Deborah Ashcraft, Jesse St Pierre, Heather Davis, Susan Scariano, Maria Latsis, Royanne Vortisch, Samantha Smith, George Pankey
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We compared the accuracy of T2R testing to AST for positive blood cultures.</p><p><strong>Methods: </strong>This investigator-sponsored, single-center study prospectively enrolled 802 patients with a standard of care blood culture. Five hundred forty-seven patients had adequate blood for culture and T2R testing. Blood cultures with positive isolates were identified, and AST was performed. Blood samples with positive blood cultures were tested with the T2R Panel.</p><p><strong>Results: </strong>Blood cultures were positive for 58/547 (10.6%) patients. Contaminants (18/547 [3.3%]) were excluded. T2R testing results (n=31) showed 2 <i>bla</i> <sub>CTX-M-14/15</sub> genes with 100% sensitivity; the remaining gram-negative resistance genes were not detected, so sensitivity could not accurately be determined. Specificity was 100% for the 16 gram-negative bacilli. Three enterococci and 2 <i>Staphylococcus aureus</i> showed 100% sensitivity/specificity. However, 10 coagulase-negative staphylococci showed 17% sensitivity/100% specificity. Antibiotic resistance genes identified were 2 <i>bla</i> <sub>CTX-M-14/15</sub>, 2 <i>mec</i>A/C, and 1 <i>van</i>A/B. T2R testing results were obtained in an average of 7 hours.</p><p><strong>Conclusion: </strong>T2R testing is highly specific (100%) for the 13 antibiotic resistance genes on the panel. Sensitivity was 100% for the genes detected but was low (17%) for coagulase-negative staphylococci. T2R testing has the potential to diagnose certain antibiotic resistance genes from bacterial bloodstream infections in hours vs the days required for a positive blood culture with AST. Additional studies that include larger numbers of samples with antimicrobial resistance genes are needed.</p>","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"25 1","pages":"24-33"},"PeriodicalIF":1.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924974/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the Diagnostic Accuracy of the T2Resistance Panel (Research Use Only) in Patients With Possible Bacterial Bloodstream Infections.\",\"authors\":\"Deborah Ashcraft, Jesse St Pierre, Heather Davis, Susan Scariano, Maria Latsis, Royanne Vortisch, Samantha Smith, George Pankey\",\"doi\":\"10.31486/toj.24.0101\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early identification and antimicrobial susceptibility testing (AST) of bloodstream pathogens are important for promptly determining the appropriate therapy. Currently, positive blood culture results (identification and AST) are reported in 2 to 4 days. The T2Resistance (T2R) Panel (T2 Biosystems, Inc) uses DNA amplification with magnetic resonance from 3 mL of whole blood for direct detection of 13 antibiotic resistance genes: <i>bla</i> <sub>KPC</sub>, <i>bla</i> <sub>NDM</sub>, <i>bla</i> <sub>VIM</sub>, <i>bla</i> <sub>IMP</sub>, <i>bla</i> <sub>OXA-48</sub>, <i>bla</i> <sub>CTX-M-14/15</sub>, AmpC <i>bla</i> <sub>CMY/DHA</sub>, <i>van</i>A/B, and <i>mec</i>A/C. We compared the accuracy of T2R testing to AST for positive blood cultures.</p><p><strong>Methods: </strong>This investigator-sponsored, single-center study prospectively enrolled 802 patients with a standard of care blood culture. Five hundred forty-seven patients had adequate blood for culture and T2R testing. Blood cultures with positive isolates were identified, and AST was performed. 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引用次数: 0
摘要
背景：血液病原体的早期识别和药敏试验（AST）对于及时确定适当的治疗方法非常重要。目前，阳性血培养结果（鉴定和AST）报告在2至4天。T2Resistance (T2R) Panel （T2 Biosystems, Inc）使用3ml全血的DNA扩增与磁共振直接检测13种抗生素耐药基因：bla KPC， bla NDM, bla VIM, bla IMP, bla OXA-48, bla CTX-M-14/15, AmpC, bla CMY/DHA， vanA/B和mecA/C。我们比较了T2R检测和AST检测阳性血培养的准确性。方法：这项由研究者发起的单中心研究前瞻性地纳入了802例标准护理血培养患者。547名患者有足够的血液进行培养和T2R测试。鉴定阳性分离物的血培养，并进行AST检测。血培养呈阳性的血样经T2R小组检测。结果：547例患者中有58例（10.6%）血培养阳性。排除了污染物（18/547[3.3%]）。T2R检测结果（n=31）显示2个bla CTX-M-14/15基因，敏感性100%；其余革兰氏阴性耐药基因未检出，因此敏感性不能准确测定。16株革兰氏阴性杆菌特异性为100%。3种肠球菌和2种金黄色葡萄球菌的敏感性/特异性均为100%。而10株凝固酶阴性葡萄球菌的敏感性为17% /特异性为100%。鉴定出2个bla CTX-M-14/15、2个mecA/C和1个vanA/B耐药基因。T2R检测结果平均在7小时内得到。结论：T2R检测对13种抗生素耐药基因具有高度特异性（100%）。检测到的基因敏感性为100%，但对凝固酶阴性葡萄球菌的敏感性较低（17%）。T2R检测有可能在数小时内诊断出来自细菌血流感染的某些抗生素耐药基因，而AST血培养阳性所需的时间为几天。需要进行更多的研究，包括大量含有抗生素耐药基因的样本。
Evaluation of the Diagnostic Accuracy of the T2Resistance Panel (Research Use Only) in Patients With Possible Bacterial Bloodstream Infections.
Background: Early identification and antimicrobial susceptibility testing (AST) of bloodstream pathogens are important for promptly determining the appropriate therapy. Currently, positive blood culture results (identification and AST) are reported in 2 to 4 days. The T2Resistance (T2R) Panel (T2 Biosystems, Inc) uses DNA amplification with magnetic resonance from 3 mL of whole blood for direct detection of 13 antibiotic resistance genes: blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, blaCTX-M-14/15, AmpC blaCMY/DHA, vanA/B, and mecA/C. We compared the accuracy of T2R testing to AST for positive blood cultures.
Methods: This investigator-sponsored, single-center study prospectively enrolled 802 patients with a standard of care blood culture. Five hundred forty-seven patients had adequate blood for culture and T2R testing. Blood cultures with positive isolates were identified, and AST was performed. Blood samples with positive blood cultures were tested with the T2R Panel.
Results: Blood cultures were positive for 58/547 (10.6%) patients. Contaminants (18/547 [3.3%]) were excluded. T2R testing results (n=31) showed 2 blaCTX-M-14/15 genes with 100% sensitivity; the remaining gram-negative resistance genes were not detected, so sensitivity could not accurately be determined. Specificity was 100% for the 16 gram-negative bacilli. Three enterococci and 2 Staphylococcus aureus showed 100% sensitivity/specificity. However, 10 coagulase-negative staphylococci showed 17% sensitivity/100% specificity. Antibiotic resistance genes identified were 2 blaCTX-M-14/15, 2 mecA/C, and 1 vanA/B. T2R testing results were obtained in an average of 7 hours.
Conclusion: T2R testing is highly specific (100%) for the 13 antibiotic resistance genes on the panel. Sensitivity was 100% for the genes detected but was low (17%) for coagulase-negative staphylococci. T2R testing has the potential to diagnose certain antibiotic resistance genes from bacterial bloodstream infections in hours vs the days required for a positive blood culture with AST. Additional studies that include larger numbers of samples with antimicrobial resistance genes are needed.
期刊介绍：
The Ochsner Journal is a quarterly publication designed to support Ochsner"s mission to improve the health of our community through a commitment to innovation in healthcare, medical research, and education. The Ochsner Journal provides an active dialogue on practice standards in today"s changing healthcare environment. Emphasis will be given to topics of great societal and medical significance.
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