In-depth analysis of T2Bacteria positive results in patients with concurrent negative blood culture: A case series

Markos Kalligeros, Ioannis M. Zacharioudakis, Giannoula S. Tansarli, Katerina Tori, Fadi Shehadeh, Eleftherios Mylonakis

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: T2Bacteria assay uses T2 magnetic resonance (T2MR) technology for the rapid diagnosis of bacterial bloodstream infections (BSIs). This FDA cleared technology can detect 5 of the most prevalent pathogens causing bacteremia (Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus faecium). Because the significance of discordant results between the T2Bacteria assay and blood culture (BC) remains a challenge, in this case series we reviewed the medical records of patients who had a positive T2Bacteria test and a concurrent negative BC. Methods: Among 233 participants, we identified 20 patients with 21 (9%) discordant T2Bacteria-positive/BC-negative (T2+/BC-) results. We classified these results based on clinical cultures and clinical evidence. Results: When we analyzed these 21 discordant results in-depth, 11 (52.5%) fulfilled criteria for probable BSI, 4 (19%) for possible BSI, and 6 (28.5%) were presumptive false positives. Among the probable/possible BSIs, discordant results were often associated with patients diagnosed with closed space and localized infections [pyelonephritis (n = 7), abscess (n = 4), pneumonia (n = 1), infected hematoma (n = 1), and osteomyelitis (n = 1)]. Also, within the preceding 2 days of the T2+/BC- blood sample, 80% (16/20) of the patients had received at least one dose of an antimicrobial agent which was active against the T2Bacteria-detected pathogen. Conclusions: In the majority of discrepant results, the T2Bacteria assay detected a plausible pathogen that was supported by clinical and/or microbiologic data. Discrepancies appear to be associated with closed space and localized infections and the recent use of effective antibacterial agents. The clinical significance and potential implications of such discordant results should be further investigated.

Original languageEnglish (US)
Article number326
JournalBMC Infectious Diseases
Volume20
Issue number1
DOIs
StatePublished - May 7 2020

Keywords

  • Bacteremia
  • Bloodstream infection
  • Discordant results
  • Sepsis
  • Septicemia
  • T2 magnetic resonance
  • T2Bacteria assay
  • T2MR

ASJC Scopus subject areas

  • Infectious Diseases

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