The T2Candida Panel Has Decreased Time to Therapy Initiation for Candidemia

Blood sample in vile
Blood sample in vile
Antimicrobial stewardship traditionally focuses on optimal use of antibacterial agents, not antifungal therapy.
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SAN DIEGO — The use of the diagnostic T2Candida (T2C) panel for the identification of candidemia has resulted in a significant decrease in time to initiation of therapy (TTT) and may usher in more rapid and optimal utilization of antifungal therapy in the c patient population, according to findings from a retrospective study presented at IDWeek 2017.

Investigators reviewed cases of candidemia and compared outcomes in patients with candidemia both before and after the initiation of regular T2C testing. Specifically, researchers examined data related to antifungal therapy, TTT, and patterns of echinocandin. In this analysis, researchers included 100 and 138 patients with candidemia during the 2015 and 2016, respectively.

A total of 354 valid T2C results were reported in 2016, of which 36 (10.2%) were positive and 318 (89.8%) were negative for candidemia. From 2015 to 2016, investigators found a significant decrease in the TTT in all patients with candidemia who had a positive blood culture and/or positive T2C result (2.02 days vs 1.15 days, respectively; P <.0001). In addition, the TTT in the T2C-positive group vs the blood culture-positive group was significantly different in 2015 (.09 days vs 1.69 days; P <.00001). Researchers also observed different dosing strategies of echinocandin, an antifungal therapy, between 2015 and 2016 (15.1 vs 17.8 days of therapy per 1000 patient days, respectively).

“The high mortality and emergence of resistance in invasive infections due to Candida presents a critical opportunity for AFT stewardship,” wrote lead investigator Justin F. Hayes, MD, of the division of infectious diseases at the University of Alabama at Birmingham, and colleagues. “These results suggest that rapid identification of candidemia may be an important tool for [antifungal therapy] stewardship.”

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Hayes JF, Turner OD, McCarty TP, Manning M, Hoesley CJ, Pappas PG. Influence of T2Candida testing for rapid diagnosis of Candida infections on antifungal stewardship efforts at a large academic medical center: a retrospective, single-center study. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Poster 2137.