Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Study Design
2.2. Microbiological Evaluation
2.3. Study Aims
2.4. Statistical Analysis
3. Results
3.1. Characteristics
3.2. Microbiological Concordance and Turn-Around Time
3.3. Antibiotic Therapy Prescriptions
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | T2B-Positive (n = 35) | T2B-Negative (n = 50) |
---|---|---|
Male sex, % | 48.48% | 70% |
Age, years | 65 (50–73) | 65 (51.5–70.5) |
Weight, kg | 65 (53.5–77) | 76 (68.75, 87) |
ICU admission, % | 100% | 100% |
Max PCT, mcg/L | 1.645 (1.285–43.2) | 5.98 (1.52–18.775) |
Max lactate, mmol/L | 3.05 (1.475–4.225) | 2.3 (1.55–4.6) |
Max temp, °C | 36.9 (36.5–38) | 37.75 (36.5–38.95) |
Max WBC, cells/mm3 | 11,750 (6100–22,575) | 11,600 (7600–18,600) |
Max HR, bpm | 109 (92.25–120.75) | 102 (86–120) |
Max RR, bpm | 20.5 (16.75–24.25) | 20.5 (16.5–26.5) |
Min SBP, mmHg | 95 (90–108.75) | 104 (90–115) |
Hospital LOS, days | 47 (26.25–65.5) | 26 (13–48) |
ICU LOS, days | 23.5 (8–57.75) | 13 (5–34) |
Vasopressor, % | 83.3% | 76% |
Mechanical ventilation, % | 90% | 88% |
Mortality, % | 70% | 68% |
SOFA score, median (IQR) | 12 (7–15) | 10 (6–14) |
Platelet count, cells/μL | ||
≥150,000 | 33% | 54% |
149,000–100,000 | 27% | 10% |
99,999–50,000 | 17% | 15% |
49,999–20,000 | 13% | 12% |
<20,000 | 10% | 10% |
PaO2/FiO2, % | ||
≥400 mmHg | 13% | 12% |
399–300 mmHg | 10% | 15% |
299–200 mmHg | 43% | 37% |
199–199 mmHg with respiratory support | 27% | 22% |
<100 mmHg with respiratory support | 7% | 15% |
Bilirubin, % | ||
<1.2 mg/dl | 60% | 61% |
1.2–1.9 mg/dl | 13% | 20% |
2.0–5.9 mg/dl | 17% | 15% |
6.0–11.9 mg/dl | 10% | 5% |
≥12.0 mg/dl | 0% | 0% |
Cardiovascular SOFA (MAP/Vasopressors) | ||
MAP ≥ 70 mmHg | 23% | 29% |
MAP < 70 mmHg | 0% | 5% |
Dopamine or dobutamine < 5 mcg/kg/min | 0% | 0% |
Dopamine 5.1–15 mcg/kg/min or NE/EPI ≤ 0.1 mcg/kg/min | 13% | 15% |
Dopamine > 15 mcg/kg/min or NE/EPI > 0.1 mcg/kg/min | 63% | 46% |
Glasgow Coma Score, % | ||
15 | 13% | 10% |
13–14 | 7% | 0% |
10–12 | 7% | 0% |
6–9 | 7% | 10% |
<6 | 67% | 80% |
Creatinine, % | ||
<1.2 mg/dl | 37% | 37% |
1.2–1.9 mg/dl | 23% | 27% |
2.0–3.4 mg/dl | 23% | 15% |
3.5–4.9 mg/dl | 13% | 17% |
≥5.0 mg/dl | 3% | 5% |
Sepsis source, % | ||
Undetermined | 60% | 56% |
Respiratory | 17% | 22% |
Urine | 3% | 5% |
Wound | 3% | 0% |
Abdominal | 17% | 17% |
Results | T2Bacteria | BC Simultaneous | BC within +/− 5 Days | OTHER Cultures within +/− 5 Days |
---|---|---|---|---|
NEGATIVE | 50 | 41 | ||
Positive—ESKAPEc | ||||
E. faecium | 9 | 3 | 1 | 6 |
S. aureus | 1 | 1 | 0 | 0 |
K. pneumoniae | 9 | 4 | 4 | 1 |
A. baumannii | 15 | 7 | 5 | 3 |
P. aeruginosa | 10 | 5 | 2 | 3 |
E. coli | 4 | 1 | 1 | 2 |
Positive—NOT ESKAPEc | ||||
Enterobacter aerogenes | N/A | 1 | ||
Enterobacter cloacae | N/A | 1 | ||
Staphylococcus capitis | N/A | 1 | ||
Staphylococcus epidermidis | N/A | 1 | ||
Staphylococcus haemolyticus | N/A | 1 | ||
Staphylococcus hominis | N/A | 3 | ||
Stenotrophomonas maltophilia | N/A | 1 | ||
Candida spp. | N/A | 6 |
Channel | Sensitivity | Specificity | Sensitivity | Specificity | Sensitivity | Specificity |
---|---|---|---|---|---|---|
Proven BSI † | Proven and Probable BSI † | Proven, Probable, and Possible BSI † | ||||
E. faecium | 67% | 91% | 75% | 93% | 91% | 100% |
S. aureus | 100% | 100% | 100% | 100% | 100% | 100% |
K. pneumoniae | 100% | 94% | 100% | 99% | 100% | 100% |
A. baumannii | 100% | 90% | 100% | 96% | 100% | 100% |
P. aeruginosa | 100% | 94% | 100% | 96% | 100% | 100% |
E. coli | 100% | 96% | 100% | 98% | 100% | 100% |
Overall | 95% | 94% | 97% | 97% | 98% | 100% |
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Bonura, C.; Graceffa, D.; Distefano, S.; De Grazia, S.; Guzman, O.; Bohn, B.; Ippolito, M.; Campanella, S.; Ancona, A.; Caputo, M.; et al. Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients. Antibiotics 2024, 13, 885. https://doi.org/10.3390/antibiotics13090885
Bonura C, Graceffa D, Distefano S, De Grazia S, Guzman O, Bohn B, Ippolito M, Campanella S, Ancona A, Caputo M, et al. Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients. Antibiotics. 2024; 13(9):885. https://doi.org/10.3390/antibiotics13090885
Chicago/Turabian StyleBonura, Celestino, Domenico Graceffa, Salvatore Distefano, Simona De Grazia, Oscar Guzman, Brian Bohn, Mariachiara Ippolito, Salvatore Campanella, Angelica Ancona, Marta Caputo, and et al. 2024. "Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients" Antibiotics 13, no. 9: 885. https://doi.org/10.3390/antibiotics13090885