Evaluation of T2Candida Panel for detection of Candida in peritoneal dialysates

Abstract

Fungal peritonitis in the peritoneal dialysis population is difficult to diagnose promptly due to the inherently slow cultivation-based methods currently required for identification of peritonitis pathogens. Because of the moderate risk for severe complications, the need for rapid diagnostics is considerable. One possible solution to this unmet need is the T2Candida Panel, a new technology designed to detect the most common pathogenic Candida spp. directly from whole blood specimens in as little as a few hours. We hypothesized that this technology could be applied to the detection of Candida in peritoneal dialysate, a matrix not currently approved by the Food and Drug Administration for testing by this system. Remnant dialysate samples from three healthy (noninfected) pediatric peritoneal dialysis patients were spiked with Candida glabrata, serially diluted, and tested in triplicate with unaltered dialysate specimens. The assay detected C. glabrata in 100% of spiked dialysate samples across the full spectrum of dilutions tested, and no assay inhibition or cross-reactivity was noted. These findings suggest one of possibly more applications of this technology. The positive clinical implications of this test will continue to be realized as its use is validated in peritoneal dialysate and other patient specimen types.

T2Candida for the Diagnosis and Management of Invasive Candida Infections

“…Spiked dialysates were loaded into 4mL tubes and run on the T2MR instrument according to the manufacturer's instructions for whole blood analysis. All assay results were valid, no interference identified, and there was 100% concordance between spiked specimens and the negative/positive samples [39]. Given that fungal PD fluid cultures typically take 24-48 h to turn positive, the rapid turnaround time of T2MR may represent an opportunity to initiate early targeted antifungals and discontinue unnecessary intraperitoneal antibiotics.…”

“…in non-blood clinical specimens. Kouri et al examined T2MR for detection of Candida in peritoneal dialysate (PD) fluid [39]. Culture negative fluid from three healthy pediatric peritoneal dialysis patients were spiked with C. glabrata in serial dilutions of 10-2, 10-4, and 10-6 along with negative controls [39].…”

“…Kouri et al examined T2MR for detection of Candida in peritoneal dialysate (PD) fluid [39]. Culture negative fluid from three healthy pediatric peritoneal dialysis patients were spiked with C. glabrata in serial dilutions of 10-2, 10-4, and 10-6 along with negative controls [39]. PD fluid compositions of 1.5% dextrose, 2.5% dextrose, and a combination of both were included to assess interference over a range of dextrose concentrations.…”