions.
使用快速分子检测可能有助于在脓毒症重症患者的血液中识别病原体和耐药决定因素。2021年4月至12月,所有接受T2细菌检测和T2耐药性检测的重症监护病房脓毒症或脓毒性休克患者被纳入一项回顾性单中心研究。主要描述性终点是快速分子检测结果和同步血培养结果。总体而言,共进行了38次T2细菌检测和T2耐药性检测的组合。T2细菌检测在26%的病例(10/38)中鉴定出一种或多种病原体,而分别有66%(25/38)和8%(3/38)的病例检测结果为阴性和无效。T2细菌检测所检测到的相同病原体在30%的血培养病例(3/10)中生长。T2耐药性检测在11%的病例(4/38)中鉴定出一种或多种耐药决定因素。基于T2细菌检测和/或T2耐药性检测结果的治疗方案改变发生在21%的病例(8/38)中。总之,在实际临床实践中,T2细菌检测/T2耐药性检测结果可影响脓毒症或脓毒性休克重症患者的早期治疗决策。仍需开展大规模对照研究,以证实其对患者预后和抗菌药物管理干预措施具有积极影响。