Haematology

The researches find that accurately diagnosing bloodstream infections or sepsis caused by five common bacteria. The test is be use in a clinical setting in place of blood cultures; therefore which are insensitive and can take a long time to show results. How these findings are affect clinical practice is not yet determine. Findings from a diagnostic accuracy study are publish in Annals of Internal Medicine.

Affect clinical practice

Bloodstream infections (BSI); are infectious diseases define by the presence of viable bacterial ; or fungal microorganisms in the bloodstream (later demonstrated by the positivity of one or more blood cultures) ; that elicit or have elicit an inflammatory response characterize by the alteration of clinical; laboratory and hemodynamic parameters.

In this sense; the definitions of BSI and that of sepsis are 2 sides of the same phenomenon, since sepsis is an infectious syndrome trigger by an infectious disease; while BSI is a sepsis trigger by viable microorganisms circulating in the bloodstream. Of course; BSI can be precede; follow or be concomitant to a localize infectious disease, like endocarditis, pneumonia, UTI, meningitis and others.

Triggered by viable microorganisms

The interest in focalizing on BSI, instead of infection in general, is in the diagnostic certainty inherent a positive blood culture; although contamination is possible. In 2018, the T2Bacteria Panel was cleared by the FDA to identify sepsis-causing bacteria directly from whole blood without the wait for blood culture; which currently takes 1 to 5 or more days and is the current standard of care for diagnosing bloodstream infections.

The T2Bacteria Panel can deliver results in 3 to 5 hours for the most common ESKAPE bacteria; or Enterococcus faecium; Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli. Researchers from the University of Pittsburgh School of Medicine studied 1,427 patients at 11 U.S. hospitals for whom blood cultures were ordered to assess performance of the T2Bacteria Panel in diagnosing suspected bloodstream infections.

Common ESKAPE bacteria

The researchers compared blood culture results to those obtained using the T2Bacteria Panel. The T2Bacteria Panel accurately identified or excluded bloodstream infections caused by five common ESKAPE pathogens in about 4 to 8 hours versus about 24 to 72 hours and 5 days, respectively, for blood cultures.

According to the researchers, these findings suggest that using the T2Bacteria Panel could shorten the time to appropriate antibiotic treatment in patients, which has the potential to improve clinical outcomes. The authors of an accompanying editorial from Atrium Health Carolinas Medical Center caution that the clinical benefit of the T2Bacteria Panel is still uncertain.

Outcomes studies are needed to determine if use of the T2Bacteria Panel can lead to better outcomes, such as significantly shorter time to appropriate therapy. Other factors, such potential overuse of antibiotics, cost, and laboratory time must also be considered.