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Evaluation of a Rapid Fungal Detection Panel for Identification of Candidemia at an Academic Medical Center

2019/12/19 by John P Bomkamp, John P. Bomkamp, Rand Sulaiman +9 · 1 citation
Medicine · Biochemistry, Genetics and Molecular Biology · #Antifungal resistance and susceptibility #Bacterial Identification and Susceptibility Testing #Fungal Infections and Studies

paper · doi:10.1128/jcm.01408-19

Abstract

species isolated from culture or detected on the panel, source of infection, days of therapy (DOT) of antifungals in patients with discordant results, and overall antifungal DOT/1,000 patient days. A total of 433 paired T2Candida panel and myco/f lytic blood cultures were identified. The pretest likelihood of candidemia was 4.4%. The sensitivity and specificity were 64.7% and 95.6%, respectively. The positive and negative predictive values were 40.7% and 98.5%, respectively. There were 16 patients with T2Candida panel positive and myco/f lytic blood culture negative results, while 6 patients had T2Candida panel negative and myco/f blood culture positive results. The overall antifungal DOT/1,000 patient days was improved after implementation of the T2Candida panel; however, the use of micafungin continued to decline after the panel was removed. We found that the T2Candida panel is a highly specific diagnostic tool; however, the sensitivity and positive predictive value may be lower than previously reported when employed in clinical practice. Clinicians should use this panel as an adjunct to blood cultures when making a definitive diagnosis of candidemia.

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